05/19/18

What happens at the end of life?

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By Rachel Schraer

Scientists are expecting a spike in deaths in the coming years. As life expectancies increased, the number of people dying fell – but those deaths were merely delayed.

With people living longer, and often spending more time in ill-health, the Dying Matters Coalition wants to encourage people to talk about their wishes towards the end of their life, including where they want to die.

“Talking about dying makes it more likely that you, or your loved one, will die as you might have wished. And it will make it easier for your loved ones if they know you have had a ‘good death’,” the group of end-of-life-care charities said.

Where to die?

Surveys repeatedly find most people want to die at home. But in reality the most common place to die is in hospital.

Almost half of the deaths in England last year were in hospital, less than a quarter at home, with most of the remainder in a care home or hospice.

What happens to human remains?

Dying wishes don’t just extend to where you die but to what happens to your body after death too.

Cremation overtook burial in the UK in the late-1960s as the most popular way to dispose of human remains, and more than doubled in popularity between 1960 and 1990.

Since then it has remained fairly stable at about three-quarters of the deceased being cremated, although it has been creeping up gradually year on year – in 2017 it hit 77%.

Although cremation is thought to be more environmentally friendly, it is not without its own costs. The process requires energy. And burning bodies releases carbon dioxide into the atmosphere.

There are hundreds of “green” burial grounds in Britain where coffins must be biodegradable and no embalming fluid or headstone markers are permitted. Instead, loved ones of the deceased often plant trees as a memorial.

The Association of Natural Burial Grounds says: “Many people nowadays are conscious of our impact on the environment and wish to be as careful in death as they have been during their lives to be as environmentally friendly as possible.”

At natural burial grounds, bodies are generally buried in shallow graves to help them degrade quickly and release less methane – a greenhouse gas.

Some people want to go further than this.

A form of “water cremation” is currently available in parts of the US and Canada, and could come to the UK.

This eco-friendly method uses an alkaline solution made with potassium hydroxide to dissolve the body, leaving just the skeleton, which is then dried and pulverised to a powder.

Sandwell Council, in the West Midlands, was granted planning permission to introduce a water cremation service, but these plans are currently on hold because of environmental concerns.

In December 2017, water providers membership body Water UK intervened and said it feared “liquefied remains of the dead going into the water system”.

Cremation by fire or burial remain the two options for most people, but those that want to do something a bit different could opt to have their ashes turned into a diamond or vinyl record, displayed in paperweight, exploded in a firework or shot into space.

The cost of death

Traditional cremation is cheaper than burial, particularly as space is short, driving up the cost of grave plots. But the cost of funerals in general has been rising.

Insurance firm SunLife, which produces an annual report on the cost of funerals, says prices have risen 70% in a decade.

It put this down to lack of space and the rising cost of land as well as fuel prices and cuts to local authority budgets leading to reduced subsidies for burials and crematoria.

A survey of 45 counties, conducted by the Society of Local Council Clerks, found half of respondents’ local council run cemeteries would be full in 10 years and half of Church of England graveyards surveyed had already been formally closed to new burials.

The same problem faces Islamic burial sites.

Mohamed Omer, of the Gardens of Peace cemetery in north-east London, says the problem is compounded by a growing population and by the fact that Muslims do not cremate their dead.

The Jewish community also do not traditionally practise cremation. David Leibling, chairman of the Joint Jewish Burial Society, says all of the four largest Jewish burial organisations have acquired extra space in recent years.

However, he says it’s not such a problem for the community since synagogue members pay for their burial plots through their membership. This means the organisation can predict how many people it is going to have to bury.

“As we serve defined membership we can make accurate estimates of the space we need,” he says.

What about our digital legacy?

There are growing concerns over what will happen to people’s social media profiles after they die.

The Digital Legacy Association is working with lawyers to produce guidelines on creating a digital will, setting out people’s wishes for what happens to social media profiles – and “digital assets” such as music libraries – after death.

Three-quarters of respondents to the DLA’s annual survey say it’s important to them to be able to view a loved one’s social media profile after their death.

But almost no-one responding to the survey had used a function to nominate a digital next of kin, such as Facebook’s legacy contact or Google’s inactive account manager functions.

Both Facebook and Instagram allow family and friends to request the deceased’s account is turned into a memorial page, while Twitter says loved ones can request the deactivation of a “deceased or incapacitated person’s account”.

Complete Article HERE!

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05/18/18

How to Talk to Kids About Death

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Discussing death with your kids can be a real concern and many tend to avoid it. Death is however an inevitable part of life and it is our responsibility to ensure our kids are aware of it and know it’s okay to discuss it.

If we allow children to talk to us about death, we can give them needed information, prepare them for a crisis, and help them when they are upset. We can encourage their communication by showing attention and respect for what they have to say. We can also make it easier for them to talk to us if we are open, honest, and at ease with our own feelings.

Death is very much a part of our lives on many different levels. We may be surprised at how aware children already are about death. They see dead insects, dead birds and animals on the road or a family pet may have died. Children read about death in their fairy tales, watch it in cartoons and even role-play death in school plays. Without realising it they already have some exposure to the concept.

Problems That Make Discussing Death Difficult

  1. We avoid talking about things that upset us. We bottle it up and hope that by saying nothing will help it go away. Children are sensitive barometers of emotion and are tremendous observers. They know something is wrong by simply watching us. Our body language, emotions on our faces, what we say and what we don’t say are all communicating a message to our kids.When we choose not to discuss an issue with our kids they too hesitate to ask questions. They automatically think “If Mummy and Daddy are so upset that they can’t talk about it, I had better not talk about it either……it must be bad!”. This causes our kids to stress and worry more as they don’t know how we are feeling.
  2.  We feel uncomfortable when we don’t have all the answers. As a teacher and parent myself, kids will often expect us to know everything, even all about death. Take it as a compliment and know that they look up to us.It is okay to say to your child “I’m not sure myself about that” or “I just don’t know the answer to that”. Children respond to this honesty beautifully and feel connected in our openness towards them. It helps them feel better about not knowing everything also. In discussing death, we may find different answers at different stages in our life or grieving process.Share with children your beliefs. Expose them to the belief of others, for example some people believe in afterlife, others do not. Allow them to be comforted in knowing your beliefs and allow them to choose their own.
  3. Death is often a taboo subject– in some cultures death is an integral part of family life. People died in their home environment, surrounded by loved ones (adults and children alike). They comforted each other and mourned together.Unfortunately today death is much lonelier. Many people die in isolation and loved ones miss sharing their last moments. The living has in some ways become separated from the dying; consequently, death has taken on added mystery and, for some, added fear.

Help to diminish this trend and openly discuss death with your child when an appropriate time arises. Model appropriate behaviour regarding death, for example express your sympathy towards someone who has lost a loved one in front of your child. Show them that it is kind to acknowledge a loss and express care towards others.

Developmental Stages of Understanding – A General Guide

  • Preschool children mostly see death as temporary, reversible and impersonal. In stories they read or watch characters will often suddenly rise up alive again after being totally destroyed. It’s not surprising they don’t understand, yet it is appropriate for their age level to think this way.
  • Between the ages of five and nine, most children are beginning to see that all living things eventually die and that death is final. They tend to not relate it to themselves and consider the idea that they can escape it. They may associate images with death, such as a skeleton. Some children have nightmares about them.
  • From nine through to adolescence, children to begin to understand fully that death is irreversible and that they too will die some day.

It is important to remember however that all children develop at different rates and that children experience life uniquely. They have their own personal ways of handling and expressing emotions.

It is not uncommon for a three year old to ask questions about death, for a child to be openly unconcerned about the death of a grandparent yet devastated over the death of a pet. Some children show their understanding of death through playing with their toys.

It is important to explain death in simple terms for young children. For example, when someone dies they don’t breathe, or eat, or feel hungry or cold and you won’t be able to see them again.

No matter how children cope with death or express their feelings, they need sensitive and nonjudgmental responses from adults. Careful listening and observing are important ways to learn how to respond appropriately to a child’s needs.

Talking About Death With Preschoolers or Young Children

Many people feel challenged when approaching the subject of death to preschoolers and young children. They in particular need brief and simple explanations. Using concrete and familiar examples may help. For example, death may be made more clear by explaining it in terms of the absence of familiar life functions – when people die they do not breathe, eat, talk, think, or feel any more; when dogs die they do not bark or run any more; dead flowers do not grow or bloom any more.

Children learn through repetition so they may need to go over this quite a few times. A child may immediately ask more questions, others may be silent, then wish to revisit the subject again later. Children sometimes get confused with what they hear so it is important you check their understanding by revisiting the subject at appropriate times.

As time passes and children have new experiences, they will need further explanations and sharing of ideas and thoughts.

It may take time for a child to comprehend fully the ramifications of death and its emotional implications. A child who knows that Uncle Tom has died may still ask why Aunt Julie is crying. The child needs an answer. “Aunt Julie is crying because she is sad that Uncle Tom has died. She misses him very much. We all feel sad when someone we care about dies.”

There are also moments when we have trouble “understanding” what children are asking us. A question that may seem dreadfully thoughtless to an adult may be a child’s request for reassurance. For instance, a question such as, “When will you die?” needs to be heard with the realisation that the young child perceives death as temporary.

While the permanency of death is not yet fully understood, a child may think that death means separation, and separation from parents and the loss of care involved are frightening.

Being cared for is a realistic and practical concern, and a child needs to be reassured. Possibly the best way to answer a question is by asking a clarifying question in return: “Are you worried that I won’t be here to take care of you?” If that is the case, the reassuring and appropriate answer would be something like, “I don’t expect to die for a long time. I expect to be here to take care of you as long as you need me, but if I did die, there are lots of people to take care of you. There’s Daddy, Aunt Laura and Uncle John or Nan.”

It is important to check which words you use when discussing death with your kids. Some children confuse death with sleep, particularly if they hear adults refer to death with one of the many euphemisms for sleep – “they died in their sleep”, “eternal rest”, “rest in peace.” Resulting from this confusion, a child may be afraid of going to bed, incase they don’t wake up either!
Similarly, if children are told that someone who died “went away”, brief separations may begin to worry them. Grandpa “went away” and hasn’t come back yet. Maybe Mummy won’t come back from the shops or from work. Therefore, it is important to avoid such words as “sleep”, “rest”, or “went away” when talking to a child about death.

To avoid confusion with preschoolers and very young children, it helps to explain that only very serious illness may cause death. When they hear that sickness was the cause of death, we don’t want them to assume that minor ailments are a cause for major concern.

When a child associates death only with old age, they can become very confused when they learn that young people can die too. It is important to explain that most people live a long time, but some don’t. However we do expect that we will live a very long time (always reassure them)!

Religious References

Religion is a real source of strength for many people in a time of grieving. If however religion has not played a part in your child’s life before dealing with death, it may be very confusing and worrying to hear religious references. For example, the explanation “Big sister is with God now” may comfort an adult, but frighten a child. They may fear that God will come and take them away as He did big sister.  Ensure that your child has an affiliation for your terms so they feel familiar and can understand.

Other messages may confuse children, including statements such as “Tommy is happy in Heaven with the angels”. They may wonder why everyone is so unhappy when they say that Tommy is happy. They need to hear about the sadness being felt from losing Tommy, along with our expressions of religious faith.

It is important to help children understand the realities of death, being the loss and the grief. Trying to shelter children from these realities only denies them from the opportunity to express their feelings and be comforted. Sharing feelings between you and your child will benefit you both.

Other Opportunities To Talk About Death

Children tend to be extremely curious when they discover death, particularly dead flowers, birds, trees and insects. This may open windows of opportunity to discuss death further and answer all the detailed questions that may arise. Try to reinforce the concept that all living things eventually die, but it makes room for new things to join us on earth.

Other opportunities to discuss death with your kids arise when well-known persons die and their funeral receives a lot of media coverage. This is a natural time to clarify any misunderstandings they may have about death. If the death is violent or aggressive however, you need to reassure your child that they are safe and most people do not behave this way towards each other.

Attending Funerals

If your child is to attend a funeral, they need to be prepared beforehand for what they might see and hear before, during and after the service. Explain that it is a very sad occasion and that some people will be crying and others feeling very sad.

Seat your child next to you or someone they are familiar with who is able to cope with their questions and be prepared to offer explanations. If your child prefers to not attend the funeral, they must not be forced.

Mourning

We all need to mourn in order to heal our sorrows and move on in our lives. By being open with our emotions and showing our sorrow and tears, expresses to our children that it is okay that they also feel sad and cry. We should never associate tears and expressing feelings with weakness.

Children often feel guilty and angry when they lose a close family member. They need reassurance that they have been, and will continue to be, loved and cared for.

In Summary

A grieving child needs information that is clear and comprehensible for their development level. They need a lot of reassurance that they are safe and loved and be made feel that they can discuss their feelings openly. Children need to maintain their activities and interests as they desire and revisit questions regularly.

When preparing a child for an anticipated death, allow them to help care for the dying person if they desire, receive lots of affection and answer questions, be given information about the physical, emotional, and mental condition of the terminally ill person and be given a choice of visiting or remaining away.

Complete Article HERE!

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05/17/18

Is the cemetery dead?

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Mount Auburn Cemetery in Cambridge.

IN 1831, ARCHITECT Jacob Bigelow built a radically new kind of cemetery at Mount Auburn in Cambridge. It was much larger than its forebears, located on what was then the suburban fringes, and designed to create a romantic space of death that also served as a horticultural, sculptural, and even recreational place. Mount Auburn and the many cemeteries that followed were a rousing success, making the American cemetery a major tourist site for much of the 19th century.

However, in the 20th century, Americans medicalized and privatized dying and death, creating a death taboo that isolated cemeteries. The dying were put in hospitals or nursing homes, visiting hours were moved to funeral homes, and cemeteries were professionalized and standardized. While Mount Auburn remained a popular spot with locals because of its natural and artistic beauty, even it could not retain the cultural prominence that it and the other great urban cemeteries, like Green-Wood in New York and Spring Grove in Cincinnati, had had in the previous century.

Today, American funerary practices are undergoing dramatic and sudden change. This year, cremations surpassed burials for the first time on record. By 2030, cremation may reach 70 percent. That’s shifted the locus of the rituals associated with death from cemeteries to corners of the world that hold particular meaning to the departed or their survivors, from backyards to bodies of water. At the same time, social media are changing the way we deal with grief — once a deeply private affair, it has increasingly become a public process online.

As customs change, cemeteries are trying to keep up.

Events such as the Run Like Hell 5K in Atlanta’s Oakland Cemetery and the beer baron tour in St. Louis’s Bellefontaine show how these places are becoming more accessible to the public. Hollywood Forever’s Life Stories where a family can submit photographs for a remembrance video suggest their new digital savvy. And, at Forest Lawn Cemetery in Buffalo, a family can scatter their loved one’s ashes, something cemetery operators have opposed including for decades.

In 2014, Mount Auburn Cemetery began offering “natural burials” that do not include embalming and other popular procedures. It was an iconic moment, for an esteemed, yet very traditional institution to adopt a practice popularized by the contemporary death reform movement. But it was actually not so contradictory. Cemeteries, even ones as august as Mount Auburn, have been trying to adjust and renew their connection to the broader public even as reformers either question the very need for a cemetery or convince them to adopt such reform measures.

Cemeteries face a sort of life-or-death crisis. The increasing popularity of cremation has meant that cemeteries are no longer critical to storing remains, while mourning on social media has removed the necessity of cemeteries as a primary place to mourn. Public mourning also has re-emerged with the widespread acceptance of roadside shrines, ghost bikes (white bikes placed on the roadside where a cyclist died), memorial vinyl decals for the back windows of cars, and memorial tattoos. While zombies roam the big and small screen, real death has returned to our streets, building walls, vehicles, and even bodies.

While these new practices relocate mourning and remembrance out of the cemetery, other trends, such as natural burial, provide new opportunities for cemeteries. Natural death advocates promote the practice as a more environmentally sensitive mode of burial that eschews embalming, hardwood caskets, and steel or concrete vaults as pollutants. Reformers have succeeded in getting widespread notice, though relatively few Americans have chosen green burial thus far.

Green advocates have often met cemeteries halfway. Some cemeteries offer natural burial adjacent to conventional sections, but have to maintain their whole cemetery without pesticides and herbicides. As a result, cemeteries such as Mount Auburn see an opportunity to offer consumers choices.

Confronting death is painful and upsetting. We lose a person we love in an act of finality which has no comparison. Yet how we did things before may not be how we will do them in the future. Consumers just need good, unbiased information, and a willingness to overcome any family hesitancy about unconventional choices.

Cemeteries can embrace change — even radical change, as the founders of Mount Auburn demonstrated. The signs of successful adaptation are mixed so far. But there are glimmers of hope.This fall, Mount Auburn will host Death Salon, a festival of alternative approaches to death and mourning, including lectures and a demonstration of green burial. That Death Salon is coming to Mount Auburn suggests cemeteries can remain beautiful, natural, historic, and artistic places, even as they embrace new practices that allow them to attract new lot-owners and reconnect them to a broader public.

Complete Article HERE!

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05/16/18

Die like a dog

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Pet dogs often have a peaceful death that forestalls protracted suffering and pain. Why can’t we do the same for humans?

Cris Cristofaro holds his dog Dino as his beloved pet is sedated during an in-home euthanasia on 9 May 2012 in New York City.

By Joseph Pierre

I killed my dog last year. Mika was a shelter mutt, so she was around 10 or 12 years old; I can’t be sure. Twelve dog years would have put her at around 80 human years, which is a pretty good run. But what’s strange about having a dog is how quickly they age relative to us – they start out younger than we are, catch up for a time, and then pass us by, declining into their twilight years, all in the space of a decade or so. As witnesses to that accelerated timeline, having a pet means that we often end up experiencing their eventual demise and learning something about death in the process.

Mika was a great dog. Obviously abused before ending up at the shelter, she had scars on her head when I rescued her and, whenever I took a broom or rake in my hand, she would cower in fear. She was easily overwhelmed when other dogs came up to sniff her, and would often growl defensively. But with time she grew to be less apprehensive and almost pathologically affectionate, if there is such a thing with animals, demanding to be petted by anyone who happened to be near. She was a great companion watching TV on the couch during my single years, and she helped me win the attention of the woman, a veterinarian, who would eventually become my wife. In fact, my wife has often joked – and maybe it isn’t a joke at all – that she would never have gone out with me in the first place if I hadn’t had a dog.

For whatever reason, the way I’d always pictured the proper death of one’s dog was like a scene taken from the 1957 Disney film Old Yeller (1956): after years of steadfast companionship, when man’s best friend no longer derives joy from chasing rabbits and can barely lift his head, his owner has to muster the resolve to get out the rifle to put him out of his misery. Although an oddly bucolic fantasy for someone living in Los Angeles, at least part of it was no doubt influenced by how I’d learned to think about death as a physician.

In human medicine, we’re used to implementing any and every life-saving intervention right up to the very end. As a medical intern 20 years ago, I remember thinking about the futility of that approach with patients in pain and suffering from multisystem organ failure, sustained only by machines and a regimen of some 30 or 40 medications, and unlikely to ever make it out of the hospital. What was the point? Whatever happened to quality of life? But those reservations be damned, we never gave up, and among the interns who transferred care to each other from shift to shift, the dictum of patients ‘not dying on my watch’ was something to which we all held fast.

As long as there were no ‘Do Not Resuscitate’ orders in the chart asking us to withhold ‘heroic efforts’, we rarely considered doing anything less to prolong life, and financial cost was never part of the equation either. As far as hastening death, that was never even mentioned. After all, the original Hippocratic oath states: ‘I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect.’

When Mika, who’d had hip dysplasia from the start, developed increasing difficulties walking and was in obvious pain much of the time, my wife and I put her on medications and even tried acupuncture, which helped for a while. But one day, at the start of our morning walk, she ambled to the end of the driveway, sat down, and refused to go on despite me pulling the leash. It was the same the next day and the next, so I stopped trying. It was at that point that my wife first brought up the possibility of putting her down, but that seemed ridiculous to me because between Old Yeller and my experiences as a human doctor, I envisioned Mika struggling through the pain, fighting for her last breath to the very end. In other words, it didn’t seem right to think about letting her go because she hadn’t yet suffered enough.

As a veterinarian, my wife viewed things altogether differently. To her, putting our dog to sleep didn’t represent throwing in the towel as it seemed to me, but a compassionate way to preempt unnecessary but inevitable pain and suffering down the line. As she saw it, we owe this option to our pets as stewards of their care, especially given that animals can’t understand pain or decide for themselves just how much suffering they are willing to tolerate.

Indeed, the American Veterinary Medical Association Guidelines for the Euthanasia of Animals (2013) acknowledges that ‘there is no consensus on when it is appropriate to let [a] life go’, but notes that: ‘Euthanasia may be considered to be the right course to spare [an] animal from what is to come … if medical intervention would only prolong a terminal condition, or if current health conditions cannot be successfully mitigated.’

When we were dating in the years before we got married, my wife would often come home from a long day at work and say: ‘I killed my patient today.’ This, I came to understand, was a kind of self-reproachful statement of defeat as well as a starkly factual statement that reflected how she’d actually administered the medications that ended a dog or cat’s life that day, typically with tearful owners and their bawling children huddled around.

This strange admixture of guilt from failing to save a life, along with the resolve to be the agent that takes it, comes with the territory in a veterinary clinic where euthanasia is a daily occurrence. Although euthanasia literally means ‘good death’, it was totally foreign to me in my training as a physician. Human doctors might feel guilty losing a patient in the end, but that guilt is almost always tempered by the reassurance that while we might have lost the battle to cancer, nature, God or whatever, we did everything we could in the process. Being a physician means that doctors must sometimes admit defeat, but in doing so, we don’t go on to be the hand of death.

As time went on, medications and acupuncture had less of an impact on Mika, and her hind legs would often give out so that she would walk only a limited distance before collapsing. She seemed to be slipping cognitively too, and one day even fell into the swimming pool while we were away at work, requiring rescue from a neighbour. In what seemed like a short amount of time, her muzzle turned fully grey, and she would often sigh heavily with a distant look in her eye. Finally, she began to lose control of her bowels, with increasingly frequent accidents around the house.

And so, discussions about euthanasia became more about ‘when’ than ‘whether’.

The difference in attitudes towards euthanasia for animals and human beings is understandable. After all, people have been killing animals without remorse for food, to avoid becoming food ourselves, and for sport long before we began domesticating animals or keeping them for companionship. Whereas traditional Judeo-Christian and Islamic teachings include strong proscriptions against murder and suicide for humans, religious doctrine questions the animal soul. And while euthanasia is used as an ethical means to preempt suffering in veterinary medicine, it’s not unusual for some owners to simply abandon their pets by the side of the road, put puppies in garbage bags, or refuse to pay for life-saving medical procedures based on both economics and expediency. No wonder the expression ‘die like a dog’ has historically referred to the most miserable of ends.

In 2009, US legislation that would have allowed physicians to be compensated by Medicare for providing voluntary counselling to patients about options for end-of-life care was defeated due to political uproar over ‘death panels’. And yet, as I discuss in the World Journal of Psychiatry in 2015, human euthanasia is being increasingly considered and sanctioned both in the US and abroad. As life-extending medical advances over the past 50 years have fuelled growing concerns about prolongation of suffering and loss of autonomy, the euthanasia movement of the 1930s has gained momentum, evolving into the modern ‘right to die’ and ‘death with dignity’ movements that challenge us to consider what constitutes a ‘good death’. Today, some form of voluntary active euthanasia – death by administration of a lethal dose of medication to avoid pain and suffering – is legal in several states in the US, as well as in Japan and parts of Europe including Belgium, Luxembourg, Switzerland and the Netherlands.

Still, if the historical divide between our attitudes towards euthanasia for humans and for animals is narrowing, the devil in the details of cultural sanctioning involves who can actually administer, or is willing to administer, the medications that end life. With existing legislation to date, the sanctioned individual – whether a physician, family member, some neutral third party, or the person seeking to end their own life themselves – varies by jurisdiction. Although ‘death with dignity’ is increasingly supported in many parts of the world, often neither doctors nor patients seeking death want to ‘push the plunger’ and take responsibility for being the hand of death. In this sense, euthanasia remains a hot-potato issue in human medicine.

Consequently, we now find ourselves debating a range of possible end-of-life care options, including passive euthanasia (withholding life-sustaining interventions including food or water), physician-assisted suicide (providing the means for a patient to end their own life), and active voluntary euthanasia (administering a lethal medication to a patient). Palliative sedation is an increasingly popular option within medicine, which involves administering medications that are intended to relieve suffering through sedation and pain control to the point of possible unconsciousness. Although death is a potential side effect, palliative sedation avoids the moral objections of suicide and euthanasia through the ethics of the so-called ‘double effect’, which argues that death is an acceptable outcome if unintended and in the primary service of relieving suffering among the terminally ill. Pushing the envelope of what it means to die a ‘good death’ for humans even further, my colleagues at the University of California, Los Angeles have been investigating the use of psychedelic drugs such as psilocybin to relieve anxiety and depressive symptoms and to find meaning at life’s end.

After hemming and hawing for weeks, my wife and I finally decided to pick a date to have Mika put down. We asked a veterinarian friend to perform the euthanasia in our home. On the agreed day, it was my wife who put off making the call until I couldn’t take it any longer, and had to prod her to do so. The vet came to our house, started an intravenous line, and filled a syringe with Euthasol as we sat on the floor by Mika’s bedside, petting her with long strokes and saying our tearful goodbyes.

When we were ready, I asked if I could push the plunger, and the vet allowed me to place my hand with hers as we did it together. I was worried that Mika might show signs of discomfort, but seconds after the medication went in, she simply took a single, long, deep breath, and then let it out slowly for the last time.

‘Good dog,’ I told her. ‘Good dog.’

It was a good death. We should be so lucky.

Complete Article HERE!

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05/15/18

Dog visits funeral home for 1 last goodbye to beloved owner

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After her owner’s sudden death, Sadie was showing many signs of grief — until she had the chance to say goodbye.

May said this photo has “not only helped (Baelieu’s wife) with this ongoing grief process, but it has also brought her a great deal of joy in this difficult time.”

by Danielle Wolf

Sadie the dog proves that humans aren’t the only ones who grieve the loss of a loved one.

When the man who raised her from a puppy, Andy Baelieu, died from a sudden heart attack, the 13-year-old mixed-breed dog was right by his side. “After the paramedics could not revive and save Andy, Sadie laid down beside him and was snuggling his hand,” Jeremy May, president of Elements Cremation, Pre-Planning, & Burial, located in Langley, British Columbia, told TODAY.

“During the 10 days (between Baelieu’s death and funeral), Sadie started showing signs and symptoms of grief,” said May, who helped organize Baelieu’s memorial service.

“Grief is not a human emotion. Love is not a human emotion. These are emotions we share with other animals,” Barbara J. King, anthropology professor at the College of William and Mary and author of “How Animals Grieve,” told TODAY.

King defines pet grief as “some kind of really altered behavior that suggests distress, such as social withdrawal, altered feeding or sleeping habits, or distressed vocalizations and body language, which persists for a while.”

Sadie certainly fits that description. After accompanying her best friend to work every day for more than a decade, she tirelessly waited by the window for Baelieu to return home. After his sudden death, she couldn’t sleep on her own, stopped eating and swiftly lost 10 pounds.

According to King, many studies have shown that dogs grieve for each other, but “the really important thing to understand is that when a pet mourns one of us that it’s because they have the emotional capacity that comes from their own relationships (with other animals in their species).”

Having Sadie involved in Baelieu’s service was not just a spur-of-the-moment decision. “From the moment Andy passed away, (Baelieu’s wife, Julia, knew) that Sadie was going to be there,” said May.

On the day of the funeral, Sadie, accompanied by Baelieu’s wife, was the last one to enter the room. The dog put her two front paws up on the casket and looked inside at her deceased companion.

“There was this unbelievable sense of emotion and power in the room because everyone knew the importance of Sadie to Andy,” said May.

After seemingly getting the closure she needed, May said Sadie “calmly walked out, went home and ate two meals and started to heal and go back to her way of life.”

King speculates that Sadie’s sense of peace may stem from two places. First, Sadie could be taking her cues from her remaining owner: “It is very possible that the funeral was closure for the wife and Sadie may have picked up on a certain closure that she felt.” Second, “maybe the dog, seeing her owner quiet, smelling differently and clearly not in a living state, had a moment of realization,” said King.

The idea of having pets at funerals isn’t a new concept. May said an increasing number of people are prearranging for their pets to attend services, a practice he finds very important.

“This is not the first nor will this be the last time this happens,” he told TODAY. “I would encourage all funeral homes to care more about closure than they do about carpets.”

Complete Article HERE!

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05/14/18

I Embalm Dead Bodies For A Living — Here’s What It’s Like

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By Annie Georgia Greenberg

The building that houses Milward Funeral Directors in Lexington, Kentucky has been around for 193 years. It’s a three-story maze that starts with a light-soaked, stone-floored entrance hallway. The hallway is home to an awfully regal cage of tiny, yellow-breasted finches, and they greet you as you walk in through the funeral home’s front doors. Even when they’re out of sight, you can hear their occasional, lively chirps, particularly if you’re in any of the nearby pastel-hued rooms on the first floor. Say, the powder blue chapel, the pink viewing room, the green family meeting room, or the front office where office associate Elaine Kincaid has found a way to answer the ever-ringing phone with a pressing sense of compassion.

By contrast, it’s nearly pin-drop-silent in the upstairs casket showroom, where, if you were preparing to bury a loved one, you would arrive to find a selection of 30-plus casket models in every variation of wood and steel. Should you be cremating your loved one, there’s an adjoining hall where you could select an urn, each one of them unique in presentation and name — “White Orchid” for the porcelain vase and “Solitude” for the simple, gold rectangle. You could also turn loved ones’ cremated remains into jewelry, a keychain, a bench or, in the words of Miranda Robinson, Milward’s youngest mortician, “pretty much anything you want.”

Like Milward funeral home, Miranda Robinson is polished and professional. Yet, at 30-years old, she both embodies and defies the stereotypes often associated with morticians. Yes, she has a fascination with death and dying. Yes, she loves the skeletal system, owns a black cat, and displays a ouija board on her apartment’s living room table — but she’s anything but morose. In fact, her bubbly Kentucky drawl is often interrupted by a burst of up-swinging giggles, even while discussing death. She used to be a cabaret performer and closely follows RuPaul’s Drag Race. Her most-used word is “lovely” and her retro-feminine personal aesthetic matches that same description.

At around 5 feet, 4 inches tall with an obvious flair for vintage, Miranda pays almost as much attention to her own presentation as she does to those on her embalming table. Robinson clips in hair extensions that she curls every morning. Her arms, which remain covered while at work, are decorated with tattoos. One of them is of a bottle of embalming fluid.

Still, at first blush you’d never guess that Robinson works with the dead on a daily basis. And, perhaps, you’d never guess how many women her age are actively entering the field, either. Frustrated by nursing school and looking for a change, Robinson shifted gears from aiding the living to preserving the dead, and enrolled in mortuary school in Cincinnati, Ohio. In doing so she joined the ranks of young women now outnumbering men in the mortuary education system. In fact, the National Funeral Directors Association reports that, “While funeral service has traditionally been a male-domination profession…today, 60% of mortuary science students in the United States are women.”

Once a male-dominated industry, after-life and funeral care is now becoming not only a budding, female-centric space but also one ripe for disruption. And no one knows this better than Miranda. “Even in mortuary school, I was taught that [funeral service] was still a different, difficult field for women.” She explains, “Women, so I’ve heard, were expected to wear skirts and heels still, so it seemed, before I got into the funeral home, that [the] funeral service [industry] hadn’t come a long way for women… but now that I’m here, I feel like I’ve made my mark and I’m really seeing women in funeral service emerge.” They’re emerging and they’re excelling, bringing with them calm, care, and attention to detail that may have long been lacking.

While embalming, Miranda says she feels like “both an artist and a scientist,” because her work combines aspects of both. Made prevalent during the Civil War, when bodies of fallen soldiers were shipped back home for viewings and funerals, embalming is a technique used to preserve the deceased by replacing a portion of their blood with chemicals (including formaldehyde). The body is also made up to look as it did in life — lipstick and all. But, while this method may long be favored in the United States, a new wave of green burial options seeks to challenge the traditional funeral industry. In fact, for the second year running, cremation is now more popular than burials, and the National Funeral Directors Association only expects this trend to continue.

That’s because green burials, alternative and eco-friendly practices are popularizing. Some of these green practices, like home funerals and vigils, pre-date the popularization of embalming, while others like bio-urn cremation (when the body’s cremated remains are buried and grow with the seeds of a plant) or aquamation (a proposed way of breaking down a body using water rather than fire) are brand new. Whether the increased options in funeral care signify an impending end of the traditional funeral industry that Miranda is a part of is a matter that may only be answered in time. For now, what it does mean is that this freshly energized attention to death care is bringing light to a space that, despite touching every single life on Earth, has largely been kept in the shadows.

Ultimately, it is not the method of end-of or after-life care that concerns women like Miranda, but rather the instinct to talk about death in a meaningful way, early and often. Miranda loves her job because what she does helps bring peace to grieving families. She explains, “The most beautiful thing about my job, is taking the loved one into my care from a removal, especially when family is gathered, just that intensity of how much they love that person. It’s an absolute honor to be in the worst possible moment in someone’s life. To be there and for them to look at me and just me to try to at least give them some answers, to try to give them some peace in that moment.”

And while it may seem strange to light up while talking about death, it’s a conversation everyone will someday need to have, regardless of personal preference or spiritual beliefs. Miranda has this conversation every day — at work, at home, with her 1,859 instagram followers — and in doing so helps to de-stigmatize a topic that’s long been off-limits.
As a mortician, Miranda believes that viewing the body is of the utmost importance. As she puts it, “I think it’s important to see the body because you face the reality of what’s actually happened.” But, it’s the trend toward personalization, transparency and increased discussion around death and dying that continues to be a universal priority for many women working in both alternative and traditional funerals.

For Miranda, part of this conversation means addressing the details of her own funeral. And, of course, she can’t imagine anything more fitting than a traditional embalming. Ever the enigma, while her choice to embalm may be traditional, her last look will be anything but. Robinson would like a “glitter casket” with a leopard interior. Dark brown extensions will be clipped and curled, her lips will be painted in the bright red pigment Ruby Woo by Mac. Years from now, when that day comes, Miranda may very well lay on the table that she works alongside every single day at Milward Funeral Directors, in the storied embalming room that she considers sacred. Perhaps somewhere beneath her in the entry hall, the finches will be singing.

Complete Article HERE!

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05/13/18

How to survive Mother’s Day when you’re grieving

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When a previously innocuous holiday becomes painful

‘As I face my second Mother’s Day without my mum, I explore how to get through this day without her.’

By

I flinch every time Mother’s Day is mentioned: every time I open an email, hear a radio or TV ad, or walk past advertising with promotions on flowers and high tea.

Mothers give us life and love. They have a hard job; they deserve to be celebrated. It’s just difficult to celebrate when your mum has gone and it feels your guts have been ripped out while your life has been simultaneously turned upside down and shaken all over the floor. When reminders of this well-marketed holiday pops up in my day, mostly I want to hit something.

Grief is a response to loss that most of us have faced, or will face soon enough. But like many aspects of mental health, it’s something we don’t seem that good at talking about. Everyone responds to grief differently, and your own response can change on a day-by-day basis. It can be a numb or raw, a staid or sobbing pain that settles in your bones, without the schedule or process you expected.

When an insidious illness wore away at my beautiful mother, the grief scrubbed me raw. Every hope I had for her was torn into tiny shreds. When she died, six terrible months after being diagnosed, this new grief was coupled with relief that her suffering was over.

I didn’t think I was feeling what I should. I felt guilty both that I was able to go to work, to laugh, to love, and conversely, that I wasn’t as strong as I thought. I learnt that grief wasn’t a tidy bundle of pain that faded in a month or two: it’s a messy, unpredictable, illogical state that, 16 months on, can still feel fresh. It’s getting used to a new way of life; I relate to CS Lewis’ visceral description in A Grief Observed: “The death of a beloved is an amputation.”

As I face my second Mother’s Day without my mum, I explore how to get through this day without her.

Let it out

Are you worried that if you let it all out you’ll start behaving like a recalcitrant, screaming toddler who throws their toys out of the pram because they can? I’m more of a puddle of chocolate and tears on the floor myself, but either way, it’s OK if you’re not “fine”. Find some space and time to be alone, to process and be sad in your own way.

Talk

The counterpart to the above is, when you’re ready, to find someone who understands your pain. It might be a colleague or neighbour who’s also experienced grief, one of your mum’s friends, or it might be a support group, psychologist or Lifeline (13 11 14). Grief can feel isolating but reach out to the ones you love too: talking is hard but it helps.

Honour her memory

When a well-meaning friend suggested this for my first Mother’s Day without my mum, I thought “You really don’t understand. I don’t want to do something nice. This is the one holiday I want to POKE IN THE FACE.” But some people might find it comforting to create a new routine or ritual – to buy themselves some flowers, to visit their mum’s favourite restaurant, to talk to your kids or friends about her.

Be good to yourself

Now’s not the time to reach for numbing substances like alcohol or drugs. If you can summon the energy, nurture yourself with healthy food, sleep and exercise.

Show gratitude

Stay with me here. It can feel like life has let you down but at the same time, I’ve got the stark realisation that I was so lucky to have my mum in my life for so long. What’s more, my mum was spectacular; smart, loving, strong as steel. This hurts so much because I love her so much. Recently a friend told me he wasn’t that sorry his difficult mother was gone, and I was knocked out of taking for granted some of the foundations of my life.

Take a moment to thank the world, or your mum, for everything she was and did for you. Then take a moment to think about the other people in your life, and be grateful they are still here.

When I asked another friend who lost her mum to sum up grief, it wasn’t the emotional response I expected. She said: “It’s a reminder to enjoy life.”

Complete Article HERE!

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