If you live in Mexico or Latin America, have you created a plan for what to do in case of an accident, natural disaster, or healthcare emergency?
Who is going to show up for you?! What if you are no longer able to speak and make decisions for yourself?
If you wish to save your family and other loved ones considerable grief and time, it is important to understand what is involved when a foreigner becomes ill or dies in Mexico or other Latin American nation.
Last month I had the pleasure of joining patient advocate and educator colleague Deborah Bickel of Be Well San Miguel to share with expats why it is wise to create a Mexican declaracion jurada (living will) and/or voluntad anticipada (advance healthcare directive). The voluntad anticipada is incorporated into the declaracion jurada in many sates. My role in the meeting was to give an overview of palliative care and hospice and how to find end-of-life support in Mexico.
We have each invested 14 years or more sharing with expats (Deborah in Mexico, Guatemala, and Nicaragua – me in Mexico and Ecuador) why planning is important no matter your age but especially if you are 55+.
Short list of reasons:
Mexican law is civil law
British, Canadian, and U.S. law is common law.
There are major differences.
If you arrive with an Advance Healthcare Directive or Five Wishes or other document legal in your native country, it will not be legal in Latin America unless you get lucky. In Mexico, you must create a declaracion jurada and/or voluntad anticipada if you want your wishes to be honored. Some attorneys and notaries will incorporate your home country wishes for you. These documents must be created BEFORE any accident, illness, or demise. As of this date only 14 of Mexico’s 32 states offer a voluntad anticipada. The purpose of the voluntad, sometimes referred to as a directriz, is to avoid legal, medical, and bioethical problems that could complicate the situation for you the patient or your family.
Mexico is a country with predominantly Catholic traditions. These traditions influence choices. If you are Catholic, the system may seem familiar, such as burial over cremation. If you had chosen to live in Buddhist or Hindu Asia, cremation would be a relatively easy matter involving fewer steps as cremation is common practice. Or, you could have opted for a Tibetan sky burial. If you wish to be cremated, you will need a notarized document stating this wish.
Latin Americans have large family systems. If something happens to you as a Latin American, a family member will show up and know what to do. Most expats live in Latin America alone or as a couple, sometimes with children.
The Mexican culture, language, and way of thinking are unique. Most of all, procedures may be unfamiliar and complex. Attitudes and response to accidents, illness, and death are different.
Non-Spanish speaking expats often need bilingual advocates to negotiate the system. At least three people are recommended to advocate for your wishes, and/or serve as your healthcare proxies. If one is not available, perhaps another will be.
April 16 is National Healthcare Decisions Day in the U.S. If you do not yet have a plan, every day is a good day to work on one no matter where you are.
Aileen Gerhardt, a fellow patient advocate and educator in Boston writes “decide, document, designate, and discuss!!” Good advice.
Deborah’s extensive advance healthcare directive service for Guanajuato state Mexico may be found at https://bewellsanmiguel.com/medical-directives/ :
Wendy Jane Carrel, MA, is a Spanish-speaking senior care advocate from California. She has travelled Mexico for several years researching health systems, senior care, and end-of-life care to connect Americans, Canadians, and Europeans with healing options for loved ones. She is a compassionate companion and palliative care liaison, legacy writer, co-founder of Café Mortality Ajijic/now Death Café Ajijic and founding member/speaker of the Beautiful Dying Expo (USA). She is a trauma-informed, gentle End-of-Life Doula (National End-of-Life Doula Alliance proficient), and a speaker and published author on subjects related to senior well-being. Wendy’s web site is https://www.WellnessShepherd.com
© All rights reserved. Wendy Jane Carrel
Wellness Shepherd 
Ms Carrel, your vast knowledge and experience is such a blessing to those expats living (and ultimately dying) in Mexico and Latin America. You make the planning for end of life decisions enlightening, and a chance to make your voice heard, instead of being a dreaded chore, and a great help to your remaining relatives…Kudos Ms Carrel for all you do!