Category: Talking about death

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How to have a green burial

‘Current Western funeral practices do prevent a return to the earth’

Duffin-Meadows Cemetery in Pickering, Ont., has a green burial section. There are no individual grave markers. Names are listed on one of four communal monuments by a central pavilion.

By Kevin Yarr

A student of philosophy and biology at Mount Allison University in Sackville, New Brunswick, wants to get people talking about more environmentally-friendly burial options.

Environmentally-friendly burials were the norm for people for tens of thousands of years says Hanna Longard, but in recent decades embalmed bodies, heavy caskets and non-compostable liners in graves have become the norm.

“We come from the land, and so it really to me makes sense that our practices should not inhibit the natural process of decomposition,” said Longard.

“Current Western funeral practices do prevent a return to the earth.”

Opening up a conversation 

Green burials differ in a number of ways from what has become the traditional Western practice.

  • Embalming with compostable fluids.
  • Compostable casket with no lacquers or varnishes.
  • Shallower grave, three to four feet deep, to put the body in range of active root systems.
  • Minimal grave marker.

Longard said cremation is not a particularly green option, because of the emissions involved.

“You take up less space if you’re cremated, is a common idea, because you’re not taking up space on land in a grave,” she said.

“However, you end up taking up space in the atmosphere as excess greenhouse gases.”

Longard has been talking to politicians, people in the funeral industry, and others interested in green burials about options where she goes to school in New Brunswick and around her home town in Mahone Bay, N.S.

Student Hanna Longard is hoping to start a conversation in the Maritimes about green burials.

She has found green burial can be a difficult option to pursue. In Nova Scotia, it is possible to arrange for a burial on private land, but P.E.I. burials have to be in cemeteries. Ontario and British Columbia both have cemeteries that are specifically designed for green burials.

Longard is hoping to start a conversation in the Maritimes about green burials.

Complete Article ↪HERE↩!

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20 physical, behavioural and emotional symptoms of grief and bereavement and how to overcome them

It’s a different road for everyone, but these suggestions could help…

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The death of a loved one is one of the hardest things an individual can go through, and there’s no set formula for how their grief will manifest itself.

Bereavement affects everyone differently, and at times it can leave you feeling bereft, alone, hopeless or angry.

The Coping with Bereavement guide from older people’s charity Independent Age reminds us that: “There’s no one way of grieving – everyone deals with bereavement differently. There’s no expected way you should be feeling or set time it will take for you to feel more like yourself again.”

And it’s not just our emotions that are in disarray after the death of a loved one, our bodies feel it, too. Like any other form of emotional stress, the body has a physical reaction which can further add to the sufferer’s distress.

With guidance from the team at Independent Age, here are the physical, emotional and behavioural symptoms of grief. It can be reassuring to know that what you are experiencing is normal, and that the symptoms of grief can be far-ranging. However, if you are worried about anything you are thinking or feeling, including physical symptoms, it’s a good idea to speak to your GP.

Physical symptoms of grief

People are often less aware of these, but grief can affect your body just as much as it can affect your emotions. This is related to the stress of the situation. Everyone is affected differently, but you might experience:

  • Exhaustion.
  • Breathlessness.
  • Aches and pains, such as chest pain and headaches.
  • Shaking and increased heart rate.
  • Feeling sick.
  • Upset stomach.
  • Oversensitivity to noise and light.
  • Skin problems and sensitivity.
  • Lower resistance to illness in general.
  • Panic attacks.

Emotional feelings of grief

Your feelings can be chaotic after a death and this can be overwhelming and sometimes frightening. However, this is usually normal and intense feelings tend to ease over time. Emotional symptoms can include:

  • Anxiety – including worries about your own mortality.
  • Relief – for example if someone died after a long illness.
  • Irritability – although family can be a source of support when you’re grieving, family quarrels are not uncommon after a death.
  • Feelings of detachment – these are particularly common in the period just after the death. You might feel detached from your life, but these feelings usually fade over time.
  • Depression and loneliness.
  • Troubling thoughts.

Behavioural impact of grief

Bereavement can also affect your behaviour. Again, you might expect some of these effects, such as being very tearful, but not others. You might experience:

  • Restlessness or hyperactivity – this can be a coping mechanism.
  • Inability to concentrate – you might be preoccupied with the death and go over and over what happened.
  • Disturbed sleep or nightmares – nightmares and flashbacks can be more common if someone has died through suicide or other traumatic death.
  • Loss of appetite or comfort eating – which can of course also cause physical changes to your weight.

WHAT CAN YOU DO TO HELP EASE GRIEF?

The Independent Age guide explains that it’s really important to be kind to yourself and do things that help you. This doesn’t mean ignoring your grief – allow yourself to feel sad and give yourself time to grieve and remember the person in your own way.

Allow yourself to also grieve for any secondary losses you may experience after a death, for example, having to move out of the family home or no longer having to maintain a role such as mother, wife, career etc.

1. Talk about it

Talking to others about the person who has died, your memories of them, and how you’re feeling can be very helpful. You might want to talk to:

  • Other people who knew the person you have lost
  • A GP
  • Counsellor – more info here
  • Helpline adviser – more info here

  • New research from Independent Age has revealed that almost half (44%) of the sandwich generation (40-64 year olds) do not feel comfortable talking to their parents about death. However, according to the older generation surveyed (over 65s), 58% think it’s important to open up about death. Janet Morrison, Chief Executive of Independent Age says:

    “It’s understandable that many people struggle to talk about death and final wishes. As a nation, we need to start embracing these conversations and promote a positive change in how we perceive and talk about this subject. We don’t expect this to change overnight, but it’s time to take action, be brave and talk about death.”

2. Books that might help

Many people find it consoling to read about other people’s experiences of grief. This can help us to process our grief and feel less alone in our experience. This could be particularly valuable in the early days after a death, when you might not feel ready to talk to others.

You can try:

1. Cruse Bereavement Care – Recommended reading list
2. The Compassionate Friends – Recommended reading list. The Compassionate Friends also operates a postal lending library.
3. Your local library
4. Your GP may also be able to recommend self-help resources.
5. Overcoming Grief, part of the Overcoming self-help series, endorsed by the Royal College of Psychiatrists.

3. Take practical steps

It’s easy to stop caring for yourself when you’re grieving, but a few simple things can help to make this period easier:

  • Try to get plenty of sleep.
  • Eat healthily.
  • Be kind to yourself and don’t put pressure on yourself to feel better too quickly.
  • Avoid numbing the pain too much with things like alcohol, which won’t help you in the long run.
  • Try to keep to a routine – it might feel easier to stop doing things and seeing people, but in the long run this can make you feel worse.
  • Try returning to activities you enjoyed before you were bereaved such as going for a walk, listening to music or swimming.
  • Find small things that help you feel better, like buying yourself flowers.

Complete Article ↪HERE↩!

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Every Estate Plan Should Include These Documents

By Evan Levine, ChFC

Approximately 64% of Americans don’t have a will. Are you one of them? If you pass away without a will, it means you have died “intestate.” When this occurs, the intestacy laws of the state will distribute your property at death. Dying without a will creates many hassles for your loved ones: A probate judge appoints your executor, you have no say in distributing your property, and a judge will decide who will raise your kids if they are minors, to name just a few.

The inflexible nature of intestacy rules will fail to account for special situations or unique circumstances. Serious problems can arise in situations with second marriages, and estates that pass by intestacy rules are more likely to become the subject of litigation.

Estate Documents Every Adult Should Have

Regardless of age, income or occupation, every adult should have the following estate planning documents: 

Will: A will is the heart and soul of your estate plan. It will transfer your assets, appoint a guardian for minor children and name an executor—the individual or institution that takes charge of your estate after you die and distributes your property per your instructions.

Durable Power of Attorney: This document appoints a trusted friend, family member or advisor as an agent to act on your behalf in a variety of financial and legal matters. (For related reading, see: Power of Attorney: When You Need One.)

Health Care Proxy: Sometimes referred to as a health care agent or health care power of attorney, this document authorizes someone to make medical decisions on your behalf. You also may want to consider obtaining a living will (also called an advance directive), which expresses your preferences about certain aspects of end-of-life care. These issues may be covered in the health care proxy or in a separate document.

How to Obtain These Documents

The best way to get these documents drafted is through an estate planning attorney who practices in your state. If you know of one, call them and arrange a meeting. Once they learn about your overall situation and objectives, they may offer recommendations that go beyond the basic documents recommended in this article. Nothing beats personalized advice and planning from a specialist who thoroughly understands your situation and what you want to accomplish. If you don’t know an estate attorney, try to get a referral from a friend, family member or colleague.

If you can’t or don’t want to meet with an estate attorney for whatever reason, you have online options for drafting these documents, which is certainly better than doing nothing. Three of the more popular online resources for drafting estate planning documents are: Quicken Willmaker, Rocket Lawyer and Legal Zoom.

There is a famous expression: “You can prevent what you can foresee.” When you foresee the problems of dying intestate, you can prevent such problems by drafting the estate planning documents covered in this article while you are alive and well. If you’re one of the 64% of Americans without a will, what are you waiting for? The future is uncertain, so get started today!

Complete Article ↪HERE↩!

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How to honor and execute a loved one’s wishes is a conversation worth having

By Judson Haims

While I enjoy almost every day of my job, I am often faced with formidable challenges. One of the most difficult challenges I encounter is discussing plans for end of life with family members, clients and my contemporaries.

During the course of life, most people are required to handle many stressful situations. One of the most stressful and life altering is dealing with the passing of a loved one. Even when families have had the forethought to discuss a shared plan and how to honor and execute the loved one’s wishes, managing emotions, fears and anxieties of family and friends can be tenuous.

When a loved one’s life nears its end, so many areas need to be addressed. Often, it is easy to become overwhelmed and, thus, become immobilized. However, for those who have chosen to accept that the end will eventually come and have taken the time to develop a thoughtful plan, much emotional pain can be spared.

Some of the specific topics that need to be addressed in developing a plan include:

“It is obviously one thing to write about what you should do to initiate these difficult, but necessary, discussions. However, it is quite another issue to face the reality of what to actually say when you are facing a loved one and thinking about how best to break the ice with the topic of death and dying.”

  • Where does the person wish to die, at home, a nursing home, hospital?
  • Who will be a caregiver until the very end? Will it be a family member or friend? Will they have the fortitude to assist properly? Will it be a homecare agency or hospice?
  • What do they want as far as medical intervention, and who is going to make sure the passing person’s wishing are going to be honored and run as smoothly as possible? (Don’t assume a spouse or child will be the best choice.)
  • Establish advanced directives and medical and financial powers of attorney.

For those who have not yet had to experience end-of-life discussions and planning, you will eventually. Don’t shy away from the hard discussions.

It is important to make time and find a place to begin discussions revolving around end-of-life issues. Maybe a group situation might make it easier, such as during a time when families gather together. These conversations can benefit from the “safety in numbers” theory and tend to be more philosophical than one-to-one situations.

Generally speaking, there are four steps to expressing end-of-life wishes:

1. Ask the right question.

2. Record those answers.

3. Discuss among the pertinent people (i.e., family members, loved ones, doctors, attorneys, etc.).

4. File documents. Make certain the important documents are filed on your computer, given to medical providers, family and anyone else who may be involved in advocating.

For those who would like to learn about which documents should be in place when planning for end of life, here are some to consider: advanced directives, living wills, medical durable power of attorney and do not resuscitate orders. Here in Colorado, the Colorado Advance Directives Consortium has made available a document called the Medical Orders for Scope of Treatment, which is designed to help you convey what your wishes are for medical care at the end of your life.

It is obviously one thing to write about what you should do to initiate these difficult, but necessary, discussions. However, it is quite another issue to face the reality of what to actually say when you are facing a loved one and thinking about how best to break the ice with the topic of death and dying.

Should you choose to further educate yourself, there are a number of resources available to assist in starting a conversation: Conversation Starter Kit (the conversationproject.org), Aging with Dignity (www.agingwith dignity.org) and Take Charge of your Life (www.takechargeofyour life.org) are just a few that you may want to look into.

When end-of-life discussions take place among doctors, family and patients, all the participants tend to feel better. Medical treatment is usually handled with more professionalism and is more effective. And, perhaps the most difficult to measure, the stress of such a difficult situation is drastically reduced.

Complete Article ↪HERE↩!

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Men Less Likely to Prefer Palliative Care Treatment at End of Life

“If there is a ‘war’ on cancer, and treatments and hopes for cures are portrayed as ‘fights’ in media, then societal beliefs may push men, in particular, to fight the disease over receiving palliative care,”

The bad of the unintended consequences cannot outweigh, or be greater than, the intended good outcome.

By Leah Lawrence

A small study has found that men with cancer were less likely than women to prefer palliative care if informed that continued treatment would not be helpful.

“These findings, which could partially account for the observed gender disparities in end of life care, underscore the need for future interventions to promote palliative care services among men,” Fahad Saeed, MD, University of Rochester School of Medicine and Dentistry, and colleagues wrote in the Journal of Pain and Symptom Management.

Prior research had shown that men and those with low educational attainment are more likely to still be receiving “curative” treatments weeks prior to death and are less likely to undergo palliative care or hospice. With this study, Saeed and colleagues hypothesized that these two groups would be less favorably disposed toward palliative care.

To test this hypothesis, they used data from 383 patients that were gathered in the Values and Options in Cancer Care (VOICE) study. In this study, patients were asked about their preferences for palliative care if they had been informed by their oncologist that further treatment would not be helpful. Palliative care was explained to the patients as care intended to provide comfort and improve the quality of life but not to cure.

Included patients ranged in age from 22 to 90 years, and 55.1% were women. The majority of the patients had also attended college.

Almost 80% of patients reported that they definitely (45.2%) or possibly (33.9%) would desire palliative care if informed that further treatment would not be helpful.

Women were about three times more likely to prefer palliative care compared with men (odds ratio [OR] = 3.07; 95% CI, 1.80–5.23). These odds decreased slightly in sensitivity analyses that accounted for additional covariates and ordinal regression.

“These gender differences may be explained by gender differences in role socialization,” the researchers wrote. “Men and women adopt beliefs about gender roles that reflect prevailing social norms. These beliefs guide decisions about socially acceptable and unacceptable attitudes such as being stoic, fearless, less expressive of symptoms, and invulnerable.”

“If there is a ‘war’ on cancer, and treatments and hopes for cures are portrayed as ‘fights’ in media, then societal beliefs may push men, in particular, to fight the disease over receiving palliative care,” they continued.

In contrast, the data did not support a greater preference for palliative care among those with more education. Patients with a high school education or less and those with a college education had comparable preferences for palliative care.

“It is not very likely, therefore, that education disparities in end-of-life care can be explained by education differences in preferences for palliative care,” the researchers wrote.

In addition, the study showed that older adults were less likely than younger ones to prefer palliative treatment (OR = 0.54; 95% CI, 0.31–0.94). To explain this, the researchers suggested that older patients may have a lack of knowledge about palliative care.

“In a survey of patients across the adult age range, more than three-quarters of the sample had never heard of palliative care,” Saeed et al said.

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Grief Resolution

By Tracy Lee

I live in a world filled with grief. My work dictates that I see it every day.

Grief is not universally the same for everyone. Professionally, I have observed that it is uniquely coded into a survivor’s collective history. It is personal with recovery predicated upon one’s abilities, strategies, and skills.

Although some would have you believe it is depression, ADHD, PTSD, a personality disorder, or some other pathological condition, it is not. It is a normal and natural reaction, albeit painful, to significant loss. It carries emotional, physical, and psychological consequences through interference into one’s comfort and health by reducing abilities to concentrate, sleep, and eat. It decreases one’s tolerance levels and coping skills and evokes fear in a multitude of facets. It imposes loneliness, creates insecurity, causes significant and immediate lifestyle changes, and at times catapults one into dire straits. In short, grief is a foe whose significance is based on the survivor’s reliance, depth of love, and/or responsibilities toward the deceased. It is the ultimate adversary to harmonious living. Additionally, one should not treat grief as a pathological condition through self-medicating or prescription drugs as these will only mask the pain, inviting illness to set in and disease to take hold.

Lack of resolution carries extreme consequences. If a survivor has compromised health or engages in a prescribed medical treatment for illness or disease, he/she would be well advised to avoid interference in their regime. A study of widowed persons found that the overall death rate for the surviving spouse doubled in the first week following the loss. Additionally, heart attacks more than doubled for male survivors and more than tripled for female survivors. Overall, surviving spouses were 93 percent more likely to get into fatal auto accidents and their suicide rate increased by 242 percent. (Mortality after Bereavement: A Prospective Study of 95,647 Widowed Persons, American Journal of Public Health 1987)

According to the US Census Bureau (USCB), 13 million survivors enter grief annually. Many of them suffer the pain of grief for 10 to 40 years. If grief-stricken survivors stack up over an average of 25 years, the number increases to 260 million suffering within the US borders. That is 80 percent of America’s population. “Thousands of mental health professionals report that although their clients come to them with other presenting issues, almost all of them have unresolved grief as their underlying problem.” (The Grief Recovery Method, Guide for Loss)

Unfortunately, many confuse Elizabeth Kubler-Ross’ study, a.k.a. “Kubler-Ross Model” on death and dying as the “Recovery Road Map” for survivors. The confusion lies in that her study concentrated on the stages of grief suffered by dying persons. She does not apply her findings to the survivor’s experience of recovery. In the blink of an eye, the survivor is faced with a very different scenario of life. He/she must instantly face the financial, physical, emotional, psychological, and spiritual realities and adjustments of survival after loss. The senseless association of the Kubler-Ross Model as grief recovery by universities and media has led to misinformation and confusion for those suffering grief.

To recover from grief, one must travel through it; not dance around it. We need smaller experiences of loss through earlier years from which to draw. The loss of a favorite toy, the death of a pet, or relocating and making new friends all serve as foundational experiences to prepare us for the ultimate loss of our loved ones. Unfortunately, society has robbed us of many of these foundational losses and recovery experiences. Many have never learned good sportsmanship by experiencing the disappointments of defeat while playing ball against their schoolmates as children. Others have never had to overcome relationship disappointments, as their friends are virtual rather than actual. The point is that our society is ill-prepared for the pain associated with loss. We live in a pseudo-reality filled with desensitizing scenarios of death. At some juncture, however, reality comes our way. One day, we will look at our electronics and feel-good scenarios and realize that whether we are prepared for it or not, we will participate in life based on the terms set forth by eternal laws of truth. That is the day that you will receive an unwelcome wake-up call into the pitfalls of adult realities, responsibilities, and crushing grief.

Do yourself a favor. Put down the electronics, the virtual realities, and the hyped up desensitizing entertainment programs sensationalizing violence and mass death. Doing so will allow you to experience life as it should be, with real joy, real fulfillment, and the ability to achieve meaningful recovery.

Complete Article ↪HERE↩!

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Why is anticipatory grief so powerful?

by

Although everyone experiences anticipatory grief—a feeling of loss before a death or dreaded event occurs—some have never heard of the term. I didn’t understand the power of anticipatory grief until I became my mother’s family caregiver. My mother suffered a series of mini strokes and, according to her physician, they equaled Alzheimer’s disease. I cared for my mother for nine years and felt like she was dying right before my eyes.

To help myself, I began to study anticipatory grief. While I cared for my mother I wrote a book on the topic. Writing a book parallel to my mother’s life was an unusual experience. Later, Dr. Lois Krahn, a Mayo Clinic psychiatrist, helped me with the final version. Our book, Smiling Through Your Tears: Anticipating Grief, was published in 2005.

Writing the book made me aware of the power of anticipatory grief and I went on AG alert. I had severe anticipatory grief when my husband’s aorta dissected in 2013. My husband was literally bleeding to death. Surgeons operated on him three times in a desperate attempt to stop the bleeding. Every time he went to surgery I thought it would be the last time I would see him.
My grief was so intense I began to plan his memorial service.

Although you realize you’re experiencing anticipatory grief, you may not understand its power. Here are some of the sources of that power.

Your thoughts jump around. You think about the past, the present, and a future without your loved one. These conflicting thoughts can make you worry about yourself. Friends may notice your distraction and think you have some sort of psychological problem. You don’t have a problem; you are grieving.

Every day is a day of uncompleted loss. If you are a long-term caregiver as I was, you wonder if your grief will ever end. Worse, you may wonder if you will survive such intense feelings. You may start to feel like anticipatory grief is tearing you apart.

The time factor can grind you down. Since you don’t know when the end will come, you are on constant alert. Friends may not understand your feelings and wonder why you’re grieving if nobody has died. Explaining your feelings to others is hard because you can hardly track them yourself.

Suspense and fear are part of your life. Because you fear others won’t understand, you keep your feelings to yourself. Grief experts call this “stuffing feelings” and you may feel stuffed with worry, insecurity, and sadness. Uncertainty seems to rule your life.

Anticipatory grief can become complex. Grief expert Therese A. Rando, PhD, author of the article, “Anticipatory Grief: The Term is a Misnomer but the Phenomenon Exists,” says anticipatory grief imposes limits on your life. That’s bad enough, but as time passes, your anticipatory grief keeps expanding. “I’m tired of waiting for my mother to die,” a friend of mine admitted. I understood her feelings.

There is a shock factor. Edward Myers, in his book When Parents Die: A Guide for Adults, says anticipatory grief doesn’t have the shock of sudden death, yet it exacts a terrible toll. As he writes, “If sudden death hits like an explosion, knocking you flat, then a slow decline arrives like a glacier, massive, unstoppable, grinding you down.”

Lack of an endpoint. Although you may think you know when your loved one’s life will come to a close, you aren’t really sure. Waiting for the end can put your life on hold, sap your strength, and prolong anticipatory grief.

You feel sorrow and hope at the same time. Hope may be the most unique aspect of anticipatory grief. While you’re grieving you hope a new drug will be invented, new surgery will be developed, or your loved one will experience a miraculous turn-around. Hope can keep you going.

Understanding anticipatory grief can keep you going too. Joining The Caregiver Space Facebook groups can be a source of support and hope. Remember, you are not alone. You are in the company of thousands of other caregivers, and we can help each other.

Complete Article ↪HERE↩!