My mother is 89 in Lusaka. Bring her here, or pay for care there?

The question

An illustrative letter.

The answer

My dear, I was born in Zambia, and I know the pull you feel. Lusaka is not just a city on a map. It is the jacaranda trees in October, the church your mother has walked to for decades, the neighbors who know her name. And I know the guilt that wakes children of aging parents at three in the morning, when an ocean lies between them and the person who once held them.

Let me say first that there is no wrong answer here born of love. Both paths can be good ones, and each asks something different of you. My part is to set them side by side as plainly as I can. The choosing is yours.

What would bringing her here involve?

There is real comfort in this path. She would be near her daughters and her grandchildren, and you would see her care with your own eyes rather than through a phone screen. If you are a U.S. citizen aged 21 or older, you can petition for your mother as an immediate relative, which avoids the long waits other family categories face. But the paperwork is only the beginning.

• A promise of support. You would sign an affidavit of support, accepting legal responsibility for supporting her, generally until she becomes a citizen or is credited with 40 quarters of work. If she received certain public benefits, the agency could ask you to repay them.
• Health coverage. A new green card holder generally must live in the United States for five continuous years before she can buy into Medicare. Even then, without her own U.S. work record, Part A would cost $565 a month in 2026, plus $202.90 for Part B. Most new green card holders also wait five years for Medicaid. Marketplace coverage may be possible in the meantime, but at 89 the medical costs alone can be enormous.
• Daily care. Someone would still need to look after her here, and paid care in the United States is among the most expensive in the world. If it falls to you, your own retirement plans change.
• The move itself. A long journey at 89, and a new climate, new food and a new church at the end of it. Some parents settle happily near family. Others grieve quietly for the home they left.

What would care at home in Lusaka involve?

This path has its own comfort. A trusted caregiver in her own home usually costs far less than care in America, and it lets her keep her routine, her church and her friends. The challenge is not the cost. It is oversight from far away.

• Someone you trust on the ground. A relative, a church elder or a family friend who visits regularly and reports honestly.
• A clear agreement with the caregiver. Duties, hours, pay, days off and what happens in an emergency, written down.
• A doctor who knows her. Regular check-ups, and a plan for which hospital she goes to if something happens.
• Regular contact. Scheduled video calls, and visits from you and your sisters, taking turns, to see with your own eyes.

How do I send money for her care?

Steadily, and in a way you can track. Since January 2026, a 1 percent federal tax applies to money sent abroad when you pay the transfer company in cash, by money order or by cashier's check. Transfers paid from a U.S. bank account or with a U.S. debit or credit card are not taxed. A regular monthly transfer from your bank, with receipts kept, makes the cost predictable for you and the support predictable for her.

How do my sisters and I share this?

Hold a family conversation with real numbers, and ask the same questions of both paths. If she came here, who would look after her each day, and who would pay for her health coverage in those first five years? If she stays, who would watch over her care, who would visit, and how often? Who can give money, who can give time, and who can travel? Write down what you agree, so no one carries resentment quietly.

How do I protect my own retirement?

You retire next year, and your own security matters too. Whichever path you choose, set a monthly amount for your mother's care that your retirement budget can sustain for years, not months, because she may live a long time, and I hope she does. Keep your own emergency fund separate. A daughter who runs out of money at 70 can no longer help anyone.

How do I choose between the two?

Put the two paths on one page, side by side, and weigh them honestly:

• Her health. Whether she can make the journey, and what care she needs each day.
• Her life there. How much of her happiness lives in her home, her church and her friends.
• Your life here. What you can give in money, time and travel once you retire, year after year.
• The full cost of each path, priced for years rather than months.

No one else can weigh these for you, not your sisters, and not me. You know your mother, and you know what you can carry.

What about the guilt?

Guilt will find you whichever way you choose. If she stays, it says you are not there every day. If she comes, it says you took her from her home. But care is not only presence, and it is not only distance. It is a caregiver who is paid on time, a doctor who is consulted, a daughter who calls every Sunday or sits beside her in the evening, and sisters who share the load. That is love, on whichever side of the ocean it lives.

Weigh both paths, my dear, with your sisters at your side, and then make your choice with a quiet heart. Whatever you decide, she will know she was not forgotten.

One thing to do this week

Write both paths side by side on one page, with what each would cost every month in money, time and travel.