Whether Traveling or Living in México
End-of-life planning is never a pleasant subject. It has been very difficult for me to write this article but is an important topic to address, especially for those of us who are expats.
Part 2 of this End of Life Planning series relates to procedures for your loved ones if you die in México, whether while traveling or living here. Some of this is specific to Puerto Vallarta, but most can be applied to other cities, as well. I recommend reading End of Life Planning in Mexico Part 1, as well.
My goal here is to summarize Pamela Thompson’s talk about this difficult subject to help others handle death in México properly. I plan to print this and place it in our safe so my spouse and/or children can find it when I die here and have a blueprint for what to do. It eases my mind to know these instructions will smooth the process for my family. I hope you find the following information helpful, too.
Sanmaré Clinic’s Entrance
Pamela Thompson, the Patient Service Coordinator at Sanmaré Clinic and with an office at Hospital Joya Marina in Puerto Vallarta (which are ssociated) organizes these End of Life talks for ex-pats and viistors to understand the legal process of handling death in Mexico. It’s significantly different than that in the U.S. and Canada. As Pam told us, many American documents regarding after-death processes are not recognized in México.
The Check-In Process Outside
The Check-In Process Outside Sanmaré Clinic
Jon and I have found Sanmaré Clinic and Hospital Joya in Puerto Vallarta and Hospital Joya Nuevo Vallarta to be very professional health institutions with extensive services. I’ll refer to these facilities in this article as "the hospital". These are the places that Pam Thompson works and speaks about from her vast experience.
We’ve had multiple procedures, lab tests, physical therapy sessions, and surgeries at these facilities and have been happy with all of them. One important point Pam made, which I agree with whole-heartedly, is that if you are admitted to a private Mexican clinic or hospital, your chances of recovery are greater than in a public sector facility, mostly because private hospitals have more medications and equipment.
1. What if I Die in the Hospital?
If you are admitted to Hospital Joya with a terminal illness, the doctor will speak with the family over the phone. If death is foreseen, the hospital staff prepares the paperwork for the Mexican Death Certificate (See Part 1 for information needed by the Mexican government).
“Do Not Resuscitate” orders and Living Wills that include medical instructions are not legal documents in México. They don't have them here and they don't recognize them from other countries. If the patient is terminal and there is no longer hope of survival, the doctors and family can agree on the steps to take.
The hospital has a CPR protocol that they are required to follow. When death is imminent, if the family chooses, the physician can discontinue all treatments, only continuing pain medication and liquids as needed. Euthanasia is not permitted, but the physician may lower the level of care when appropriate to discontinue keeping the patient alive at the end of life.
To ease the family members’ concerns and help manage end-of-life procedures, doctors at the hospital will email, video chat, or send videos of the patient to family members. When COVID is a concern, family members may not be allowed to visit the patient in the hospital. The phone calls and videos help family members realize that they don’t have to come to México right away, and can choose not to come at all if desired.
If you do not have a family member to make decisions for you and to handle your death in México, choose a “person of confidence” and complete a Mexican affidavit giving him or her the legal ability to make decisions regarding your body, including picking up the ashes from the funeral home. Pam has these affidavit forms. This is important for partners who are not legally married.
Hospital Joya Puerto Vallarta
After death, the hospital staff works with Celis Funeral Home in Puerto Vallarta (referred to below as “the funeral home”) to handle the body, prepare the Mexican Death Certificate paperwork, and file it with the local Civil Registry. If COVID-19 is the cause of death, Mexican law requires cremation within 24 hours. Organ donation is not done here—in Puerto Vallarta they don’t have the facilities to harvest and store organs.
The hospital requires that the bill for services be paid on the day of death. This is another reason to have cash available in the safe for the family members to pay for the deceased’s expenses.
The funeral home will require the deceased’s passport as well as all other information listed in Part 1 of this series to prepare the paperwork. They will punch holes in the passport, invalidating it, and return it to the family, as directed by the consulate.
Celis Funeral Home Brochure Page 2
A member of the funeral home staff will take the family member to the Civil Registry office to report the death and obtain the Mexican Death Certificate. There will likely be a long wait, especially when COVID deaths are numerous. It’s important to review all information on the form for accuracy as obtaining changes will be next to impossible. Request at least twenty notarized copies of the Mexican Death Certificate, which will cost 20 pesos each (about $1 US). The family member will sign all twenty copies and then the certificates will be endorsed with an official government stamp.
Celis Funeral Home Brochure Page 3
A member of the CELIS staff will take the family member home or back to the funeral home, as desired. It will require 24 hours for the deceased’s ashes to be ready to pick up. The ashes can be transported on an airplane, which might be best in carry-on luggage. While it’s not legal to spread ashes in the bay here, talk to Pam Thompson or a CELIS staff member about where it can be done.
A family member doesn't need to go to the consulate. A hospital staff member will call the consulate and request fifteen copies of the official “death of a citizen abroad” document (different than the Mexican Death Certificate) which may be needed for banking, attorneys, insurance, estate management, etc. in the home country. For Americans, the document is called “Death of a U.S. Citizen Abroad” and may take four to six months to receive from the U.S. Consulate. This process is expedited if the person has registered with their consulate when traveling or moving to México, a very important step in end-of-life planning (See Part 1 of this series).
2. What If I Die at Home in México?
If the death at home is from accidental or violent causes, it's considered a crime scene, so don’t touch anything, stay outside, and don't get involved. Call Pam Thompson (322-252-1711)or CELIS Funeral Home (See brochure below) where an authorized representative will guide you through proper procedures. (I recommend adding these numbers to your contact list on your phone.) The police will respond. An agent from the Ministerio Público (Public Ministry) will go to the home and determine where the body will be taken.
If the patient dies from natural causes, a chronic illness such as cancer, cardiac disease, etc., call the funeral home for assistance. The Ministerio Público goes to the home and determines whether the body will be released to the funeral home or taken to the morgue. If the cause of death is questionable, the body will go to the morgue. Suicide is considered a crime so, in this case, it may take about a week to get the body from the morgue. If a family member can’t be located immediately, the morgue may hold the body until a family member is found, for up to four years before burial.
CELIS Funeral Home is very helpful in guiding people through the legal procedures required. Some funeral homes are less hands-on with the process. CELIS can take care of the funeral services for burial or cremation. Their brochure spells out the steps to take and how part of the funeral home's service is to guide people through the legal and functional process surrounding death.
Bodies can be flown to the United States or Canada, but the process is cumbersome and expensive. Since 9/11, legal restrictions state which Mexican city the body can be flown from and where it can enter the other country. The COVID pandemic has made this even more difficult. The majority of expats here choose cremation and can prearrange and prepay with CELIS funeral home.
If you live or travel in areas other than Puerto Vallarta, I recommend contacting a local, reputable funeral home near you for an explanation of their services and fees. In some cities, such as San Miguel de Allende, there is a private service to assist expats in arranging end-of-life plans.
I urge you to read Part 1 of this End-of-Life Planning series. This is equally important, providing steps to take before you die in this country.
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Book #3 of the "In Sickness and In Health" series, For Better or For Worse, is in the works and will be published this year. Set partly in Mexico, these three stories revolve around love, life, and medical care for an expat couple.
When Lindsay and Jake fell in love, it was magnetic and powerful. Then health issues complicated their lives, tested their love, and stress took them to the breaking point.
Will moving to Mexico save their health and their relationship? How will they get the medical care they need living as foreigners south of the border?
Read more on Amazon at In Sickness and In Health novels.
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Happy reading and traveling!