08/13/17

Meet the “Death Positive” Women Changing the Funeral Industry

Share

Courtney Lane, who practices the art of Victorian hairwork, with some of her creations.

by

Sooner or later, the end is coming — for all of us. But women in particular have been at the forefront of the “death positive” movement, which aims to strip away the mystery and fear around the end of life and help us each find our own “good death.”

Amber Carvaly is a mortician and service director at Undertaking LA, the funeral home she coruns with Caitlin Doughty. A women’s studies major whose life’s passion has been to work harder, better, smarter, and kinder as a human being, she soon found herself in the nonprofit industry, preparing meals and holding birthday parties for LA’s homeless. When she lost her job after the economy crashed in the late aughts, she made friends with a funeral director. “It seemed like it had similar characteristics to what I was doing at the Downtown Women’s Center,” Carvaly remembers of their talks about funeral work. She wanted to continue helping people and decided to go back to school, this time to study mortuary science. “I had been emailing Caitlin throughout this,” Carvaly says, “although we had never met.” Eventually, Doughty asked if Carvaly was interested in helping her start Undertaking LA and the rest, as they say, is death-positive history.

Amber Carvaly of Undertaking LA.

“It is not death that is important, but how we live our lives as we near it,” Carvaly explains. “How we view and treat the dead is a reflection of society and our values. What I want is to change our hearts and souls and the way we literally see and process the world around us. I think our very existence and survival as a species depends on it.” Carvaly’s next big plan is to offer house death calls, where families are given a person to guide them through washing and dressing the body. “In my experience,” Carvaly says, “families have not needed anything spiritual or extravagant. They just want someone to stand with them and help give them the confidence to use the strength they already have within themselves to start.”

Melissa Unfred with her sidekick, Kermit.

The Summer before Melissa Unfred‘s senior year of high school, a local funeral home was featured on the news. They were a family-owned business looking for assistance and, as a joke, her mom turned to her and suggested she get a job. A budding rebel, Unfred did just that. “I was fascinated by the science and art involved in funeral service and embalming,” Unfred says. “And led by such a strong woman, no less! Billie White Everett [the home’s owner and one of the first female directors in Texas] made a huge impression on me.”

These days, Unfred educates people about home funerals and green burial, which focuses on returning the body to the earth in its natural state by foregoing embalming and using biodegradable materials like wooden caskets. She partners with an Austin crematory that shares her core values and is one half of Texas’s first certified therapy dog team working in funeral care, along with her furry sidekick, Kermit the dog. Originally adopted to be a pet and emotional support source for Unfred, Kermit’s knack for interacting with others, particularly the grieving, quickly became apparent. Now, the two are inseparable during transfers to funeral homes after someone has died, at graveside ceremonies, and everywhere in between. Together, they’re on a mission to clear out the smoke and mirrors of the funeral service, helping families understand their options so they can make an informed decision on what they want for themselves and their loved ones.

One of Lane’s hairwork pieces.

Courtney Lane of Never Forgotten braids hair for a living. She’s following a tradition called “hairwork,” which was part of the extensive Victorian mourning process. “What really makes hair art and jewelry special is that it can contain the hair of your loved ones,” Lane says. Her clients might provide her with their own hair to make into a romantic gift or a snippet from their child’s first haircut. Lane also works with cancer patients who lose their hair during treatment. “A cancer survivor once explained to me that this was an artistic statement that helped her feel like she wasn’t losing her hair, but transforming it into something new and beautiful,” Lane says. Very often, of course, the hair she’s working with is that of a deceased family member; because hair doesn’t decompose, Lane explains, it’s a perfect relic with which to remember our dead.

In addition to custom work for clients, Lane also makes art out of antique Victorian hair and travels to give lectures and workshops on the misunderstood history behind hairwork and its elaborate techniques. The first time she showed her art at a convention, a man walked up to her table and asked, in what she calls a Disney villain voice, if she could make him “something truly evil” if he brought her the hair of his enemies. Since then, she has gotten so many similar requests that she added a section to the FAQ on her website. The answer is no.

The theme of education runs throughout the work of Lane, Carvaly, and Unfred. For while death is ubiquitous, it is also misunderstood and maligned. “I do completely believe that humans should not be afraid of dead bodies,” Carvaly says. “By leading by example, I can show others that there is another way to approach our existence and demise. And that if I can do it, so can they.”

Complete Article HERE!

Share
08/12/17

Prehistoric Britons ate the dead & carved their bones – research

Share

Prehistoric cannibals who once lived in a Somerset cave engraved human bones with zig-zag designs as part of a “complex” eating ritual, according to new research.

The bones, which had a number of deliberate cuts and human teeth marks, were discovered at Gough’s Cave in the Mendip Hills and are believed to be between 12,000 and 17,000 years old – when the cave was occupied by Ice Age Britons.

Scientists from the Natural History Museum in London and University College London (UCL) compared hundreds of cut-marks found on human and animal bones in the cave. They discovered one human body with the bones separated, filleted, chewed and then marked with a zig-zag design, before it was finally broken to extract the bone marrow.

Researchers ruled out an initial theory that the marks were made during the butchery process, because they were found on a part of the bone with no muscle attachments. There is no indication on the skeletons that the humans had suffered violence before they died.
They concluded that the “zig zagging incisions are undoubtedly engraving marks, produced with no utilitarian purpose but purely for artistic or symbolic representation.”

The study, published in the journal PLOS ONE, says the marks may have represented the “story” of the victim’s life or a memorial to how they died. Whatever the reason, researchers agree it must have been part of a ritual or ceremony to mark the person’s passing, like modern day funerary rites.

“The sequence of modifications performed on this bone suggests that the engraving was a purposeful component of the cannibalistic practice, rich in symbolic connotations,” says Dr Silvia Bello, lead author of the study.

“Archaeologists have linked the engraving of objects and tools to ways of remembering events, places or circumstances, a sort of ‘written memory’ and ‘symbolic glue’ that held together complex social groups.

“Perhaps the engraving of this bone may have told a sort of story, more related to the deceased than the surrounding landscape. It could be that they are indicative of the individual, events from their life, the way they died, or the cannibalistic ritual itself.”

Gough’s Cave was first discovered in the 1880s and frequent excavations at the site found evidence that humans lived there for thousands of years, including “Cheddar man,” Britain’s oldest complete human skeleton, which dates from 7,150BC.

DNA taken from the skeleton was found to match that of Adrian Targett, a man living in the local area today.

The cave is 115 meters (377ft) deep and 3.405km (2.12 miles) long, and contains a variety of large chambers and rock formations.

Human bones have been found intermingled with butchered large mammal remains as well as flint, bone, antler and ivory artefacts, including a 13,000-year-old carving of a woolly mammoth.

The team has previously found skulls at the site which had been turned into bowls or cups, possibly to eat or drink from.

Complete Article HERE!

Share
08/9/17

Crematory Is Booked? Japan Offers Corpse Hotels

Share

Part mortuary, part hotel, Japanese corpse hotels allow grieving families to spend the night near the bodies of their loved ones as they make their final farewells. Here’s a look inside of one.

The minimalist rooms at the Hotel Relation here in Japan’s third-largest city are furnished with plain twin beds. Flat-screen televisions adorn the walls. Plastic-wrapped cups and toothbrushes are provided in the bathrooms. And just across the hall are the rooms where the corpses rest.

Checkout time, for the living and the dead, is usually no later than 3 p.m.

The Hotel Relation is what Japanese call an “itai hoteru,” or corpse hotel. About half the rooms are fitted with small altars and narrow platforms designed to hold coffins. Some also have climate-controlled coffins with transparent lids so mourners can peer inside.

Part mortuary, part inn, these hotels serve a growing market of Japanese seeking an alternative to a big, traditional funeral in a country where the population is aging rapidly, community bonds are fraying and crematories are struggling to keep up with the sheer number of people dying.

By custom, Japanese families take the bodies of their loved ones home from the hospital and sit for an overnight wake followed by a service the next morning in the company of neighbors, colleagues and friends. Then, in the afternoon, the body is sent to a crematory.
Continue reading the main story

But as neighborhood ties have weakened, funerals that once involved entire communities are increasingly the province of small, nuclear families. At the same time, Japanese society is getting old so fast and deaths per year are climbing so quickly that families sometimes have to wait several days before a body can be cremated.

The funeral for Hajime Iguchi at Sousou, a so-called corpse hotel in the Tokyo suburb of Kawasaki City, last year.

The corpse hotels offer a practical solution — a place where a body can be stored at low cost until the crematory is ready, and where small, inexpensive wakes and services can be held outside the home.

“We can say the supply doesn’t meet the demand,” mainly in urban areas, said Hiroshi Ota, an official at the Japan Society of Environmental Crematories. While Japan has an estimated 5,100 crematories, Tokyo, with a population of more than 13 million, has just 26.

“The demand for cremation will increase until the baby boomers disappear,” Mr. Ota said.

Japan has funeral parlors, too, an industry that developed as people moved from the countryside to the cities and it became difficult — and often impossible — to take corpses into high-rises. But they cater to larger groups and more elaborate ceremonies, and these days, that can seem a bit much.

In the bubble economy of the 1980s, “Japanese funerals were based on showing off to other people, and people cared how they were viewed by others,” said Midori Kotani, executive researcher at Dai-ichi Life Research Institute, an arm of one of Japan’s largest insurance companies. “But fewer and fewer people talk to their neighbors, so they don’t have to show off or think about how they are viewed by them.”

The corpse hotels are used by families who want a simpler affair, or want to skip a funeral altogether. According to Ms. Kotani, about 30 percent of deaths in the Tokyo area are not marked by a funeral service, up from just 10 percent a decade ago.

After cremation, families usually keep the ashes at home for 49 days before a burial service at a cemetery. On the 49th day, according to Buddhist tradition, the dead are believed to arrive at the next world.

Mr. Iguchi’s body on its way to a crematory.

When Hajime Iguchi died at age 83 last autumn, his sister and brother-in-law held his wake and funeral at Sousou, a corpse hotel in the Tokyo suburb of Kawasaki City. Mr. Iguchi, a lifelong bachelor, had died in a nursing home after a protracted illness, and had few friends left.

“Back in the day, we used to have funerals at home, but times have changed,” said his sister, Kunie Abe, 73. “Neighbors all used to know each other and would help one another out. But today, you don’t even know your next-door neighbor.”

The demand for “itai hoteru” is likely to grow. Last year, 1.3 million people died in Japan, up 35 percent from 15 years earlier, and the annual toll is expected to climb until it peaks at 1.7 million in 2040, according to the Ministry of Labor, Health and Welfare.

About 37 percent of Japanese women who died last year were over 90, with few surviving friends to mourn them. And close to one-fifth of Japanese men never marry or father children, leaving behind few relatives to plan or attend funerals.

The number of people dying alone is also on the rise. In Tokyo, for example, the number of people over 65 who died alone at home more than doubled between 2003 and 2015, the latest year for which government figures are available.

At the Hotel Relation here in Osaka, about a third of the customers forgo a formal funeral. Instead, they sit in the rooms with their dearly departed for a day or two, with only close family in attendance, and then send the bodies for cremation.

Relatives of Mr. Iguchi departing the crematory with his ashes.

“In the past, if you heard someone held a funeral just for family members, people in the neighborhood would say, ‘What kind of people would hold a family-only funeral?’ But now it is accepted,” said Yoshihiro Kurisu, the hotel’s president.

Corpse hotels are more economical than large funeral homes. According to the Japan Consumer Association, the average funeral in Japan runs 1.95 million yen, or about $17,690. The cheapest package at the Hotel Relation costs 185,000 yen, or about $1,768.

The package includes flowers, a room for the family to spend the night in the same room as the corpse, a traditional white gown for the deceased, a simply decorated coffin, transport of the body from the hospital and then to the crematory, and an urn to hold the ashes. Each additional night costs 10,800 yen, just under $100. Families who want separate rooms, wakes or funerals pay extra.

“Itai hoteru” first appeared about five years ago in Japan’s largest cities, and there are only a few across the country. Some have angered residents who do not want to live in such proximity to death and mourning.

Near the Sousou hotel in Kawasaki City, signs on fences protest, “Corpse storage: absolutely opposed!”

Hisao Takegishi, the hotel’s owner, said he understood why neighbors were uncomfortable. But he said his staff tried to be as discreet as possible when bringing in bodies.

A cemetery outside Tokyo. Nearly all people who die in Japan are cremated.

Inside, Mr. Takegishi painted the walls in pastel colors and equipped the rooms with green sofas and stools. They look more like start-up break areas than a setting for wakes or funerals. The entryway, with shelves of plants and a few books, evokes a spa.

“I did not want it to look too sad or lonely,” he said. Sousou has relationships with funeral directors and monks, and can help clients plan modest services.

Yuki Matsumoto, the executive director of the All Japan Funeral Directors Co-operation, which represents about 1,340 long-established funeral homes, said some owners of the new businesses paid little regard to standards or the dignity of the dead.

Japan does not require a license to open a funeral business, and there are few regulations for how they operate. “So in this situation, it is possible that bad-intentioned businesses can enter the industry,” Mr. Matsumoto said.

But Mr. Kurisu at the Hotel Relation said traditional funeral homes just resented the new competition. “I am hated by people in the business because I am driving down the prices of funeral services,” he said.

At Mr. Iguchi’s tiny funeral ceremony last fall, a monk chanted last rites as his body rested in a coffin lined with white satin. Five guests, all relatives, sat in folding chairs nearby.

After the chanting, they rose to lay flowers and origami cranes on Mr. Iguchi’s body, making a bright garland around his head and on his chest.

His sister, Mrs. Abe, leaned close to her brother’s ear. “So long,” she whispered.

Complete Article HERE!

Share
08/5/17

A good death

Share

It would be foolish to think that we can control when our time is up. But neither should we face that moment unprepared. Not only for our sake, but for the people we leave behind.
 

By Vivien Shiao

THE only certainty in life is death. But this is not something we like to think about – not when we are at our prime, our careers powering ahead, and the future bright. In fact, as you flip through the papers, about to tuck into a nice brunch with loved ones, you may even question why we want to mention it at all, potentially casting a pall on a perfectly good weekend. The reality is, there are just as many ways to die as there are ways to live. It can come like a thief in the night, sudden and without warning. For others, death comes as an impending train – relentless and closing in. Or sometimes, long after the body and mind have withered, death still does not come. As the ultimate human experience we all cannot run away from, it matters how we approach death. How we live the rest of our days depends on it.

What a good death means

A good death is hard to define. In many instances, the process of dying is described as a battle to be won, a fight between life and death. Rage, rage against the dying of the light, wrote poet Dylan Thomas.

But doctors intimate with death tell The Business Times that this struggle to extend life without thought to its quality is not necessarily what people want.

Dr Ng Wai Chong, chief of clinical affairs, Tsao Foundation, is a physician who is well acquainted with death. To him, a good death is the ultimate challenge. “It is one with a good mind, one that is peaceful, one that has closure. All the big questions in life have been answered… To prepare for a good death, you need to live a life that is responsible and with a clear conscience.”

Those who are prepared are typically contented, accepting and also grateful, says Dr Ng. For Dr Neo Han Yee, a palliative care consultant at Tan Tock Seng Hospital, a good death means a life of little regret or guilt, and being at peace knowing that loved ones will be taken care of. “It is difficult to achieve zero suffering, but on a spiritual aspect, these people feel that their lives have been worthwhile and they are ready to move on.”

A good death also has a social dimension, he explains: People with the “foresight” to invest their time and effort in relationships, in turn, receive support in their last days from family and loved ones. They are the ones with the wisdom to prepare early and help family members cope with their impending passing, he says.

Planning for the end

A good death doesn’t come by accident. It takes planning and preparation in many aspects – financial, legal, psychological, social, medical, and even spiritual – to make it happen. This is not just to ease one’s passage, but also to ease the burden on loved ones.

If the end-of-life process is a long drawn out one, the stakes are even higher. For example, if you become mentally incapacitated due to your illness and your children have no idea what your last wishes are, they could end up spending tens of thousands trying to treat you, in the hopes of extending life.

Not only could this increase your distress in your last days (though with no ill intention), the lack of clarity is likely to result in conflict among family members, and financial issues. Such a scenario may seem like the stuff of TV dramas, but it is a lot more common than you think, according to experts that BT spoke to. So, rather than wait for a crisis to strike, it may be prudent to plan ahead when things are hunky dory and you still have sound presence of mind. This could prevent unnecessary expenditure, heartache and headache for others further down the road.

Alfred Chia, CEO of financial advisory firm SingCapital, says that procrastination is one of the biggest mistakes that people tend to make regarding their finances. He is also the co-author of Last Wishes: Financial Planning, Will Planning and Funeral Planning in Singapore. “Planning for death should not be viewed as taboo or negative. In fact, it is a celebration of our life in this world,” Mr Chia says. He advises people to plan for retirement early to avoid “huge financial stress” later. Work out the amount needed each month for the ideal lifestyle post-retirement and the number of years you expect to provide for, he says. The right insurance policy can also help achieve your goals in a more cost-effective way, he adds.

Other mistakes he has observed others make is to fall prey to financial scams, and to invest in instruments that don’t suit their risk profile. He says: “There is a saying that when I pass on, I have not spent all my money. While that is a regret, it will be even more regretful if I have spent all my money, and yet am still alive with no capacity to earn an income.”

On the flipside of the coin, those who are extremely wealthy have even more compelling reasons to plan. To manage their wealth, they often turn to family offices – private wealth management advisory firms.

Mr Chia says that planning ahead for the wealthy can help keep family unity and prevent squabbles over inheritance. Family offices can also spread the distribution of wealth over an extended period so that the children won’t be “spoilt” with the sudden wealth, he adds.

Working with the law

When life ends, a host of issues crop up for loved ones, that can only be properly resolved within the confines of the law.

Most people know the significance of wills, but there are other considerations such as trusts and Lasting Power of Attorney, or the LPA.

A will is for the distribution of assets after one’s death, while an LPA is for the appointment of a person or persons (known as the donee) to make decisions for you on “health and wealth” before your death.

Doris Chia, litigation partner of David Lim & Partners, saysthat most people with elderly parents would want to do an LPA, so that they are able to access their parents’ bank accounts or assets to pay for their parents’ medical bills when their parents are unable to do so.

One thing to bear in mind is that the LPA only kicks in in the event of loss of mental capacity. So although you may do an LPA now, it may only be valid decades later, says Ms Chia. Or, it may never come into effect at all if the person who appointed the LPA remains mentally healthy.

Ms Chia also warns that the LPA comes under the Mental Capacity Act, which means it can only be made by a person of sound mind. Once there is an onset of a mental issue such as Alzheimer’s or senile dementia, it will be too late to make one.

The consequences can be serious. She cites an example where the mother of one client became mentally incapacitated and then fell ill, and the client was unable to sell a private property that she owned jointly with her mother.

Without an LPA, she had to apply to the court for deputyship to sell the property, to fund her mother’s medical needs. This process cost “tens of thousands of dollars”, according to Ms Chia.

“A person applying to be a deputy has to file several affidavits in court. This also costs money. You can save all this heartache now by doing an LPA. What’s the harm?”

According to the Office of the Public Guardian, the fee for LPA certificate issuers ranges from S$25 for a general practitioner to S$500 for a psychiatrist – still much more affordable than applying for deputyship.

Another group of people that Ms Chia urged to apply for LPAs are singles, and people who identify as LGBT (lesbian, gay, bisexual, transgender).

“For LGBT people, it is essential to do an LPA as it allows the partner – and not family members, if that is your choice – to make decisions on your personal welfare and property and affairs. Otherwise, legally, your partner has no say over such matters in such circumstances.”

Where there’s a will

Aside from the LPA, the will is another matter to be considered seriously. For non-Muslims who die without making a will, distribution of assets will be according to the Intestate Succession Act. For example, the surviving spouse will get 50 per cent of assets, with the rest divided among their children. For singles, the assets will go to their living parents. Otherwise, it will go to their siblings.

Muslims follow the Muslim intestacy law, the faraid. Only one-third of their assets can be willed away, with the rest distributed according to the faraid.

For those who don’t want to follow the standard distribution rules, making a will is vital. Some people, Ms Chia has observed, don’t trust their spouses too much and prefer to give everything to their children.

The existence of a will gives much quicker access to assets. For people who die with a will in place, a Grant of Probate allows the process to move much faster compared to the Letter of Administration for those who die without a will, says Ms Chia.

Even so, the existence of a will is no guarantee that it will be carried out. It may be hidden, or lost, or challenged. It’s important that the executors of the will – those who will administer and distribute your estate upon death – know where the will is, together with proper instructions on bank accounts, assets and insurance policies.

Details make all the difference. “I always say to my clients, do a will that can last many years,” says Ms Chia. “Don’t say Property A goes to one son, and Property B goes to another son. If you sell Property B and you forget to amend your will, one son will end up with nothing.”

Instead, she recommends that the executor be instructed to sell all assets and for the proceeds to be distributed according to percentages.

State of mind and health also matter. It’s better to make a will when you are healthy and of sound mind so that there will be no dispute later, Ms Chia advises. She observes that most people do not think about end-of-life decisions until they are forced upon them. But wills are sometimes contested if the person had made it when they were very old or very sick.

Giving the assets in a trust, as opposed to in a will, prevents challenges by family members, says Ms Chia. Often used for succession planning, a trust protects family assets for the good of beneficiaries who are either too young, financially immature or vulnerable until they either come of age or reach a certain maturity.

The assets put into a trust are a gift made in a person’s lifetime, and not upon his death. Once the assets vest in the trust, they no longer belong to him. The assets will not form part of his assets at the point of his death and hence, a trust cannot be contested, explains Ms Chia.

Having a trust could also mitigate the heavy taxes applicable to estate duty in certain overseas jurisdictions, or safeguard assets from the possibility of lawsuits by creditors.

One particular group that can benefit are family members with special needs, she adds. Setting up a trust with that particular person as the beneficiary is a way to plan for a day when one can no longer care for him or her in person, says Ms Chia.

A conversation about care

Perhaps, due to cultural mores, or perhaps the need to “protect” their parents, some children refuse to even talk about death with their elderly parents, even as it is looming.

Sometimes, the severity of their condition – or even the amount of time they have left – is deliberately kept from them by well-meaning family members, thinking that mentioning it will result in emotional instability.

TTSH’s Dr Neo observes: “Quite often, when a person is so sick, family members are pushed into a corner. They don’t know how to broach the topic.”

But doctors and healthcare professionals are actively trying to change this mindset with the introduction of the Advanced Care Plan (ACP). It is a voluntary discussion on future care preferences between an individual, his or her family and healthcare providers.

While not legally binding, it describes the type of care the person would prefer, if he or she is to become very sick and unable to make healthcare decisions in the future. Compared to the Advanced Medical Directive (AMD) which has a very narrow scope of criteria, the beauty of the ACP is in the conversation, says Dr Ng from the Tsao Foundation.

“The goal is to respect a person’s rights to self-determination. It encourages people to think about existential issues and helps the people conducting it to get into the value system of the person. Scenarios might change, but the general drift is there, so it will bring some clarity.”

Otherwise, caregivers who don’t know what patients want will end up going on the “path of least resistance”, which often means over-investigation of treatment, says Dr Ng.

An AMD allows you to register in advance your wishes not to have any extraordinary life-sustaining treatment to prolong life in the event that you become terminally ill and unconscious and where death is imminent. However, the definition of a “terminal illness” is extremely specific.

Among the wealthier and more educated patients or caregivers, Dr Ng has also observed a sub-group of people who approach medical conditions with a consumer attitude. Instead, he advocates having a doctor as a lohealth partner that you can trust, with a relationship built over a long time.

“I see people over-treat, over-investigate, but a primary care doctor is a better way of managing health. The person can help you clarify your purpose, your goals and the best strategy to proceed. Along the way, he can even do your ACP with you and be a facilitator when it comes to complex family dynamics.”

Beginning with the end

It is not just the medical aspect of health that people should take into account in their last days. There’s also the need to think about the social, emotional and psychological state of the person.

TTSH’s Dr Neo explains that the intensity of pain is often heavily coloured by one’s emotions. To cope with the end of life, people must build up psychological preparedness and fortitude, he says.

To him, thinking about death is constructive for thinking of life.

He observes: “Life is impermanent. You treasure people around you a lot more, you don’t waste time on things not worth it. You invest your time and effort in things worthwhile. You know how to value relationships much more, so when the time comes, you will be wiser as you have thought about it for a longer period of time.”

To build psychological maturity, he advises people to find a higher meaning in life, or a certain “calling”. Singaporeans tend to forget this, he notes, as we trudge along in our work and family life. Happiness is always projected in the future, instead of finding meaning in one’s current existence.

At the crux of it, people are too busy trying to beat each other or accrue financial gain to think about their own vulnerability, says Dr Neo.

“We live in a very illusory world. Only when a crisis hits then will the person be shaken and realise that life is fragile. If we don’t make mental, emotional and financial preparations before, you will find it hard to cope with the situation. We often underestimate how much we can prepare for death.”

No one can predict how much time we have left on this Earth. But if we put in as much thought about how we want to die as much as we think about how we want to live, surely our days here – limited though they may be – will be all the more precious and meaningful.


What you need to know

Will

  • Make sure your executors can find it. Ms Chia from David Lim & Partners cites an incident when a client made a will and was so secretive about it that his family couldn’t find it after his death. Be aware also that:
  • The will is sometimes contested if it was made at a time when the person was very old or ill.
  • CPF nominations and insurance policies with a named beneficiary are not part of the will.
  • Property – private or HDB – held in joint tenancy will automatically go to the survivor and hence cannot be part of the will for distribution.

Lasting Power of Attorney

  • Can only be used when the person who makes it (the donor) loses mental capacity and is only valid when the donor signs it when he is of sound mind.
  • One fear that people have about LPAs is that their children or donees can “help themselves” to the donor’s money when he or she is mentally incapacitated. Ms Chia debunks this: The money can only be used for the person’s welfare and medical expenses, and they will need to submit accounts to the Office of the Public Guardian, which serves to safeguard the interests of individuals who lack mental capacity and are vulnerable. In addition, more than one donee can be appointed to guard against dishonesty.

Trust

  • Anyone can set up a trust, says Ms Chia, but the costs are higher compared to arranging a will, or even setting up a private interest foundation, an entity which has the characteristics of both a company and a trust. “If the trust requires professional trust managers to make investment decisions or payments over several generations, this will cost money to administer. One needs to weigh the asset value against the cost of administering the trust,” she says.

Advance Medical Directive

  • Legally binding, but very narrow definition of “terminal illness”.
  • The AMD registry is only accessible during office hours. A doctor facing an emergency situation in the night will be unable to retrieve and verify an AMD. In fact, the AMD Act Section 15 has also been frequently interpreted as an offence for a doctor to query his patient about his AMD, according to Dr Neo of TTSH.

Advance Care Plan

  • Puts everyone on the same page, as it describes the type of care you would prefer, if you become unable to make healthcare decisions in the future. U For people with an ACP, the palliative care is much smoother for everyone involved as they don’t feel burdened with tough decisions, says Dr Ng of Tsao Foundation.
  • Not legally binding, and can be changed and reviewed, preferably with your primary care doctor or the main doctor tending to your advanced illness.

Complete Article HERE!

Share
07/15/17

The long goodbye: Home burial can bring comfort

Share

BY CATHERINE ASHE

I never had any reason to think I’d have to plan my own child’s funeral. And yet, last July, that’s exactly what my husband and I found ourselves doing. Our unborn son, James, had just been diagnosed with trisomy 18, a terrible chromosomal disease, at 32 weeks of gestation. We’d read the grim statistics for this disease, the second-most common trisomy after Down syndrome (trisomy 21), and we knew that his time with us was likely to be short.

This awful news forced us to confront impossible questions: How did we want his brief life to look? How did we want him cared for after death? Instead of buying diapers and looking at cute baby boy clothes at Target, I was looking at cemeteries and trying to decide between cremation and burial. At 32 weeks pregnant in the miserable summer heat, I was writing a eulogy for my unborn child.

Catherine Ashe and her son, James

During this time, I came across a beautiful article written by a grieving mother whose adult daughter had died at home in hospice care after battling cancer. The writer cared for her daughter’s body, held an extended at-home visitation, and then buried her daughter at home. The article moved me to tears, because it captured perfectly how I feel about death.

In a society where death is largely relegated to hospitals, impersonal mortuaries and mass cemeteries, home burial has fallen by the wayside. Yet just a generation or two ago, death was recognized as a natural part of life. The deceased’s remains were handled by the family, and burial was done at home, in a family plot. Visitations often lasted for days. There was time for loved ones to say goodbye in a peaceful, familiar and welcoming environment.

After reading that article, I started researching North Carolina’s funeral and burial laws, and what I found surprised me. Home burial is permitted, as long as the interment is on private land, and just about anyone can transport the body. At no point does a funeral home have to be involved. The only specific regulations involve burial of a body too close to a reservoir or other public water source.

When James was born, he surprised everyone with his strength. He had five wonderful months with us. During his 154 days on earth, he was always with either me or his father. We cared for him through the good times and the bad. He was a fat, contented baby with big blue eyes and crazy brown hair.

On Jan. 2, 2017, he slipped out of this world, cradled in our loving arms. At that point, he was a patient in Mission’s pediatric intensive care unit. After his death, we held him, his grandparents and uncles held him, and his care team said goodbye to him. And then we simply walked out of the hospital, carrying James in our arms. We had cared for him in life; now we would care for him in death.

On Jan. 3, we hosted an extended visitation at our house. This was made possible by a CuddleCot — a cooling device that will preserve a small body for quite some time. It’s a noninvasive alternative to embalming. During my research, I’d also learned that embalming a body isn’t necessary: Cooling serves the same purpose.

Thanks to the CuddleCot, we were able to have James at home with us so we could say goodbye. Prior to his birth, I’d read about other parents doing the same thing — and at the time, much as I’m ashamed to say it, I thought it was morbid. Why would you want your child’s body in the house with you?

It wasn’t till James died that I understood: James was still James. Nothing changed when he died. He was still my baby. It seemed only natural to bring him home to the place he’d known his whole life, to give us time to adjust to losing him, to give his sisters (ages 3 and 5) time to see him, say goodbye and understand that he was gone.

His visitation was lovely, as lovely as something so tragic can be. My husband and I were in our own home, so we were comfortable, able to retreat into our bedroom when we needed to, and there was no established time frame limiting visits. We spent two nights with him, saying goodbye, telling him all the things we wanted him to hear.

On Jan. 4 at 4:52 p.m. — the same time of day he was born — we buried James in our backyard with over 100 people in attendance. His presence there, in the yard where his sisters play, brings us comfort on some very dark days: Though his spirit is gone, his earthly remains are nearby. We visit him often, keep fresh flowers on his grave and have wind chimes in the maple that he’s buried beneath.

I hope that by writing this, I can help others realize that home burial is possible for their loved ones — all of them, not just children.

Complete Article HERE!

Share
07/5/17

Navigating the end of the road

Share

Death doulas offer education, support to those seeking alternative options while dying or grieving

A screenshot of a video documenting a home funeral shows family members visiting their deceased loved on in a home setting. The video was produced by Lee Emmert and the University of Oregon’s School of Journalism and Communications Department.

By Courtney Vaughn

When both of her parents died six weeks apart, Nancy Ward had to confront death in a profound way.

She was lucky, sort of. Her parents had prearranged for their care after their deaths, but Ward recalls being uneasy with the post-mortem process when her father died of congestive heart failure.

“Up until this point, I had never seen a dead body because I was about as death-phobic as they come,” Ward says. “A man came into the room, he looked about 14, and unrolled a black plastic body bag on the gurney. I’m going, ‘Oh my God. This man was just living and breathing and now you’re gonna put him in a black plastic bag and do what?’ Put him out on the curb for waste management to pick up?”

Ward succinctly recalls the emotional sterility of the situation.

Nancy Ward

“This doesn’t feel right, this doesn’t feel good, it doesn’t feel loving, or respectful,” she thought to herself. “He doesn’t know my father. I know my father.”

Six weeks later, her mother died.

“I knew what was coming and didn’t like it, but I had nothing to replace it with,” Ward says.

Afterward, she became a death midwife, or “death doula” as some call it, availing herself to others so they didn’t have to go through the same process she did with her parents.

Ward is now used to confronting death. In fact, she and others have made a living out of it.

A few years ago, Ward and other colleagues in the death directives industry teamed up to form the End of Life Care Collaborative. Members help educate and guide people in their quest for home funerals and other self-directed death practices.

The group focuses on serving those who are dealing with the death of a loved one, or preparing for their own death.

Services range from home funeral preparation and arrangements, to help with navigating the traditional funeral process, to emotional and practical support for those delving into the end of their own lives, and a gamut of other services to serve those confronting death.

The ultimate goal, members say, is to help people achieve greater meaning, or a more comfortable process around dealing with death and accepting loss. To get there, clients must be willing to shake off some of the cultural stigma of death.

“As a society, we aren’t comfortable with dealing with death because it reminds us of our own mortality,” Ward says. “We think everybody should know what their options are and right now, they don’t. We’re trying to reach the people who want it done differently but don’t know what different looks like.”

Ward and the collaborative team help educate people on what their options are for preserving a loved one at home after they’ve died, or bringing the body of a loved one home if they choose.

Ward says most members of the collaborative try to operate on a sliding-scale fee system, to make sure no one is turned away because of finances.

“We all have different areas we like to focus on and that’s what makes the collaborative so important,” she says. “We can do everything from the totally esoteric to the toally practical.”

That means being a listener and helpful guide, or doing a load of laundry or providing a meal for a grieving household.

She points to a recent client she worked with- a woman dying of cancer- who wanted to be prepared when her final moments came, but more importantly, wanted to rely less on her family for her physical and emotional needs.

“She said, ‘my family is having a really hard time with this …I don’t want to burden them with my own questions and expressions, this is what I need you for,'” Ward recalls.

“Their psychological and emotional needs are unmet,” Ward says of many terminally ill patients. “My involvement is just simply working with the person on a psychological, spiritual, emotional level.”

Members of the collaborative are not isolated in their quest to provide resources and support for death directives, but their services aren’t widely available, or even widely culturally accepted.

Asher Wallis

“I have seen a good deal of anxiety arise from family members who are trying, in the midst of disorienting grief, to figure out what their loved ones, who had not planned logistically or financially for the events that would follow their death, would have wanted,'” Asher Wallis, an End of Life Care Collaborative member and grief counselor, explains.

He attributes some of the sources of that unnecessary stress to “culturally sanctioned misinformation about the physiological and psychological nature of dying such that both the family caregivers and the dying person think they are doing it wrong.”

Deborah Threadgill, a collaborative member who is also a certified funeral director, says the End of Life Care Collaborative focuses on making “everything family-directed,” meaning they never suggest or push services on clients. Rather, they try to educate them on their full range of options surrounding death and dying.

“We take something that is very, very traumatic in our society and taboo and make it something natural and beautiful,” she says.

Complete Article HERE!

Share
06/30/17

I’m terrified of dying — and, apparently, so are you

Share

Every Sunday Mindy Gillenwater volunteers for hospice care at the Robison Residence. Over the course of four years she as served as a companion to many patients like Kevin Sweat.

by Richard C. Gross

When I once conveyed concern to my father about his eventual death, his matter-of-fact response was, “We all die.”

And he did. At 89, of complications of pneumonia. Some say it was the best way to greet the hereafter: He went to sleep, into a coma, helped by doctor-administered doses of morphine. Yet when the ambulance initially came for him at the assisted living facility, his light brown eyes widened with fear.

I’m deathly afraid of dying. The idea of no more Richard weighs on me the older I get, and I’m getting up there. There’s so much more to do, so many more people to meet, so much to see, so much to live for, so much more to know. But there is no cure for aging.


 
I learned my fear of dying is not irrational; I have lots of company.

“Death is still a fearful, frightening happening, and the fear of death is a universal fear even if we think we have mastered it on many levels,” wrote Swiss-American psychiatrist Elisabeth Kübler-Ross in her seminal 1969 book, “On Death and Dying.”

Cultural anthropologist Ernest Becker, in his Pulitzer Prize-winning 1973 book, “The Denial of Death,” writes that “anxiety about death is a constant fact of life for everyone and that it is the underlying cause of the many other fears and phobias people experience.” Fears of being alone or stuck in a confined space, for example, are substitutes for fear of death.

Maybe singer Neil Diamond, now 76, expressed those very fears in the lyrics of his 1971 song about loneliness, “I Am … I Said:”

“But I got an emptiness deep inside/And I’ve tried/But it won’t let me go/And I’m not a man who likes to swear/But I never cared/For the sound of being alone.”

Alone or not, one’s mortality and the inevitability of death becomes more real the older we get, especially as relatives, friends and onetime coworkers — people with whom we’ve spent many years — die, shrinking our world, reminding us with a jolt that one day we will join them. Attending funerals becomes commonplace.

Seeking others for opinions about the fear of death, I attended a 90-minute seminar, called “Santa Fe Doorways,” hosted by Denys Cope, a registered nurse for nearly 50 years, including about 30 of them in hospice care. About 30 elderly people attended, all but three of them women; we sat in a wide circle in a windowless room in a retirement home.

Ms. Cope said, “We are all hard-wired to fear death,” and threw out a question: “When you think about death, what matters to you most?”

“To be able to die resting in God’s mercy,” replied one woman, acknowledging she is Christian.

Deep faith in one’s religion must be potently comforting, providing virtually certain assurance of peace as death approaches, perhaps, as another woman said, because of an abiding belief in an afterlife. Enviable. And for the secular among us?

One white-haired man, who experienced a near-death episode, approached the subject lightheartedly, maybe because he appeared so organized. He said he since has written his own obituary, letters to his loved ones and has paid for his cremation. This is a man who will meet his maker head-on.

Another woman took an amazingly positive approach toward death, reveling in its opposite: life.

“What I love about death is thinking how I’m going to live,” she responded to Ms. Cope’s question.

I’m not as sanguine and stubbornly turned back to Becker’s “Denial of Death” to reinforce my feelings about dying. For me, he hit a bull’s eye:

“This is the terror: to have emerged from nothing, to have a name, consciousness of self, deep inner feelings, and excruciating inner yearning for life and self-expression — and with all this yet to die. It seems like a hoax.”

Ms. Cope has another way of looking at death.

“When first faced with the fact they are dying, many people experience a tremendous amount of fear,” she wrote in her 2008 book, “Dying: A Natural Passage.” “Often, I am told, it is not death but the process of dying that is frightening. … As long as we remain attached to this world and to our life, it is a struggle to die. … When we surrender to the process of dying, there is an incredible inward flow of peace and grace.”

I hope I can surrender.

Complete Article HERE!

Share