I know I need a plan for my future care. I want it to be good and lead to peace and comfort in my twilight years. Over my 21 years of living with quadriplegia, I have independently cared for my personal needs with minor help from my husband. I know this will not last forever. We are both aging, and I continue to lose vision due to an inherited retina disease. I will need more help in the future. And I will have to pay for it myself.

In thinking about my options, one tantalizing idea from the July 2021 issue of New Mobility stood out. The article, “Expats: Building an Accessible Life Abroad,” featured three wheelchair users who had left the U.S. and Canada to live abroad in Japan, Cambodia and Panama. They shared windows into their lives and how they handled their care needs and costs. I was riveted. I lived in South America way back when. Why not go abroad again?

Of the countries mentioned in the article, I focused on Panama. I love warm tropical breezes, sandy beaches, palm trees and vibrant parrots. I like the friendly, family-oriented Latin culture. My Spanish is decent. And Panama is closer than Cambodia and Japan. I wondered, should my future home be in Panama?

My Research

I kicked into research mode, looking for the answers anyone considering moving abroad would want — and those most important to a wheelchair user. I was happy to find out Panama has more sidewalks and ramps than most Central American nations. It is one of the wealthiest Central American countries because of the famous canal. It has some of the best water treatment in Latin America due to significant infrastructure put in place by the U.S. military during its 95 years of Canal Zone control. As a result, it is perfectly safe to drink the tap water there. The electricity in homes is the same voltage and amperage as in the U.S., and Panama uses the U.S. dollar for currency. These are all very handy attributes. What’s more, medical facilities are good. There is a Johns Hopkins Hospital affiliate in the capital, Panama City. And the Panamanian government makes it reasonably simple for U.S. citizens to become legal residents and own land. All of this makes Panama an attractive option for an aging quad, but I needed to know more.

My Visit

My husband and I flew into Panama City’s Tocumen International Airport, planning to take a taxi to a few selected towns after checking out the capital. I whittled down which towns to visit based on my own needs and criteria. I wasn’t looking for fancy, just accessible. Like much of the U.S., the newer neighborhoods tend to be more accessible but also more costly. As a wheelchair user, naturally I focused on areas with sidewalks that I could independently navigate. I cannot drive a car because of my vision, so sidewalks and the availability of taxis are critical. I ultimately decided to explore a few neighborhoods within the capital, including Costa del Este and Casco Viejo, then visit the expat town of Playa Coronado, the mountain town of El Valle de Anton, and Penonome, the home of Tony Boatright, the expat from the July 2021 NM article.

Panama City

Modern and impressive, Panama City boasts numerous high-rises that merge to produce a remarkable skyline. Expansive, world-class malls, like Albrook and Multiplaza Panama, and scores of quality restaurants and shops make this a very convenient, comfortable city.

Big cities anywhere are pricier than their nearby small towns. This is true of Panama, but food and taxis in Panama City still cost less than in the U.S. I got a breakfast sandwich, fruit and cafe con leche at a nice sidewalk cafe for $6; a chicken Caesar salad or a sandwich with side cost $8-$10 each. Groceries I bought were 20%–30% less than at home. I loved the excellent mountain-grown Panamanian coffee for $5–$8 per pound. On Amazon, the same thing is $24.

Since buses are not wheelchair accessible in Panama, I relied on taxis. Taxi service was $4–$7 per ride around the city. And the 48-mile trip from the capital to Playa Coronado was $75 — much less than an Uber at home.

Absurdly, in my 21 years of wheelchair use, I never realized how essential sidewalks are to my independence. Where I live, they are simply there. In Panama, although there are laws encouraging construction of sidewalks, it became a treasure hunt. I successfully found pockets of accessibility in Panama City primarily based on existence and quality of sidewalks. Most public malls, grocery stores and museums are accessible from the parking lot. Some great tourist sites, like Miraflores Locks and Canal Visitor Center, Panama Viejo, and the Amador Causeway are wheelchair-friendly. To live here, though, I would need housing with at least a few blocks of adjacent, usable sidewalks.

My visit to Costa del Este revealed a very wheelchair-accessible neighborhood. I wheeled along wide, well-maintained sidewalks in the 90-degree heat, among magnificent palms. Never far from the ocean, I heard seagulls calling on the gentle breeze. Most buildings are high-rise apartments, which means elevators. I successfully found apartment buildings with multiple elevators and backup generators in case of power outages, making the high-rise scenario plausible.

Closer to the center of the city, Avenida Balboa also has potential for accessible living, with a scenic sidewalk running continuously along the avenue, all the way down to the fish market by the sea. Unfortunately, the neighborhoods were expensive.

Finding a small apartment affordable for a manual chair user might be doable, but I was looking for a place with enough space for my power chair, eventual live-in help and visitors. I used encuentra24.com to compare rental costs for furnished three-bedroom accommodations across Panama. With desirable locations, low crime and newer buildings, listings in Costa del Este and Avenida Balboa started around $3,000 per month. I found a number of areas with similar rentals running around $600 per month, but in less-desirable neighborhoods with less, if any, access.

I was disappointed when I took a taxi to see the historic neighborhood of Casco Viejo. The architecture is beautiful. San Jose Church, which houses the historic gold altar that privateer Capt. Henry Morgan tried to steal, is magnificent. But the sidewalks are too narrow to accommodate a wheelchair.

Outside the Capital

The drive to Playa Coronado, 54 miles southwest of Panama City, gave me an opportunity to practice Spanish with Oscar, my driver. Oscar dropped me off at Hotel Coronado Inn. The hotel has an accessible lobby, a room with toilet grab bars, and an awesome open cafe, but the town of Coronado is not for wheelchair users. There are no sidewalks anywhere and the streets are in poor condition. I viewed everything from the window of a cab. The gorgeous beaches are inaccessible, unless one has a beach wheelchair. I would get one if I lived here. Wheelchair users are at least on the radar, though, as both the local grocery and shopping center have ramps. I spent one night in Playa Coronado, feasting on excellent panfried red snapper fillet with veggies and rice for only $6, then took off to see Boatright in Penonome.

I met Boatright at the local hospital. It was a convenient rendezvous spot and provided an opportunity to check out the small, clean medical facility. In terms of size and quality, it reminded me of a community hospital in the U.S. If I lived in Panama, I would opt for the Johns Hopkins affiliate in Panama City for major surgery.

We stayed with Boatright for two nights in his secluded, rambling home. I knew that Penonome would not work for me because of the absence of sidewalks and my inability to drive. So, instead of exploring the town, we relaxed and chatted on his fantastic deck overlooking Rio Zarati — why leave such a great place with an awesome view? Boatright gets around by driving to destinations with entry ramps. He is elated with his relaxed, tropical life, his open-air-style home and his warm, adopted Panamanian family.

We wrapped up our trip visiting the beautiful mountain town of El Valle de Anton. Higher in elevation, nestled in a valley surrounded by verdant mountains, this small town is cooler, often in the 70s. A good sidewalk/paved bike path runs the length of the town. Many but not all of the stores and restaurants are wheelchair accessible. I loved this place, even when I got caught in a tropical downpour and was soaked to the bone in seconds by warm rain. I escaped into an inviting cafe for a hot cup of excellent mountain-grown coffee. El Valle would be a great choice for me, except that there are essentially no long-term rentals listed — only Vrbo, Airbnb, and homes for sale at $375,000 and up.

In a Nutshell

Of the Panamanian towns and neighborhoods I visited, I really like Costa del Este and Avenida Balboa in Panama City, and El Valle de Anton. The capital would be easiest for finding helpers since that’s where most people live. A brief search for domestic helpers showed workers available for $35 per day. It is common to have live-in help in Panama — it’s part of the culture. Ease in finding affordable help is a huge plus in my book. Transportation, medical care, and access to goods and services are easiest in Panama City. But the quiet mountain town of El Valle de Anton calls to me. So, it remains on my list.

So far, Panama has potential and meets part of my needs — I would just have to find the right neighborhood. Wherever I live, I want a home where I can roll out my door to a useful or interesting place. My next step is investigating more neighborhoods in Panama City, especially former U.S. military bases that have reverted to Panamanian control.

Whether I end up moving abroad or staying in the States, going through this process has helped me better understand what I am looking for and how to find it.