Relocating abroad is an increasingly popular choice for many Europeans, especially those who live in cooler climates, such as Germany, Scandinavia and the UK. The attractions are numerous: better weather, cheaper cost of living, improved quality of life and sometimes being closer to family members or friends. Such a move can be highly successful, but it is important to plan well in advance because there are pitfalls to be aware of. This is particularly true for anyone living with a chronic health condition like Parkinson’s. It will be vital to ensure that the health and social care services offered by your prospective new country meet your needs – both now and in the future.
Relocating abroad is a complicated life choice with many variables. There are some key points that people with Parkinson’s and their families should consider when thinking about such a move. Some of these may seem obvious, but are worth keeping in mind because difficulties can lie ahead without the right preparation.
350,000 people leave the UK every year to start a new life over-seas, according to the Institute for Public Policy Research.
You will want to gather as much information as you can about the country you are considering moving to. You may want to try contacting:
The embassy of the country you wish to relocate to
Government departments for foreign affairs, health, pensions and social security
Parkinson’s organisations - particularly those based in your prospective new country. They should be able to advise you on national and local health services, Parkinson’s-specific treatment available in their country and recommend other sources of help to you
Disability organisations that may provide advice on relocating abroad – for instance, in the UK, Age Concern (www.ageconcern.org.uk ), a charity concerned with ageing issues, provides a factsheet on retiring abroad and has an office in Spain where many British citizens live
Expatriate organisations and websites - the local consul in your prospective new country should be able to provide you with a list of expatriate associations and clubs.
If you are moving to a European Economic Area (EEA) country – ie the EU countries, plus Iceland, Liechtenstein and Norway – you must apply for a resident permit within three months of arrival.
When moving to a country where your mother tongue is not spoken widely, understanding the language or having someone close to you with a good knowledge of it will be important for communicating effectively. Finding someone who can translate for you could be difficult, especially in an emergency. So it is wise, if you are unfamiliar with the language, to learn a few useful words and phrases before you actually move there. This can provide you with a good basis from which to learn the language over time.
Culturally, some countries may seem very similar to your own in respect of day-to-day living, but can be very different in reality. Cultural sensibilities can impact on all aspects of daily life, including health and disability, and it is important to spend some time familiarising yourself with the customs and traditions of your prospective new country.
The EPDA produce a credit card-sized flexicard that contains the name, address and telephone number of the carrier’s emergency contact, should a situation arise where a person with Parkinon’s were unable to communicate with other people because of his/her symptoms. These cards are translated into five languages and are available free of charge from the EPDA website – www.epda.eu.com/flexicard
It will be very important to address the following questions before you go:
How is healthcare funded and what is covered?
You could be required to pay for some services or need to take out insurance. Reciprocal health cover exists between some countries and you may wish to compare services in detail to see whether these include the treatments you need
Will your medications be readily available?
Are they free or will you have to pay for them, and, if so, how much will they cost?
How are the health and social care systems organised – generally and in relation to Parkinson’s-specific care?
The type of services you are used to in your own country may not be available or may operate differently. For instance, in some countries, family or friends maybe expected to provide some hospital care, such as washing bed linen and providing meals. You may not be used to arranging these aspects of care for yourself
What services are available specifically for people with Parkinson’s and their families?
Services will vary from country to country and, of course, your needs and your family’s need for services might change as your Parkinson’s progresses or you get older
How far will you have to travel for specialist services?
Transport may be complex and costly. Travelling long distances may become difficult as your condition develops or as you get older.
In South Africa you’ll be required to pay a maximum of 43 euros per day for any state healthcare that you receive. In Bulgaria, if you make contributions to social security, you can receive free emergency care. And in Greece, medical care is subsidised if you’ve made regular social security payments.
You will probably need to review your financial situation before you decide to relocate abroad. It would be wise to see if there are any contingency measures you can put in place to ensure your finances remain sound should your circumstances change:
Check that your pension rights are transferable and you are entitled to future increases in your new country- this can be complicated!
Find out if you will still be eligible to receive social care benefits when you move.For example, some services in your new country may only be free of charge when you have reached retirement age
When buying property you may need to take additional costs into consideration- such as adaptations for accessibility.
According to www.goodhealthworldwide.com, if you take out healthcare cover, insuring for US$1.6million will provide sufficient cover for all contingencies. Many schemes fall well below that.
Always check that your insurance includes specific cover for Parkinson’s disease and any other conditions you have or may develop.
If you want to drive and run a car in your new country it will be important to find out whether there are any specific rules that apply to people with Parkinson’s. Being able to rely on public transport or taxis maybe important to you and checking how good services actually are could be worthwhile.
Once you have gained resident status in an EEA country, you can exchange your driving license for an EEA national license. For non-EEA countries, you will need to get an International Driving Permit (IDP) before you arrive.
After making the move and relocating abroad, some people may find that they want to return to their home country – permanently or temporarily. This may not be straightforward, so you might want to find out well in advance about any rules and regulations that would affect you. If domiciled abroad, you may have to pay for health services that residents receive free of charge.
There may be tax, pension and social care implications if you decide to return to live in your country of origin permanently – for example, you may not have an automatic entitlement to certain financial benefits if you have lived abroad for several years.
If you are considering returning temporarily to your home country for medical reasons, make sure that this is the best option. You may be able to get the type of treatment you need more readily and cheaply in your new country.
More than 40% of emigrants return ‘home’, says the UK’s Expat Coach.
A person living or working outside of the country for which they hold a passport.
An official appointed by the government of one state and residing in the territory of another, whose role is to assist and protect the citizens of the consul's own country, and to facilitate trade and relations in a foreign city.
