Category Archives: School, Health & Professional Records

Expat Essentials: Safeguarding your longterm health, finances and family. Defining Moves - The Art of Successful Relocation. Information, Inspiration and Resources for the Expat Trailing Spouse / Accompanying Partner

Not Just For Expats: 3 Ways to Safeguard Your Life, Health and Family at home and abroad.

Not Just for Expats - 3 steps to safeguard your longterm health, family and finances. Defining Moves The art of successful relocation
My version of long term care

This post was sparked by an episode Mad Men –  a series about adverting executives in  New York in the 50’s and 60’s.  This particular one covered the characters’ responses to the Cuban missile crisis.

Kennedy was had just given his famous television broadcast, highlighting the potential threat to the US from the Soviets, plunging the characters into a frenzy of uncharacteristic behaviors.

In justifying their sudden need to fulfill life dreams and expectations, one of the characters made the comment:

” We might not be here tomorrow”,

to which the reply came;

“Isn’t that always true?”.

We all applaud the idea of living each day as if it were your last, but are incredibly naive about what that actually means. Most of us imagine finally parachuting, walking the Inca Trail or any other number of ambitious, death defying activities listed on our bucket list. It bears little relation to the reality of life and death.

The concept of seizing the day is reliant on good health, or at least mental consciousness, the absence of pain, and a considerable amount of forward planning. If I ask how many of you have checked your medical records, understand your health insurance rights and coverage, or have an advocate who knows your wishes in the event you are unable to make decisions, 97% of the room start twitching nervously and suddenly find their notes fascinating. Sound familiar?

For those of you who are now in a state of panic, let me reassure you. You don’t need to start visiting psychics, ordering crystal balls or trying to predict every eventuality – in fact, the simpler you keep it, the better.

To get you started, here are the three essentials to consider:

 

Health Insurance for Locals and Expats Living Overseas.

For those of you who don’t live in a country with a National Health Service (and for many of you who do), for any travel abroad or residence overseas, health insurance is essential. While many services and regular care can be contracted more cheaply without going through an insurance service provider, for the expense  of chronic, emergency and long term health coverage, you need a safety net.

Sadly, most insurers are for-profit businesses, which means that they are careful (and in some cases, downright difficult) about handing out money, and have many ways of avoiding or limiting it. Not being completely honest about your age, activities, destination and current or previous health is the fastest way to get your claim rejected and end up with a huge bill.

Pre-existing conditions, so-called ‘extreme sports’ and high risk behaviors (i.e. drug taking, using prostitutes) are common exclusions and many policies only cover your host country. They often specify services and providers that you can use, required co-pays and ineligible treatment and procedures. This means that either you personally, or your family, will be liable for any healthcare costs not met by the insurers, and these can stack up really, really quickly.

The basics to consider include:

  • What exclusions apply to your policy, and are they relevant to your situation?
  • What are the insured maximums, and what does that really mean in terms of local care?
  • Are you covered for transport home?
  • In the event of your death, will your remains be repatriated or is that the responsibility of your next of kin?
  • If you have company insurance, how are your benefits affected if you are no longer able to work or have to terminate your assignment early?
  • What happens if care is not available in your host country? Will you be sent home, or to another country, and if so, can family members accompany you?
  • If you are taken ill when overseas, are you covered for a family member to join you? Who will look after the children? Who will be your advocate? How do I make my wishes known in a way that is legally binding?

 

In the event of serious or long term illness, where do you want to be?

Common wisdom dictates that we like to be surrounded by our nearest and dearest, but for some, that qualifies as the one of Dante’s Rings of Hell.

As Greta Garbo is famously uttered “I want to be left alone”.

Most of the time the answer is “wherever I can get the best care”, but the reality is harsher and involves finance, family, support and legal residence issues.

For working expats, the decision is often taken out of their hands – once you are no longer able to work, your visa is invalid, and you are repatriated. For those permanent overseas residents the choices are wider, and many choose to stay where care is cheaper and there is less pressure on family members to be full time caregivers.

Returning ‘home’ is often not as easy as it seems, and may require significant adjustment –  repatriation is difficult under the best of circumstances, so expect a period of transition for the whole family, especially if you have been expats for a long period. Consider both mental and physical health needs for all the family – there are many excellent counselors that can deal with adaptation and coping issues, both for you, your partner and your children. x

Before you take the decision to move back, you will also need to check that you are entitled to healthcare benefits – either though the national health service or via your insurance – before you move; many insurance companies will not cover people with certain pre-existing conditions or will demand high premiums, and your expat insurance may only include your host country. Consider also what is included, whether it is just urgent care, inpatient care or ongoing long term care – and also, the standard of care and and waiting lists.

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Do you have an Advanced Directive of Health Care?

More commonly known as a Living Will, this document defines who will make decisions for your care in the event that you are unable to do, and sets guidelines for your care. We tend to assume that here only apply if we have a serious debilitating illness, however having a stated person to advocate for you is invaluable for acute and emergency medical conditions too – whether you are simply under anesthetic, unconscious, in severe pain or have temporary amnesia.

Your advocate doesn’t have to be your life partner – I have chosen my sister for four reasons: firstly, we have similar decision making processes; I would rather that my partner was free to concentrate on his own needs and those of the children; she has a great relationship with my partner and I trust her to make the best decisions for both him and I without being burdened with guilt and expectations, and finally she has a great sense of humor, and if anyone can find the laughter in any situation, it’s her.

Many doctor’s offices have ADHC template forms that you can complete, but it’s worth getting legal advice – many terms vary between states and countries. Use simple language to eliminate the chance of misunderstandings, be specific about your intentions, state what treatments you are and are not willing to receive (especially in countries with different health standards and practices), nominate a healthcare proxy (someone who you trust to make decisions for you) and ensure that they understand, agree and that their contact details are accurate and finally, get it witnessed, preferably by someone with legal standing.

 

Expat Essentials: Safeguarding your longterm health, finances and family. Defining Moves - The Art of Successful Relocation. Information, Inspiration and Resources for the Expat Trailing Spouse / Accompanying Partner
How my children see it..

Ill health happens, and never when we expect it. When it does happen, it’s a knee jerk, all hand-on-deck approach, dominated by the need to get care quickly, the demands of the medical staff and the fear of the unknown. It is always inconvenient, unexpected and bewildering, and as a former nurse I can tell you that the last thing your partner or loved ones want to be doing is second guessing your choices. They need to know what you would want, and they need it in writing. It needs to be discussed, agreed upon, written down and easy to find. You can change your mind at any point, but we all need somewhere to start. 

And as a final piece of advice, bear in mind the words of wisdom from Phyllis Diller:

“Always be nice to your children – they are the ones who will choose your rest home.”

 

Choosing schools - the Defining Moves Expat Guide to Relocation

Choosing Schools

Choosing schools - the Defining Moves Expat Guide to RelocationOh boy. If you thought sending your child off to school for the first time was the hardest day of your parenting life, think again. Try taking them out of the first school, transporting them across town /state/country/continent (delete as applicable) and then asking them to go to a new one, where they know “NOBODY – ALL MY FRIENDS ARE BACK HOOOOME..”.

In reality, starting a new school is not the end of the world that our children would have us believe, but until they are settled, it is incredibly stressful for all concerned.

The bottom line is that you and your child are looking for completely different things in a school;  for you, you need to be sure that the school provides a safe and nurturing environment and is academically stimulating, while your child wants friends, interesting teachers, fun play equipment and good snacks. Not necessarily in that order.

Ask yourself what is most important to you long term.  For “Third Culture Kids”, they are unlikely to achieve long term academic success without first addressing their emotional well-being, so my advice is to look for a school that meets those needs first, and worry about the academics later. The same applies to a local move however – no matter what the reason for the move, until a child is comfortable and secure in their environment, they are unlikely to learn anything effectively.

My mother, a child development specialist, always maintained that children only developed in one area at a time, so when they were going through a physical growth spurt, their emotional development would slow down for a time, and if they were in a socially challenging situation, their academic performance would dip.  Education is a journey, not a race, and so my preference is to go with a school that meets their social and emotional needs, rather than necessarily having the best academic record. However, there are plenty of people who would disagree with me, so whatever your parenting preferences, here are my top strategies for choosing schools.

 

Make a list of available schools.

Ask your HR department, future work colleagues, destination service provider, relocation counselor, realtor or your Embassy. Go online, do a Google search, and explore expat websites like School Choice International if you are still struggling.

 

Contact schools in advance,

requesting a prospectus or information. Private schools will usually have a printed prospectus available, public schools may have a website.

 

Information to look for includes:

 

  • Numbers of children at the school, and demographic profile
  • Numbers of children moving in and out of the school
  • Academic curriculum followed – most commonly US, UK or International Baccalaureate
  • Age range at school, and which schools children commonly progress to
  • Class size / student:teacher ratio
  • Range of classes offered
  • Qualifications of teaching staff
  • Test results
  • Overall philosophy and values of the school
  • Antisocial behavior policy.
  • Fee schedule
  • Transportation – public / school bus / car pools / sidewalks
  • Accessibility – traffic, bell schedules, after school care

Bear in mind that school test scores can be affected by high numbers of ESL / EFL (English as a Second /Foreign Language) students, by having a higher number of students with differentiated learning needs, or by rigorous entry requirements. It is most important to find a school that reflects your values, whether they be academic rigor, cultural diversity, sporting excellence, alternative teaching methods or all the above, rather than looking simply for high test scores or a foreign language program. However, if you know you will be moving often but would like your child to attend college in a specific country, it’s a good idea to follow a single type of curriculum that is widely accepted once they reach high school years. While colleges are becoming more flexible about the range of entry qualifications they accept, there is no point in making it more difficult for your child than it needs to be.

 

Consider curriculum options.

Depending on if, when and where your child/ren will be attending college, choose a curriculum that will support those future choices, while meeting their wider learning needs. Consider also the long term implications: should your assignment be extended, become permanent or your allowances change, will you be able to afford the fees privately, and will you be paying international student rates.

 

Visit shortlisted schools.

If possible, take the child attending the school with you, so that they can experience it, and  you can see how school staff interact with your children. Visit during school hours to observe classes, watch how the children and teachers behave, and get an understanding of the school culture as a whole. Encourage questions from your children, and take time to visit the parts of the school that they want to see. Especially the bathrooms – you can learn a great deal about a school from their bathrooms..

 

Request a copy of the school transcript

Once you have selected a school, arrange for your child’s school transcript to be sent to them in advance and keep a copy for your own records. Request copies of the new school calendar, the name and email of your child’s teacher, and any immunization, uniform or school supply requirements, and the contact details for any parent organizations, both in the school and the community.

 

Write a brief note to your child’s teacher,

introducing yourself, your child and anything you feel would it would help them to know, and invite questions from them.

 

Ask if there are any supplies / resources / donations etc. that you can bring

as part of your household shipment that are not on the official list. Teachers have home lives too, and are a wonderful source of information, recommendations and support in the early days, so any efforts you make now will be amply repaid when you land…