BajaNomad

Advance Directive, also known as: Durable Power of Attorney, also known as Living Will.

EnsenadaDr - 9-28-2013 at 12:06 PM

I found some excellent information on this topic at this link which will also allow you to download an Advance Directive in English and Spanish.

http://smahealthinfo.com/Advanced_Directives.html

The Durable Power of Attorney for Health Care, also known as an “Advance Directive” and “Living Will” (Use of this term is discouraged because there is unnecessary confusion with a Last Will and Testament.) is a document detailing the level of care you desire in the event of illness or injury which may seriously affect your quality of life, such as renal failure or an injury which leaves you in a vegetative state. It also details the level of care you desire in the event of a terminal condition, such as the advanced stages of cancer. You may request that all measures available currently and in the future be exercised to maintain your life, that no “heroic” measures be taken and only comfort and care be administered, or any treatment procedures in between.

The Durable Power of Attorney for Health Care allows you to designate others, as your Patient Advocates, to act in your behalf if you are unable to communicate your desires yourself. These are people you trust to honor your wishes when end-of-life decisions may need to be made.

The Durable Power of Attorney for Health Care is not acted on unless you are considered permanently unable to speak in your own behalf. As long as you are capable of making your own decisions, you may request any relevant treatment you desire, even if it is different from what is stated in your Durable Power of Attorney for Health Care.

In Mexico there are two forms of The Durable Power of Attorney: One is for financial powers of attorney, the other is for designation of a power of attorney for health care. Both of these documents need to be in English and Spanish and signed by a Notario. Because of the fact that the Right to Palliative Care Law (2009) is relatively new in Mexico, your Notario may not be familiar with this new law.

It is generally suggested that you review your Durable Power of Attorney for Health Care from time to time, and if necessary rewritten, especially when there is a change in your health or family status. When you review it, if it still expresses your intent, sign and date it again under the Reaffirmed Section to show that you still agree with its contents. It could be that when you wrote your first Durable Power of Attorney for Health Care you had no major health considerations, and your friends and family named as your Patient Advocates were all close by. However, a couple years later you may have moved to Mexico, you may have developed a pre-diabetes condition, and/or you may have been diagnosed with having had some minor strokes. In these cases, your health situation is somewhat different now and may give you reason to look at your end-of-life decisions a little differently. The people who would be your Patient Advocates may no longer be in a position to act quickly on your behalf, so you need to designate someone geographically closer to you. In another few years, one or both of these conditions may change even further. The Durable Power of Attorney for Health Care is a “living” document, changing as one’s life changes.

Living in Mexico presents a few interesting challenges with regard to the execution of a Durable Power of Attorney for Health Care. First of all, people locally should be designated to act in your behalf as it might be very difficult for members of your family to arrive to take over your care in a timely manner. Because people living in San Miguel tend to come and go to their home country or are frequently traveling, several people should be named in the event that one or two of your Patient Advocates are unavailable. In addition, you can name members of your family to take over the responsibility once they arrive in San Miguel.

Secondly, the Durable Power of Attorney for Health Care should be in both English and Spanish. Your doctor may be quite fluent in English, but not all those giving you care may be. It is important that everyone involved in your care be knowledgeable of your wishes.

Thirdly, should you wish to live your last days in the States, you need to be aware of that each state has its own form for Advanced Directives. You may find your state’s form and a more thorough discussion of this important document at The U.S. Living Will Registry.

If you use a State form you should still have it translated into Spanish for use in Mexico. In reality, you may wish to die surrounded by your family in your home country, but your health condition may not allow for that possibility.

Generic Advanced Directive Forms are provided here, in English and in Spanish. However, they may not be recognized in your home State.

You will need to distribute copies of your Durable Power of Attorney for Health Care to several people. This includes your primary care doctor, all of your specialist doctors, the hospital when you are admitted (if possible), each of your Patient Advocates, members of your family (even if they aren’t named as Patient Advocates), and members of your Care Share Group (see link). You may also consider others who you feel have reason to know your desires, even if they have no direct responsibility with carrying them out. Make a list of who has received a copy so that you remember who has it and can replace it when you update it.


Provided by Mark Baker, Past Executive Director, Hospice San Miguel

MY LIVING WILL

DavidE - 9-28-2013 at 02:09 PM

chippy - 9-28-2013 at 02:48 PM

Come on David I doubt your estate could afford that? Shovel? Ditch?

DavidE - 9-28-2013 at 03:03 PM

Can't burn me - ain't enough wood and anyway the smell would force evacuation of Asuncion.

durrelllrobert - 9-28-2013 at 04:36 PM

Quote:
Originally posted by DavidE
Can't burn me - ain't enough wood and anyway the smell would force evacuation of Asuncion.


I donated by ENTIRE body to UCSD medical school to avoid the cost/hassle of cremation. The card I care states DO NOT PERFORM ATOPSY and they come to pick up the corpse anywhere within a 50 mile radius. Now all I have to do is find a way to get it to the border.

DENNIS - 9-28-2013 at 04:46 PM

Quote:
Originally posted by durrelllrobert

Now all I have to do is find a way to get it to the border.


You might consider Ms. Davis' mail service. You just have to make sure your wife applies sufficient postage

DavidE - 9-28-2013 at 04:48 PM

YEAH I CAN JUST SEE IT !!!

"WHAT'CHA BRINGING BACK FROM MEXICO TODAY?"

bajaguy - 9-28-2013 at 04:51 PM

Quote:
Originally posted by durrelllrobert
I donated by ENTIRE body to UCSD medical school to avoid the cost/hassle of cremation. The card I care states DO NOT PERFORM ATOPSY and they come to pick up the corpse anywhere within a 50 mile radius. Now all I have to do is find a way to get it to the border.


Have your wife call UCSD and have them meet her in secondary at the US side of the San Ysidro border. Then have her prop you up in the front seat with a beer in your hand and head for the border. Once you cross that yellow line on the pavement, you are home free!!!

EnsenadaDr - 9-28-2013 at 06:09 PM

I don't know why you guys are making fun of this thread, if you want to make fun of death then go off-topic if you want to be flippant or sarcastic. That's what I do. But we are here with some serious illnesses and concerns. You cannot bring the body to the border you have to contract with a local Mexican funeral service who will arrange with an American funeral parlor to receive your remains and then from the American funeral home your family or other people making the arrangements you can arrange for UCSD to pick up the body at the Funeral home.
Quote:
Originally posted by durrelllrobert
Quote:
Originally posted by DavidE
Can't burn me - ain't enough wood and anyway the smell would force evacuation of Asuncion.


I donated by ENTIRE body to UCSD medical school to avoid the cost/hassle of cremation. The card I care states DO NOT PERFORM ATOPSY and they come to pick up the corpse anywhere within a 50 mile radius. Now all I have to do is find a way to get it to the border.

DENNIS - 9-28-2013 at 06:29 PM

Quote:
Originally posted by EnsenadaDr
I don't know why you guys are making fun of this thread, if you want to make fun of death then go off-topic


Death is only a problem for the living. Come to terms with mortality........die....and pick up your seventy virgins at the WalMart-Heaven freight dock. :biggrin:

EnsenadaDr - 9-28-2013 at 07:03 PM

That is if you go to heaven, DENNIS. And the way you are totally being a bad boy troll on this thread, you might meet 70 diablitas waiting for you somewhere else, but then again you might have more fun!!:fire:

BajaLuna - 9-29-2013 at 12:47 AM

thanks Doc for sharing this info. I had all my stuff done a few years ago here in the States but it's good to know this info about Mexico!

My feeling is even if you don't think it's important to take care of this stuff, think about your family and what they will have to go through, I for one want to make things as smooth as possible for my kids and as headache-free as I can. After going through 2 deaths recently, it can really be a headache for loved ones if you don't have your ducks in a row, I'm just sayin'!

Keep the important info coming, Doc!

bajalinda - 9-29-2013 at 06:38 AM

Thanks for the link and all the info, EnsenadaDr.

Shimmer - 9-29-2013 at 07:20 AM

Gracias.... Having danced with cancer this last year, I understand just how important this issue is, in the US and in Mexico. While the cancer is gone, I have not forgot the stress one feels when in the grips of reaper. I am based in Oregon... (on the record), where these affairs are easily handled... Mexico I am told is a different story, and much harder to have a definitive say in the health care, or end of. Again gracias.

Leo - 9-29-2013 at 11:07 AM

I am with EnsenadaDr that this is not a subject to make fun off. Use the information, have questions or vent your experience and take the fun somewhere else.

Barry A. - 9-29-2013 at 11:46 AM

This is an excellent thread, Dr. Janene, and I think very serious and important. My wife and I went thru all this 15 years ago, and considered it well worth the effort and expense (which is minimal) and the kids sure appreciated it, also. (that's the most important part). We have all those documents on file, both in our personal Living-Trust files, and with our Doctors and Attorney's, and with each kid..

Barry

Thank you, Dra Janene!

toneart - 9-29-2013 at 12:10 PM

Sometimes I wonder, "Why bother?" I put the following on the other related string and got no acknowledgement whatsoever. Then the frivolous posts killed that important string.

Anyway, I will try again. I think this is so important. This is what I have done for over 10 years. My family has taken it to an attorney and gotten confirmation that this is an iron clad, secure and inexpensive way to do it:

To Nomads In The United States- There is a wonderful software program from Nolo Press. It costs $60.00. It is a four part legal document; Will, Healthcare Directive, Durable Power of Attorney your final wishes. It is updated annually and is State Specific. It asks you questions so thoroughly (some that you may not have even thought of), that when you make your decisions you are left with a peaceful, confident feeling. You can update periodically as your circumstance and assets change.

EnsenadaDr - 9-29-2013 at 01:04 PM

I did see that Toneart, and thank you for that important contribution. That was a great suggestion. It is also important that the advance directive be approved by a Mexican attorney and notarized if living in Mexico part or full-time. There are some great notaries in Ensenada, and they pretty much know if something is legal or not because they work hand in hand with their attorneys. It is important that this information is in the archive for all existing Nomads and future Nomads that need this information.
Quote:
Originally posted by toneart
Sometimes I wonder, "Why bother?" I put the following on the other related string and got no acknowledgement whatsoever. Then the frivolous posts killed that important string.

Anyway, I will try again. I think this is so important. This is what I have done for over 10 years. My family has taken it to an attorney and gotten confirmation that this is an iron clad, secure and inexpensive way to do it:

To Nomads In The United States- There is a wonderful software program from Nolo Press. It costs $60.00. It is a four part legal document; Will, Healthcare Directive, Durable Power of Attorney your final wishes. It is updated annually and is State Specific. It asks you questions so thoroughly (some that you may not have even thought of), that when you make your decisions you are left with a peaceful, confident feeling. You can update periodically as your circumstance and assets change.

Cisco - 9-29-2013 at 01:18 PM

Quote:
Originally posted by BajaLuna
thanks Doc for sharing this info. I had all my stuff done a few years ago here in the States but it's good to know this info about Mexico!

My feeling is even if you don't think it's important to take care of this stuff, think about your family and what they will have to go through, I for one want to make things as smooth as possible for my kids and as headache-free as I can. After going through 2 deaths recently, it can really be a headache for loved ones if you don't have your ducks in a row, I'm just sayin'!

Keep the important info coming, Doc!


So many times death is laid in the laps of the living.

And the living are befuddled. Prior arrangements help so much.

Wonderful thread as we all will be experiencing the beauty or the trauma of this transition into the "Great Perhaps".

"Earl of Sandwich: 'Pon my honor, Wilkes, I don't know whether you'll die on the gallows or of the pox.
John Wilkes: That must depend my Lord, upon whether I first embrace your Lordship's principles, or your Lordship's mistresses.

* Exchange retold by Sir Charles Petrie, The Four Georges, p. 133 (1935)."

The above quote came from this interesting site below. Ponder and enjoy the fact that you are able to ponder.

http://en.wikiquote.org/wiki/Death



http://en.wikiquote.org/wiki/Death

Cisco - 9-29-2013 at 03:46 PM

Quote:
Originally posted by toneart
Sometimes I wonder, "Why bother?" I put the following on the other related string and got no acknowledgement whatsoever. Then the frivolous posts killed that important string.

Anyway, I will try again. I think this is so important. This is what I have done for over 10 years. My family has taken it to an attorney and gotten confirmation that this is an iron clad, secure and inexpensive way to do it:

To Nomads In The United States- There is a wonderful software program from Nolo Press. It costs $60.00. It is a four part legal document; Will, Healthcare Directive, Durable Power of Attorney your final wishes. It is updated annually and is State Specific. It asks you questions so thoroughly (some that you may not have even thought of), that when you make your decisions you are left with a peaceful, confident feeling. You can update periodically as your circumstance and assets change.


Toneart:

Thank you soo much for the referral. They seem to have all kinds of good stuff there that will save a bunch of money in many directions of everyday law in addition to death and dying.

Gracias...

SFandH - 9-29-2013 at 03:58 PM

Quote:
Originally posted by toneart

To Nomads In The United States- There is a wonderful software program from Nolo Press. It costs $60.00. It is a four part legal document; Will, Healthcare Directive, Durable Power of Attorney your final wishes. It is updated annually and is State Specific. It asks you questions so thoroughly (some that you may not have even thought of), that when you make your decisions you are left with a peaceful, confident feeling. You can update periodically as your circumstance and assets change.


It is an excellent product. I first used it 5 years ago and it's time for me to do an update. Just answer questions, print out perfectly legal documents for the state you're in and follow instructions about signing and signature witnesses.

Will
Health Care Directive
Durable Power of Attorney
Executor Documents
Final Arrangements

I don't know about the legality in Mexico but a translation into Spanish is a thought.

http://www.nolo.com/products/quicken-willmaker-plus-wqp.html



[Edited on 9-29-2013 by SFandH]

EnsenadaDr - 9-29-2013 at 04:02 PM

A will and an advance directive (or "living will" which is not the same as a will) is an excellent idea. Unfortunately just translating it into Spanish doesn't work. I have had to submit many documents to the Mexican government and you need the seal of an official translator on the documents to make them legally binding. All this information is important and should be available to anyone who comes to the Baja Nomad site and searches for Advance Directive, Living Will or will.
Quote:
Originally posted by SFandH
Quote:
Originally posted by toneart

To Nomads In The United States- There is a wonderful software program from Nolo Press. It costs $60.00. It is a four part legal document; Will, Healthcare Directive, Durable Power of Attorney your final wishes. It is updated annually and is State Specific. It asks you questions so thoroughly (some that you may not have even thought of), that when you make your decisions you are left with a peaceful, confident feeling. You can update periodically as your circumstance and assets change.


It is an excellent product. I first used it 5 years ago and it's time for me to do an update. Just answer questions, print out a perfectly legal document for the state you're in and follow instructions about signing and signature witnesses.

I don't know about the legality in Mexico but a translation into Spanish is a thought.

http://www.nolo.com/products/quicken-willmaker-plus-wqp.html

SFandH - 9-29-2013 at 04:05 PM

Well, what do you think about using this product and getting official translations?

http://www.nolo.com/products/quicken-willmaker-plus-wqp.html

[Edited on 9-29-2013 by SFandH]

bajalinda - 9-29-2013 at 04:38 PM

Thanks Toneart - I did see your post on the other thread also and noted down the info. Good that you tried again and re-posted so others can see it on this thread too.
Thanks again.

toneart - 9-29-2013 at 08:24 PM

Thanks for your replies, Sra. Janene, Cisco, SF&H, and Bajalinda. I think the main importance of Bajanomad is when we can contribute experience that can help others. In this case, Nolo Press legal docs are for U.S. residents. I think, to translate it into Spanish wouldn't do much good because it would not be valid in Mexico.

Cisco, your long copy of the Death quotes is most entertaining and yet, gives a lot to ponder. One of my favorites (but I didn't find it in your piece), is by Woody Allen: "I don't want to be immortal for my work. I want to be immortal for not dying!" :yes: