12/15/17

The Drift Called the Infinite: Emily Dickinson on Making Sense of Loss

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Reflections on silence and eternity from the poet laureate of death.

“The people we most love do become a physical part of us, ingrained in our synapses, in the pathways where memories are created,” poet Meghan O’Rourke wrote in her stirring memoir of losing her mother. More than a century earlier, another poet with a rare gift for philosophical prose reflected on mortality in the wake of her own mother’s death.

Emily Dickinson (December 10, 1830–May 15, 1886) was about to turn fifty-two when her mother, after whom she was named, died. A stroke had left her paralyzed and almost entirely disabled eight years earlier. Despite her lifelong infirm health, her disinterest in the life of the mind, and the surges of unhappiness in the Dickinson home, Emily Norcross Dickinson had been attentive and affectionate to her daughter, igniting the poet’s little-known but ardent passion for botany and prompting her to write that “home is a holy thing.”

Although a contemplation of mortality haunts nearly all of Dickinson’s 1775 surviving poems in varying degrees of directness, her mother’s death forced a confrontation with mortality of a wholly different order — loss as an acute immediacy rather than a symbolic and speculative abstraction.

In a letter to her cousins penned shortly after her mother’s death in November of 1882 and found in The Letters of Emily Dickinson (public library), the poet writes:

Mother’s dying almost stunned my spirit… She slipped from our fingers like a flake gathered by the wind, and is now part of the drift called “the infinite.”

We don’t know where she is, though so many tell us.

Emily Dickinson, daguerreotype, circa 1847.

Even as a child, Emily had come to doubt the immortality so resolutely promised by the Calvinist dogma of her elders. “Sermons on unbelief ever did attract me,” she wrote in her twenties to Susan Gilbert — her first great love and lifelong closest friend. Dickinson went on to reject the prescriptive traditional religion of her era, never joined a church, and adopted a view of spirituality kindred to astronomer Maria Mitchell’s. It is with this mindset that she adds in the letter to her cousins:

I believe we shall in some manner be cherished by our Maker — that the One who gave us this remarkable earth has the power still farther to surprise that which He has caused. Beyond that all is silence…

Writing less than four years before her own untimely death, she ends the letter with these words:

I cannot tell how Eternity seems. It sweeps around me like a sea… Thank you for remembering me. Remembrance — mighty word.

In another letter from the following spring, penned after receiving news of a friend’s death, Dickinson stills her swirling sorrow the best way she knew how — in a poem:

Each that we lose takes part of us;
A crescent still abides,
Which like the moon, some turbid night,
Is summoned by the tides.

She adds a sobering reflection on the shock each of us experiences the first time we lose a loved one:

Till the first friend dies, we think ecstasy impersonal, but then discover that he was the cup from which we drank it, itself as yet unknown.

Complement with a collection of moving consolation letters by great artists, writers, and scientists ranging from Lincoln to Einstein to Turing, psychoanalyst Adam Phillips on how Darwin and Freud shaped our relationship to mortality, Seneca on the key to resilience in the face of loss, and this unusual Danish picture-book about death, then revisit Cynthia Nixon’s beautiful reading of Dickinson’s “While I was fearing it, it came” and Dickinson’s forgotten herbarium — an elegy for time and mortality at the intersection of poetry and science.

Complete Article HERE!

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12/14/17

People are hiring doulas to help them die

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By Molly Shea

Chad Lewis charges $20 to $25 an hour to assist the gravely ill and their families.

When Chad Lewis’ mother passed away seven years ago from complications from diabetes, he couldn’t stop thinking about her death. “It wasn’t loving and sweet,” he says. “It was chaotic and angry and scary.”

So Lewis, a 39-year-old who lives in Astoria, set out to find a better way to process the end of life, ultimately making a career shift from Broadway stage manager to death doula.

Doulas who aid women in giving birth have been trendy for years, but now a different type of support person is helping people navigate life’s other major passage. Dying people and their loved ones are hiring death doulas to help them coordinate end-of-life care and vigils, plan funerals and provide a sympathetic but unattached ear.

The profession first came into being in the early aughts and is growing increasingly popular. In 2014, Suzanne O’Brien launched the New York City-based Doulagivers, an online training program for death doulas.

“I can hardly keep up with demand,” says O’Brien, who also holds monthly seminars at an Upper West Side branch of the New York Public Library.

The process usually starts with a patient deciding how they want to die and outlining that with the doulas.

“It’s similar to a birthing plan … Where [do] you want to die? What kind of room you want to die in? What [do] you want to be looking at? What [do] you want it to smell like?” says Shelby Kirillin, 41, a Richmond, Va.-based death doula. She charges between $1,000 and $3,000 as a retainer fee, and asks for payment upfront to avoid chasing down money posthumously. She’ll also work pro bono if a situation merits it.

The “scary” death of Chad Lewis’ mother led him to become a doula.

“I had one young girl say she wanted to die in a yurt,” says Kirillin of a client who’s currently planning her own death. The girl’s cancer condition makes a yurt too impractical, so Kirillin is getting creative. “We decided on mosquito netting over her bed, and twinkle lights to look like stars.” After she takes her last breath, her loved ones will put wildflowers in her hair.

Death doulas also help out after someone passes. Lewis, who charges $20 to $25 per hour, likes to create a basic plan to take care of issues such as child care, grocery shopping and bill payment, to clear up mental space for grieving families.

And more than anything, the professionals help patients process what they’re going through.

“Families buffer pain — you hate to see people you love in pain. And doulas aren’t buffers,” says Kirillin. “Instead of saying, ‘OK, let’s see if we can give you meds,’ I’ll say, yeah, ‘I bet you are in pain. Tell me about it — what does it feel like?’”

When Richmond resident Mel Titus’ best friend of 31 years, Kim, was entering the final stages of her battle with cervical and breast cancers last year, they were introduced to Kirillin.

They were skeptical at first, but Kim (whose last name is being withheld for personal reasons) decided on a death doula so she could manage her death the way she did her life. “She was a processor,” says Titus. “She really liked that she could come up with a plan and do things a certain way.”

And for Titus, Kirillin provided emotional support during an impossible time. “I would have tough days, and I’d call Shelby, and she’d walk me through it,” she says.

Kirillin helped the duo plan Kim’s visitor schedule, and what music they’d play and books they’d read in the final days. Taking care of logistics freed them up to reminisce about Kim’s life, and even laugh about how things were going. “We actually had some funny moments, believe it or not,” says Titus. “It’s sad, but it can be a happy thing, too.”

Complete Article HERE!

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12/13/17

“Please Read This Before You Post Another RIP On Social Media.”

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by InspireMore Staff

There is nothing more painful than the death of a loved one. Aside from sadness that comes with the loss, there’s also the task managing that comes with sudden tragedies. Calling the family, talking to the police if necessary, and– yes– posting on Facebook.

As silly as that last point may sound, it’s become a very real part of the grieving process in this social media age. So much so that, a woman named Taya Dunn Johnson, wrote the following open letter after her husband’s death, titled “Please read this before you post another RIP on social media.”

It’s a powerful reminder to put people first– to honor what Taya calls “the hierarchy of grief”– even in our social media obsessed world.

Grieving in the technology age is uncharted territory.

I’ll take you back to Saturday, June 9, 2012. At 8:20 a.m., my 36-year-old husband was pronounced dead at a hospital just outside Washington, D.C.

By 9:20 a.m., my cellphone would not stop ringing or text-alerting me long enough for me to make the necessary calls that I needed to make: people like immediate family, primary-care doctors to discuss death certificates and autopsies, funeral homes to discuss picking him up, and so on. Real things, important things, time-sensitive, urgent things.

At 9:47 a.m., while speaking to a police officer (because yes, when your spouse dies, you must be questioned by the police immediately), one call did make it through. I didn’t recognize the number. But in those moments, I knew I should break my normal rule and answer all calls. “He’s dead??? Oh my God. Who’s with you? Are you OK? Why am I reading this on Facebook? Taya, what the heck is going on?”

Facebook? I was confused. I hadn’t been on Facebook since the day before, so I certainly hadn’t taken the time in the last 90 minutes to peek at the site.

“I’ll call you back”, I screamed and hung up. I called my best friend and asked her to search for anything someone might have written and to contact them immediately and demand they delete it. I still hadn’t spoken to his best friend, or his godsister, or our godchild’s parents, or a million other people!

Why would someone post it to Facebook SO FAST?

While I can in no way speak for the entire planet, I certainly feel qualified to propose some suggestions — or, dare I say, rules — for social media grieving.

How many RIPs have you seen floating through your social media stream over the last month? Probably a few. Death is a fate that we will each meet at some point. The Information Age has changed the ways in which we live and communicate daily, yet there are still large voids in universally accepted norms.

This next statement is something that is impossible to understand unless you’ve been through it:

There is a hierarchy of grief.

Yes, a hierarchy. It’s something people either don’t understand or understand but don’t want to think or talk about — yet we must.

There is a hierarchy of grief.

Hierarchy is defined as:

1. a system or organization in which people or groups are ranked one above the other according to status or authority, and

2. an arrangement or classification of things according to relative importance or inclusiveness.

What does this mean as it relates to grief? Let me explain. When someone dies  — whether suddenly or after a prolonged illness, via natural causes or an unnatural fate, a young person in their prime or an elderly person with more memories behind them than ahead — there is one universal truth : The ripples of people who are affected is vast and, at times, largely unknown to all other parties.

A death is always a gut punch with varying degrees of force and a reminder of our own mortality. Most people are moved to express their love for the deceased by showing their support to the family and friends left behind.

In the days before social media, these expressions came in the form of phone calls, voicemail messages, and floral deliveries.

If you were lucky enough to be in close proximity to the family of the newly deceased, there were visits that came wrapped with hugs and tears, and deliveries of food and beverages to feed all the weary souls.

Insert social media. All of those courtesies still occur, but there is a new layer of grief expression — the online tribute in the form of Facebook posts, Instagram photo collages, and short tweets.

What’s the problem with that? Shouldn’t people be allowed to express their love, care, concern, support, and prayers for the soul of the recently deceased and for their family?

Yes.

And no.

Why? Because there are no established “rules,” and people have adopted their own. This isn’t breaking news, and you’re not trying to scoop TMZ. Listen, I know you’re hurt. Guess what? Me too. I know you’re shocked. Guess what? Me too. Your social media is an extension of who you are. I get it. You “need” to express your pain, acknowledge your relationship with the deceased, and pray for the family.

Yes.

However…

Please give us a minute.

We are shocked.

We are heartbroken.

Give the immediate family or circle a little time to handle the immediate and time-sensitive “business” related to death. In the minutes and early hours after someone passes away, social media is most likely the last thing on their minds. And even if it does cross their mind, my earlier statement comes into play here.

There is a hierarchy of grief.

Please pause and consider your role and relationship to the newly deceased. Remember, hierarchy refers to your status and your relative importance to the deceased. I caution you to wait and then wait a little longer before posting anything. This may seem trivial, silly, and not worth talking about, but I promise you it isn’t.

If the person is married, let the spouse post first.

If the person is “young” and single, let the partner, parents, or siblings post first.

If the person is “old” and single, let the children post first.

If you can’t identify the family/inner circle of the person, you probably shouldn’t be posting at all.

Do you get where I’m going with this?

In theory, we should never compare grief levels, cast the grief-stricken survivors into roles, or use words like status and importance. But maybe we need to at this moment (and for the next few weeks and months).

The “RIP” posts started hitting my timeline about an hour after my husband’s death, and I certainly didn’t start them. This created a sense of confusion, fear, anxiety, panic, dread, and shock for the people who knew me, too. What’s wrong? Who are we praying for? Did something happen? Did someone pass? Why are there RIPs on your wall and I can’t reach you? Call me please! What’s going on?

That’s a small sample of messages on my voicemail and text inbox. I had to take a minute in the midst of it all to ask a friend to post a status to my Facebook page on my behalf.

Your love and expressions of support are appreciated and needed, but they can also be ill-timed and create unintended additional stress.

The person is no less dead and your sympathy no less heartfelt if your post, photo, or tweet is delayed by a few hours. Honestly, the first couple of hours are shocking, and many things are a blur. Most bereaved people will be able to truly appreciate your love, concern, prayers, and gestures after the first 24 hours.

I’ve learned this from the inside — twice within the last four years. And I assure you that if we each adopted a little patience and restraint in this area, we would help those who are in the darkest hours of their lives by not adding an unnecessary layer of stress.

A few extra hours could make all the difference.

Complete Article HERE!

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12/12/17

The Difficult Business of Dying

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The U.S. funeral industry is the most expensive and corporate in the world. Can Americans find a better way to grieve?

By Jess Bergman

In the six years since my father died, I’ve visited the cemetery where his ashes are interred exactly twice—the second time only because of the Jewish tradition of unveiling, where the initial graveside funeral service is followed within a year by a ceremony to uncover and dedicate the headstone. It’s not that returning would be too difficult. It’s more like the reverse: I fear an inability to perform the sadness and solemnity the pilgrimage seems to require. I miss my dad, but the cemetery, nestled alongside the highways and strip malls of suburban South Jersey, fails to evoke him in any meaningful way. It’s a site associated with him only retroactively, for the worst of all possible reasons. Where I’m supposed to feel his presence, there’s only a void.

FROM HERE TO ETERNITY: TRAVELING THE WORLD TO FIND THE GOOD DEATH by Caitlin Doughty

Los Angeles-based mortician and writer Caitlin Doughty argues that such feelings result from the failures of America’s death industry, which has become “more expensive, more corporate, and more bureaucratic than any other on Earth.” According to the National Funeral Directors’ association, the median cost of traditional funeral with a viewing and burial was $7,181 in 2014; Doughty cites the current average at $8,000 to $10,000. 14 percent of US funeral homes are run by publicly traded firms. Service Corporation International, the largest funeral services provider in the US, operates over 2,000 funeral homes employing more than 24,000 people. The $20-billion industry often pushes grief to the margins by pressuring families to make a series of high-stakes decisions on a very short timeline—most funeral homes come to pick up a body within an hour of being contacted.

In some cases, funeral homes deliberately exploit families for financial gain at a time of profound vulnerability. A 2013 undercover investigation conducted by the Federal Trade Commission revealed that up to one in five American funeral homes engage in “deceptive and manipulative practices.” The offenders violated the 1984 Funeral Rule, which stipulates that funeral homes must provide itemized price lists. The compulsory bundling of products and services is prohibited: They can’t require that you buy a traditional varnished casket when all you want is a cremation; an inexpensive, unfinished wooden box must be made available. And the law bans the aggressive sale of products that are not required by law, like the use of a hearse to transport remains to a cemetery. Though most funeral homes keep dedicated websites, few display their prices online, which makes it challenging to compare costs.

With its focus on profits, the industry has also changed the way we treat dead bodies. As recently as a hundred years ago, “no one would have questioned a wife washing and dressing the body of her husband,” Doughty writes, “or a father carrying his son to the grave in a homemade coffin.” The Civil War is often identified as the point at which practices began to shift. Embalming became more common as soldiers’ bodies were transported from the South to the North. It gained even more popularity after Abraham Lincoln’s funeral train tour, which took his embalmed corpse to 180 cities between Washington D.C. and Springfield, Illinois. Now, the United States is the only country in the world in which chemical conservation of the dead is common practice—a process that can cost anything from $495 to over $1,000. What was once a practical solution with a historically specific context has become a profitable norm, despite, according to the CDC, providing no public health benefit.

In her book From Here to Eternity: Traveling the World to Find the Good Death, Doughty tries to find a better way to die and to grieve, seeking out death rituals from the Western United States to Japan, Spain, Indonesia, and beyond. It sounds a bit like Eat, Pray, Die, but her project is much larger than its premise first implies. She is searching not for personal spiritual enlightenment or the morbid titillation of thana-tourism, but for practical, radical alternatives to our corporatized death industry. Her travels illuminate a host of compelling possibilities for better funerals and a less fraught relationship with our dead. But the book also reveals a larger failure of our culture to allow for mourning and grieving after the last goodbye. If it is hard to navigate the death care industry, it is harder still to work out how to live with grief.

On her travels, Doughty finds many rituals that involve prolonged contact with corpses—prolonged, at least, by American standards. All around the world, she meets people less troubled by the physical reality of dead bodies, whether those bodies are burned to ash, mummified, “decomposting,” or lying under glass in their natural, un-embalmed state. In Japan she visits a corpse hotel where families may rent a suite that looks like an ordinary condo and “just be with the body, free from the performance required at a formal viewing.” And at the Rinkai crematory, Doughty learns about the practice of kotsuage. According to this custom, families are escorted into a room called a shūkotsu-shitsu after a cremation, where they pick up their loved one’s remaining bone fragments and place them gently into an urn.

In North Carolina, Doughty spends time at Western Carolina University’s Forensic Osteology Research Station (FOREST), where corpses donated to science are turned into compost. The bodies are laid to rest in a wooded research facility, blanketed with alfalfa and woodchips, covered in a silver shroud, and in the hot sun to turn into dark, nutrient-rich soil after a period of weeks. The project is still in its experimental phase, but the FOREST researchers hope it will become a green solution with a therapeutic arc. Families will ultimately be invited to collect the soil made from the body of their loved one and with it, cultivate new life.

Doughty finds her most extreme example of dead body positivity in Tana Toraja in Indonesia. For Torajans, the border between the living and the dead is porous. Corpses frequently remain in the home for a period of weeks, months, or even years, and are cared for like any other member of the family—bathed, fed, dressed, and spoken to. After they are finally buried, following elaborate community funerals, bodies are periodically exhumed during what is called the ma’nene’. Families have the opportunity to reunite, and even picnic, with their dead; they can make animal sacrifices they may not have been able to afford at the time of the original burial. What sounds grisly to some is, to the Torajans, both tender and sacred: “Hauling someone out of their grave years after their death is not only respectful,” Doughty writes, “but it provides a meaningful way to stay connected to their dead.”

Doughty’s chatty calm in the presence of dead bodies and her arguments against American squeamishness are admirable. But it feels, at times, like From Here to Eternity’s focus on death comes at the expense of grief. This is not a failure of the project so much as its shape; the nature of Doughty’s inquiry makes grief a secondary concern. It does appear sporadically: In the chapter on the Day of the Dead, she travels to Mexico with her friend Sarah to visit a mummy museum, as well as the altars families erect to honor the people they’ve lost that year. Sarah is still reeling from the decision to obtain a late-term abortion when her fetus was diagnosed with trisomy 13, and Doughty writes about the isolation of Sarah’s grief, her feeling that the inability to move on from the loss had made her “radioactive” to her friends and coworkers. Her loss, and the future she had imagined, is devastatingly rendered. There is a digression, too, on the Western funeral industry’s fixation on “dignity,” by which they really mean silence, composure, and repression—this, too, is a moment of genuine feeling, and Doughty shows that though her tone is often light, she has the capacity to move and enrage.

But just as often, Doughty fails to engage with the realities of mourning. At an open-air cremation she attends in Crestone, Colorado, she professes to witness the “pall of grief [lifting] from the circle.” I don’t doubt the power of this ceremony. But the implication that it was able to dispel sadness—that such a thing is possible, or even desirable, at a funeral—gives me pause. Worse, in the book’s epilogue, she writes, “A sense of purpose helps the mourner grieve. Grieving helps the mourner begin to heal.” This is a neat, linear progression; in other words, it’s exactly what the experience of grief is not.

There is more to death and dying than funerals. From Here to Eternity is in some ways a missed opportunity to explore how the profit motive has distorted our experience of death—not just burial, but all the feeling that comes after a body is buried. In The Last Word, Julia Cooper writes of the difficulty of grieving under late capitalism. The amorphous, endless, and unpredictable nature of grief puts it fundamentally at odds with pressures “to be efficient, to progress, to—most of all—get back to work.” But, she writes, “mourning doesn’t work that way. There is no timeline because the work of grieving is never done. There is nothing efficient or productive about loss, but there it is all the same.” Grieving is the enemy of work, and we’re expected to suppress the former in the interest of the latter.

Minimizing the pain of personal loss, Cooper argues, is in service of “maintaining productivity for the benefit of a capitalist system.” Public displays of grief are shunned in part because they undermine the relentless positivity our economic system feeds on. The isolation of those who are unable to successfully curb their mourning is “a socially enforced strategy of our neoliberal era.” The repression of grief is also materially enforced: The standard paid bereavement leave, where it does exist, is three days. At Facebook, COO and Lean In author Sheryl Sandberg changed the company’s bereavement policy following the sudden death of her husband in 2015; the company now offers employees a comparatively generous 20 days paid leave following the loss of an immediate family member.

In the op-ed Sandberg wrote for The New York Times about her children’s experience of bereavement, she talks about grief in the language of business. The death of a parent is “adversity”; the word “resilience” is used six times, while “grieving” makes one appearance. Sandberg writes of her son and daughter’s loss (and her own) alongside the story of a friend’s child who was bullied at summer camp, with the implication that both experiences can be “overcome” with the same set of therapeutic tools. Sandberg’s approach isn’t insincere; original or not, the idea that “there is no wrong way to grieve” is an important one. But for those who don’t find this way of thinking helpful, our culture offers few other ways to address grief and work.

Caitlin Doughty’s mission to reimagine the death industry—to cast out our shame and fear of the dead—is an important one, for which she makes the case well and with good humor. More humane and meaningful rituals around death would doubtless ease the transition into the new reality that awaits the living after a traumatic loss. For my part, I look forward to one day spreading what I’ve kept of my father’s ashes, at a site less dour than a New Jersey tomb. But reforming our funeral industrial complex is only the beginning of the work ahead of us.

Complete Article HERE!

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12/11/17

Most people want to die at home, but many land in hospitals getting unwanted care

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By Andrew MacPherson and Ravi B. Parikh

Where do you want to die? When asked, the vast majority of Americans answer with two words: “At home.”

Despite living in a country that delivers some of the best health care in the world, we often settle for end-of-life care that is inconsistent with our wishes and administered in settings that are unfamiliar, even dangerous. In California, for example, 70 percent of individuals surveyed said they wish to die at home, yet 68 percent do not.

Instead, many of us die in hospitals, subject to overmedication and infection, often after receiving treatment that we do not want. Doctors know this, which may explain why 72 percent of them die at home.

Using data from the Dartmouth Atlas — a source of information and analytics that organizes Medicare data by a variety of indicators linked to medical resource use — we recently ranked geographic areas based on markers of end-of-life care quality, including deaths in the hospital and number of physicians seen in the last year of life. People are accustomed to ranking areas of the country based on availability of high-quality arts, universities, restaurants, parks and recreation and health-care quality overall. But we can also rank areas based on how they treat us at an important moment of life: when it’s coming to an end.

It turns out not all areas are created equal. Critical questions abound. For example, why do 71 percent of those who die in Ogden, Utah, receive hospice care, while only 31 percent do in Manhattan? Why is the rate of deaths in intensive care units in Cedar Rapids, Iowa, almost four times that of Los Angeles? Why do only 12 percent of individuals in Sun City, Ariz., die in a hospital, while 30 percent do in McAllen, Texas?

Race and other demographics in a given area certainly matter. One systematic review of more than 20 studies showed that African American and Hispanic individuals utilize advance-care planning and hospice far less than whites. More research is needed to explore these differences and to close these gaps and demand high-quality, personalized care for people of all races.

But race and demographics don’t provide all the answers. For instance, Sarasota and St. Petersburg, Fla., are only 45 miles apart and have similar ethnic demographics. Yet we found that they score quite differently on several key quality metrics at the end of life.

A variety of factors probably contribute to our findings. Hospice, which for 35 years has provided team-based care, usually at home, to those nearing the end of life and remains enormously successful and popular, is under­utilized. Most people enroll in hospice fewer than 20 days before death, despite a Medicare benefit that allows patients to stay for up to six months. Hospice enrollment has been shown to be highly dependent on the type of doctor that you see. In fact, one study among cancer patients with poor prognoses showed that physician characteristics (specialty, experience with practicing in an inpatient setting, experience at hospitals, etc.) mattered much more than patient characteristics (age, gender, race, etc.) in determining whether patients enrolled in hospice. For example, oncologists and doctors practicing at nonprofit hospitals were far more likely than other doctors to recommend hospice.

Also, physicians in a given geographic area are likely to have similar approaches to health care. They may collectively differ from physicians in another area in their familiarity and comfort with offering hospice care to a patient. This may explain why hospice enrollment significantly varies among geographic regions.

Palliative care, which focuses on alleviation of suffering, is often misunderstood by doctors as giving up. Health professionals’ lack of longitudinal, substantive training in end-of-life care only compounds the problem.

Perhaps most important, fewer than half of Americans have had a conversation about their end-of-life wishes — a process known as advance care planning — and only one-third have expressed those wishes in writing for a health-care provider to follow when they become seriously ill. If people do not have a clear sense of their end-of-life wishes, it is easy to imagine that they may be swayed by a physician’s recommendation.

The private sector has led the way in addressing the under­utilization of hospice and improving end-of-life care. For instance, health insurers such as Aetna have devised programs integrating nurse-led case management services for seriously ill individuals, reducing costly and undesired emergency room visits while increasing appropriate hospice referrals. And start-ups including Aspire Health are working with communities to provide palliative care in people’s homes while devising algorithms to help payers and providers identify individuals who might benefit from palliative and hospice care.

Congress also is considering bipartisan solutions consistent with best practices. Congressional leaders have recently introduced several pieces of legislation that would test new models of care for those facing advanced illness, support health professionals in training for end-of-life care and ensure that barriers are removed for consumers to access care.

And Medicare, via its Innovation Center, has led the way in testing promising care models to support those at the end of life, including the Medicare Care Choices Model, which allows individuals to receive hospice care alongside traditional, curative treatment.

But the secret sauce may be a shift in culture. We will not improve the death experience until we demand that our public- and private-sector leaders act and that our local health professionals encourage person-centered end-of-life care.

As with any social change, progress will be driven by a growing awareness and a desire for justice among families and patients. There are good and bad places to die in America. However, to ensure a better death for all, we must confront not just geographic disparities but also our resistance to thinking about death.

Complete Article HERE!

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12/10/17

SARCO CAPSULE: Check Out This State-Of-The-Art Suicide Machine

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“Sarco does not use any restricted drugs”

By Paul Bois

Once upon a time, people in Western society would invest their time into developing ways to heal people, enrich their lives, and restore their bodies to natural law. Now, we invent sleek new machines for people to commit suicide with.

According to LifeNews, the new “Sarco capsule” from Australia’s top euthanasia activist, offers people a fresh and easy new way to kill themselves without the presence of any doctor.

“The machine will allow anyone who has the access key to end their life by simply pressing a button,” reports LN. “Developed in the Netherlands by Nitschke and an engineer, the machine can be 3D printed and assembled in any location.”

After taking an online mental questionnaire, people are then provided with a four-digit access code to help build the Sarco capsule. Here’s how it works: people wishing to go into the great beyond will lie inside the capsule which will then slowly deplete the oxygen level with the use of liquid nitrogen. Shortly after a few minutes, people pass on to the afterlife to meet their maker.

When the person lies in the capsule, he can activate it and liquid nitrogen will rapidly drop the oxygen level, leading to death in a few minutes.

“Design criteria for the Sarco will be free, made open-source, and placed on the internet,” reports LN.

Nitschke believes that the Sarco capsule will usher in a new era of rational people ending their lives in peaceful ways without the use of doctors or drugs.

“Sarco does not use any restricted drugs, or require any special expertise such as the insertion of an intravenous needle,” says Nitschke. “Anyone who can pass the entry test, can enter the machine and legally end their life.”

No “restricted drugs” or needles? So long as it involves no animal testing or contributes to climate change, progressives will love the Sarco capsule.

Complete Article HERE!

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12/9/17

Four Tasks Between Death and Burial

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After death, there are four main tasks that need to happen before the burial. These can be achieved with the help of a funeral home or with the help of loved ones facilitating a home funeral. Learn what needs to take place between death and burial and the role of a funeral home versus a home funeral during the process.

When preparing for death, many people know that there are options for how a person is treated as they are dying. Documents may be completed, hopefully well in advance of the dying process, to express those personal wishes. Documents may include a Living Will, Health Care Power of Attorney, or 5-Wishes. Few know that there are options for after-death care. There are 3 options for the disposition of the body between death and interment or cremation:

Option 1: Hire a funeral home to carry out all aspects of after-death care, including transportation, refrigeration, initiation of death certificate, obituary, cremation and/or transportation to place of burial, and coordination of set up at cemetery for the graveside service.

Option 2: Hire a funeral home to carry out some of the above mentioned aspects of after-death care and take care of other details utilizing family and friends.

Option 3: Have family and friends direct the details of after-death care. This process is call a Home Funeral.

Four Main Tasks

Regardless of which option you choose for after-death care, four main tasks will need to take place between death and burial:

  1. Transportation From Place of Death: The body may need to be moved from the place of death (such as a hospital/nursing facility or home) to the place of after death care (either a home or a funeral home).
  2. Care of the Body: The body will need to be cared for until the time of burial. This care may include bathing, dressing, refrigeration or dry ice application, and perhaps wrapping in a shroud before cremation or burial.
  3. File Death Certificate: A death certificate will need to be filed. This includes gathering the information to complete the certificate, signature from attending physician, and filing with the county registrar.
  4. Transportation To Burial Site: The body will need to be transported from the place of care to Carolina Memorial Sanctuary when it’s time for the burial.

Between Death & Burial: Four Tasks

Before we go over the four steps that take place between death and burial, it’s important to understand the difference between a funeral home and a home funeral. If you’re not clear on the differences, read this page first.

The four tasks between death and burial are pretty detailed, so we’ve created the following graphic to help show your options. Scroll down to see a written explanation of the four main tasks.

Task 1: Transportation From Place of Death

Death can occur anywhere but will often occur at home, in a hospital, or in a hospice center. For unexpected deaths, the body is often brought to a hospital to be examined by the medical examiner. Depending on whether you’re opting for a home funeral or the assistance of a funeral home, the body will need to be transported to the place of care.

Funeral Home

If you hire the assistance of a funeral home, they will come to the place of death and pick up the body and take it to the funeral home for care.

Home Funeral

If you are having a home funeral, you can pick up the body from a hospital, hospice center or morgue and bring it home yourself. You also have the option of hiring a funeral home to pick up the body and transport it to the home for you. If you choose to pick up the body yourself, CEOLT is happy to act as a liaison to help that transition go smoothly.

Task 2: Care of the Body

Until the time of burial, the body will need to be cared for and kept cool. Again, this can be done at home or at a funeral home.

Funeral Home

Once a funeral home has picked up the body and brought it to their facility, they will then clean and dress and/or shroud the body. Afterward, the body will be placed in refrigeration to keep it cool until the day of burial, at which point the body will be transported to the burial site.

Home Funeral

For home funerals, once the body has been transported to the house, the body is first cleaned and then dressed and/or shrouded, and then placed in a room where the body can rest and where friends and family can visit if they choose. To keep the body cool, dry ice is usually employed. Certain traditions and spiritual faiths observe the practice of allowing the body to lie in state for multiple days. Using proper care, a body can be kept in the home for multiple days without issue until the time of burial. There are exceptions to this and having the support of an experienced person from CEOLT or going through the home funeral course will help to address the circumstances that could arise. Caroline Yongue, our Director, has been assisting families with home funerals for over 20 years, and has rarely encountered a situation where a home funeral wasn’t possible.

Task 3: File Death Certificate

While the body is being cared for and waiting for burial, a death certificate will need to be filed.

Funeral Home

If going the route of a funeral home, they will file the death certificate for you. You will need to provide personal information of the deceased.

Home Funeral

If doing a home funeral, an individual who is assisting will need to file the death certificate.  This includes gathering the personal information for the deceased, obtaining the signature and cause of death from the attending physician and filing the death certificate with the County Registrar (in the county where death happened).

Task 4: Transportation To Burial Site

The final task to carry out will be to transport the body to the burial site just prior to the time of burial. The date of burial will need to be coordinated with Carolina Memorial Sanctuary in advance so that we can prepare the grave and prepare for the service.

Funeral Home

On the date of the burial, the funeral home will transport the body to Carolina Memorial Sanctuary usually 30-60 minutes before the service is scheduled to begin. They will either release the body to Carolina Memorial Sanctuary or transport the body to the gravesite, depending on the circumstances.

Home Funeral

Just like with the first transportation, from the place of death to the place of care, getting the body from the home to the Carolina Memorial Sanctuary can be done by friends/family assisting with the home funeral or a funeral home can be hired for this service. Carolina Memorial Sanctuary will consult with you and recruit the help of volunteers if additional hands are needed to transport the body from the vehicle to the gravesite.

Final Thoughts: Saying Goodbye Before the Body Is Taken Away

We want to end by sharing some final thoughts on saying goodbye to your loved ones. Contrary to popular belief, the body does not have to be whisked away the moment death occurs. When death occurs at home, most people believe that they are obligated to immediately call 911 or a funeral home so they can quickly transport the body away. Or if a loved one has died at a hospital or hospice center, there may even be pressure from the staff to have the body removed. If you have decided to use a funeral home and the body will not be coming back home, you have the right to ask to spend time with the body of your loved one and say goodbye before the body is transported away from your home/the hospital/hospice center. The opportunity and time to say goodbye can be very healing and beneficial and help with closure and grieving. If a loved one dies at home, you can let the funeral home know that you would like some time with your loved one before they come to pick them up. It doesn’t even have to be the same day (this is known as a “delayed pickup”). If a loved one dies at a hospital or hospice center, let the staff know that you would like time with your loved one. They will often allow a number of hours for this to  take place. You even have the option of having the funeral home bring the body to the home for goodbyes, and then have them transport the body to the funeral home for care and refrigeration before burial. Last – you always have the option of going to the funeral home and having your goodbyes there. The time after death is the last time some people have to see their loved ones and say goodbye – so be sure to ask for what you want and what you need and know that you can take your time.

Complete Article HERE!

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