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My husband died in Hospital Chiriqui on June 22, 2016. Fortunately, I had attended the class sponsored by Boquete Hospice and Heath Care Foundation on the subject of how to prepare for death in Panama so as to satisfy government requirements and facilitate arrangements required of one's next of kin or designated representative. On the whole, the procedures are as outlined by Hospice, and I encourage everyone who has not already to retrieve the various forms from the Hospice website [www. boquetehospice.org/ ], complete them, and put them where they are available to whoever will be handling your affairs following your passing. I will concentrate in this post on procedures I found to be somewhat different from the advice given by Hospice and on those which I found to be extraordinarily important.

The importance of having a "living will" cannot be overstated. My husband was hospitalized for 16 days, in and out of intensive care. On day 12 or thereabouts, he was moved from intensive care back to his room in a regular ward, and the doctor informed me that all his organs were failing and that he would not recover. Nevertheless, he was hooked up to a ventilator, and kidney dialysis was scheduled for later that day. He was on intravenous morphine and was unconscious, and had been for several days. I produced his living will, the doctor perused it carefully and checked with hospital administration/legal. The hospital agreed to honor it. My husband died peacefully--still unconscious and still on morphine--four days later. Gracias a Dios, I had gone to trouble and expense of having living wills for both of us drawn up by our lawyer less than a year previously. It is my understanding that only living wills that are in Spanish and that are executed by a lawyer--with all the appropriate embossing, stamps, and signatures--are honored by the Panama medical community. Don't put this off, and, however tight your budget may be, find the money in it to pay for this important document.

I found the Hospice written materials somewhat unclear about two documents required for the funeral home and the Electoral Tribunal. The funeral home will issue the death certificate, but only upon the presentation of a different certificate or declaration of death issued by the attending physician. Sometimes, I understand, the doctor himself will deliver this declaration to the funeral home, particularly in Boquete. In my case, where the death was in a hospital in David, I was responsible for getting this declaration from the doctor and taking it with me to the funeral home. Perhaps routinely or perhaps fortunately, my doctor had it prepared and waiting for me at the nurse's station in the hospital. I took it, as well as other paperwork recommended by Hospice, to the funeral home (Funeraria del Retiro, in my case), where I graciously was met by Pedro Gonzalez, my insurance agent, who served as translator and witness. (My son also was with me, but he was ineligible to service as a witness because he is not a resident of Panama.) I paid for the services of the funeral home, the cremation, and copies of the death certificate (in cash), signed some papers, and was on my way in just over 30 minutes. The funeral home handled all the paperwork with the Tribunal Electoral, so these steps as outlined by Hospice were unnecessary.

After I reported the death to the U.S. Embassy in Panama City, the Embassy sent me multiple copies of a document entitled "Report of the Death of an American Citizen Abroad." This is invaluable when dealing the entities in the U.S. (insurance companies, banks, credit card companies, etc.) because it is in English. The Embassy took the necessary steps to stop social security payments.

Finally, I would like to put in a plug for having maximum insurance coverage. I never saw the bill (and don't want to) because my insurance paid it in full directly to the hospital. It had to have been enormous, particularly since my husband spent so much time in intensive care. As an example, I noted on the bottle of morphine that it costs $500, and I'm sure he received more than one bottle intravenously over a 24-hour period, and he received morphine for at least 12 days. It's my understanding that the public hospital does not provide morphine free of charge, so without adequate insurance or cash reserves, a patient may undergo substantial suffering. The care at Hospital Chiriqui was excellent, particularly in intensive care, and the two doctors handling my husband's case were superb. They were available at any time, were communicative, were forthright, and were very caring. All of this relieved much of the burden that accompanies so emotionally draining an experience. In short, because we decided to make the financial sacrifice and purchase good health insurance, both my husband's suffering and my own were greatly ameliorated.

I would be remiss if I didn't take this opportunity to thank the Boquete community for all of its support via phone calls, emails, and personal visits. And a special thanks goes to my friends who brought food to the house so that my son and I could return home to a good meal after a long, trying day at the hospital. I have endeavored to thank folks individually, but it's likely that someone was missed. So a heartfelt thanks to everyone for being so kind and supportive.

 

 

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Dear Bonnie,

It strikes that one of the most important aspects of existence in life is a fundamental recognition of the simple fact that our time here on this beautiful earth is limited; that for each and every one of us, one journey ends, and the sendero to the next begins in a place we cannot know and will never fully understand.

In my own reckoning, to pursue life and living is to pursue dignity and honor, and your actions and your words demonstrate the very essence of honor and dignity as you and your loved ones face the difficult realities of your beloved husband's passing.

May I be so bold as to salute your grace and aplomb in this most trying of times, and may the strength of your character sustain you with ease and grace in those moments when you most need them.

With deepest respect,

Dav

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Thank you. Bonnie.

I suspect this was not an easy post for you. It is incredibly insightful, well written, and valuable information.

I am so glad that we were able to meet Larry prior to his passing. That was a special event for us. And you are special for us as well.

With love,
Bud and Marcelyn

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Bonnie

 

I could only say that I am so sorry for your loss.  Also good job on your writting.  I know that could be very hard for you in this moments of grief but it is a good information for other people who may face this same situation in the future.

 

Roger B

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Thank you for this "nudge" Bonnie.  I have been putting off going through the steps to make it easier for those who will deal with my passing.  I am sorry for your loss and urge you to join Chicas when you are ready.  We are single women who help each other, luncheon once per month and provide scholorships for young native/Panamanian girls to further their educations.  A great group!

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Bonnie,

Your posting has been incredibly well received.

This afternoon I found three requests for your posting to be converted to PDF format so that it could be downloaded, printed out in a nice format, and then saved on a local device. At first, I was not aware of how to achieve that goal, and actually responded to two people via email to that effect. And then I did some research. This is not an issue with CL, but rather a data interoperability issue that I previously was not aware of how to achieve. Turned out not to be difficult at all.

I am presuming that you you would not object, and so I am posting a PDF version of your posting here for others to download and print out.

My Experience Dealing with Death in Panama.pdf

P.S., To download documents from CL, a user must be a registered user and logged in.

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