‘A Good Death’ In Costa Rica! Positive notes on Costa Rica’s healthcare system

The new garden is taking shape; all very exciting but I’m putting that on hold to share some reflections on the sad death of our friend and neighbour, Susanna Spencer.

We have asked ourselves ‘how will we cope if we develop serious illness’, and ‘would we want to die here’? – questions which I’m sure other pensionados also debate, so I hope my reflections may be helpful to some readers. Some shots of our wondrous mountains convey the mood.

In April last year, Susanna was diagnosed with extensive secondary cancer. Courageously, she decided against more chemo and radiotherapy, and instead to tackle her symptoms with natural approaches. Having planned a European trip and a visit ‘home’ to her sons and their families in Canada, off she went undaunted – intent on enjoying quality time while she could.

In Canada, she sought expert advice and returned with a stock of pain control medication. However, by December she was failing rapidly and we feared her death was imminent. It certainly was, until a very skilled oncology and pain control specialist from our local hospital took on her care.

He prescribed steroids to reduce the inflammation and impact of her tumours and, thereafter, did wonders in balancing her medications. Few drugs are without side effects and cancer patients can end up with a proverbial cocktail to control symptoms like nausea, dizziness and constipation.

According to WHO experts, 50% of cancer patients around the world still do not have their symptoms and pain well controlled. Susanna did, and the fact that this high standard of service was available here in San Isidro, enabled her to enjoy many more months than she expected.

Certain CAJA (the Costa Rican health system) services are provided by independent contractors, including orthopaedica shops in town. As Susanna became disabled, I went off in search of ‘aids for daily living’ (ADL) – equipment that helps people maintain their independence.

As an occupational therapist, I knew what I was looking for, but I wasn’t very successful. Orthopaedicas stock very little on the ADL front, so I turned to industry friends in the UK and had some aids sent over. Simple things such as cutlery and dishes designed for one-handed eating, helped her maintain the pleasure of mealtimes.

Partner Frank bought a lightweight office chair which enabled her to ‘glide’ from A to B – another compromise, but it worked. Now as I pass these shops in town, my professional head goes into ‘business opportunity’ gear… retaining the dignity of independence is a basic human desire and though provision might be better in San Jose, there’s a definite gap in the ‘independence’ market out here in the sticks.

Lastly, a practical reality – there is no crematorium here and they’re rare in rural areas. That option would have cost a small fortune (well in excess of US$2,000) for transportation to San Jose, an obligatory autopsy, undertaker and crematorium costs.

So Susanna chose to be laid to rest in the cemetery up the road, within sight of her home. Expat and Tico friends paid very touching tributes at the interment, but here’s a truly remarkable note – the Tico men who dug her grave did not expect to be paid (though they were) – this is a service they give to the community. Once again, these truly good people humble us.

Susanna died peacefully in her own home as she wished, surrounded by her glorious plants, and in the presence of those who loved her. Medical care as good as she would have received in any ‘developed’ country made that possible, and for that we are all so very grateful. The experience has been very sad, but we’ve gained knowledge and some reassurances on the way.

I close with thanks to Frank for his permission to share these thoughts, and with a rainbow above their land, in memory of our dear friend who now rests in peace.

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Written by VIP Member Sheelagh Richards. Sheelagh is originally from Scotland and her husband John who is from Wales are two inveterate British travellers who fell in love with Costa Rica, the beauty of the Talamanca mountain range and the perfect climate of the Rio General valley where they have established a small Bed & Breakfast called Casa de Los Celtas. You can see a free online video interview with John & Sheelagh Richards here.

You can see more about John and Sheelagh’s very affordable B&B outside San Isidro here and photographs and prices here.

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Andrew Makarik

to@welovecostarica.com

Andrew Makarik is the main editor of WeLoveCostaRica, a fan of this sunny country. He is also a loving husband and a has a lovely daughter. By being a devoted family man and the biggest Costa Rica fan, he wants to make more people feel at home there. WeLoveCostaRica unites people and helps them find new home or a new travel destination. This website is a friendly community where everyone can find not only information, but also new friends and travel pals. Andrew is also passionate about IT and programming, so he himself maintains a friendly atmosphere in this cozy environment of WeLoveCostaRica.com.