Why the First Cremation in the U.S. Was So Controversial


It was a scandalous topic before Dr. Francis Julius LeMoyne in 1876.

By Amy Elliott Bragg

LeMoyne Crematory in Pennsylvania.

LeMoyne Crematory in Pennsylvania.

“Things were a little ghostly,” wrote a reporter for the Philadelphia Times, setting the scene for a morbid public spectacle. The press had been invited to the first “modern” cremation performed in the United States. It was December 6, 1876.

The Times reporter was among a crowd of journalists and townspeople gathered at the top of a hill in Washington, Pennsylvania to witness the first run of a new crematory built by Dr. Francis Julius LeMoyne. The furnace, designed by LeMoyne and built on his own property, was based on a working model presented at the Vienna Exposition in 1873. The remains to be cremated were those of Joseph Henry Louis Charles, Baron de Palm, a Theosophist who was fascinated by “Eastern” philosophy, and besides that had once known a woman who had been buried alive, and was terrified by the prospect.

Burning the dead is an ancient practice, and in some cultural traditions, it’s a thousands-year-old norm. Today, cremation in the U.S. is soaring in popularity; by 2018, the Cremation Association of North America predicts that over 50 percent of Americans will choose to have their bodies cremated.

Dr. Francis Julius LeMoyne.

Dr. Francis Julius LeMoyne.

But in late 19th-century America, cremation was a radical, tradition-bucking idea. LeMoyne and other cremation advocates believed that burying the dead in the ground allowed germs to seep into the soil, thus contributing to the spread of diseases like cholera, typhus, and yellow fever. Cremation promised to sterilize human remains and bypass the altogether slow and icky process of decomposition. When performed in a state-of-the-art indoor furnace, it was a sanitary and high-tech alternative to burial.

Cremation was also a solution to an urban problem. As cities expanded, they surrounded burial grounds that had once been miles away from town—and rested on prime real estate. “In and about New York, Brooklyn, and Jersey City, 4,000 acres of valuable land are taken up by cemeteries,” wrote Hugo Erichsen in his 1887 pro-cremation treatise The Cremation of the Dead. “It is calculated that with the probable increase of population in the next half a decade, 500,000 acres of the best land in the United States will be enclosed by graveyard walls. … It is an outrage!”

But cremation didn’t catch on with the masses right away. LeMoyne had first approached a local cemetery with an offer to build the crematory on their land; they dismissed him with disgust. The Times reporter who witnessed the de Palm cremation was horrified: “If [de Palm] could have foreshadowed the startling scenes his poor bones would have to go through he would have thought twice before he jumped into the fire.” Anti-cremationists put aside their religious discomfort with cremation to argue that burning bodies would encourage crime—you can’t exhume a cremated corpse!—and dismissed the public health claims of cremationists as unfounded fear-mongering. (They weren’t wrong; there’s no evidence that in-ground burial encouraged the spread of epidemics.)

Cremation was also a solution to an urban problem. As cities expanded, they surrounded burial grounds that had once been miles away from town—and rested on prime real estate. “In and about New York, Brooklyn, and Jersey City, 4,000 acres of valuable land are taken up by cemeteries,” wrote Hugo Erichsen in his 1887 pro-cremation treatise The Cremation of the Dead. “It is calculated that with the probable increase of population in the next half a decade, 500,000 acres of the best land in the United States will be enclosed by graveyard walls. … It is an outrage!”

But cremation didn’t catch on with the masses right away. LeMoyne had first approached a local cemetery with an offer to build the crematory on their land; they dismissed him with disgust. The Times reporter who witnessed the de Palm cremation was horrified: “If [de Palm] could have foreshadowed the startling scenes his poor bones would have to go through he would have thought twice before he jumped into the fire.” Anti-cremationists put aside their religious discomfort with cremation to argue that burning bodies would encourage crime—you can’t exhume a cremated corpse!—and dismissed the public health claims of cremationists as unfounded fear-mongering. (They weren’t wrong; there’s no evidence that in-ground burial encouraged the spread of epidemics.)

Inside the Detroit Crematorium columbarium at Woodmere Cemetery.

Inside the Detroit Crematorium columbarium at Woodmere Cemetery.

Throughout the 1870s and ’80s, as debates about cremation raged in the papers, local cremation societies were organized to argue their case and — more importantly—to raise funds to build crematories. The first public crematory in the U.S., at Lancaster, Pennsylvania—funded by the Lancaster Cremation and Funeral Reform Society—was built in 1884. By 1887, Cincinnati, Buffalo, Los Angeles, and Detroit had all built crematories, many of them designed to look like chapels, with stained glass and stonework. These crematories operated independently of cemeteries, which saw cremationists as competitors.

A few of these early crematories still exist; in Cincinnati, the building is hiding behind deceptive new construction.

The opening pages to 1887 book The Cremation of the Dead.

The opening pages to 1887 book The Cremation of the Dead.

Sometimes the dead traveled hundreds of miles to have their last wishes fulfilled. When Barbara Schorr died in Millersburg, Ohio in 1887, her family honored her wish to be cremated by sending her body to the Detroit Crematorium—nearly 200 miles away, it was nonetheless the closest crematory. But it was still under construction, so Barbara Schorr lay in state for several weeks while it was completed.

Today, a portrait of Barbara Schorr, commissioned by her sons, hangs in the columbarium at Woodmere Cemetery, honoring her as a pioneer of the cremation movement in Detroit.

 A stereoscope view of Lancaster Crematorium, Pennsylvania.

A stereoscope view of Lancaster Crematorium, Pennsylvania.

Because cremation was a moral crusade for the betterment of public health, it attracted sympathizers from other moral causes to its ranks, including no small number of women activists. The suffragist Lucy Stone was the first person cremated at the Forest Hills Crematory in Boston in 1893. Frances Willard—suffragist, temperance activist, and avid bicyclist—was also a vocal advocate of cremation. In 1900, the New York Times ran a satirical news item about the cremation of Willard’s cat: “Each of Toots’s human friends will sprinkle a little myrrh or frankincense over the body, and while it is being consumed the incense will counteract any odor which might be emitted through the furnace chimney.”

By the early 20th century, the sensationalism of cremation had waned, and the practical case for cremation was winning minds. After all, cremation, which requires no elaborate monument marker or plot purchase, is significantly less expensive than in-ground burial. Eventually, cemetery directors realized they might be better off joining the cremationists than trying to beat them. In 1899, Mount Auburn Cemetery—famously one of the original rural cemeteries in the U.S.—hired an architect to renovate an existing chapel on the grounds into a crematory. It was the first cemetery crematory in the state of Massachusetts, and it marked a turning point in the history from what was once a “ghostly” spectacle to an agreeably American way of death and burial.

Complete Article HERE!


Dying traditions, and new life, in the funeral industry



Vice president Arthur DeFilippo prepared a headstone at Woodlawn Memorials in Everett, a family-run business where sales have been declining for a decade.

Vice president Arthur DeFilippo prepared a headstone at Woodlawn Memorials in Everett, a family-run business where sales have been declining for a decade.

Death is inevitable, but, increasingly, traditional burials are not.

From diamonds made from cremated remains to eco-friendly interments, the $20 billion funeral industry is being reshaped, creating opportunities for the entrepreneurially minded — and financial hardship for those with business models more set in stone.


At Rockland Golf Course a few years ago, a kayaker paddled to the middle of a pond with the cremated remains of a golfer who had hit many an errant ball into the water. As the rower released the biodegradable container and the ashes dispersed, a bagpiper played “Amazing Grace” and 75 members of the man’s golf league chipped shots into the water.

A Great Barrington woman wrapped her mother’s body in a cotton sheet and laid her in a cardboard coffin lined with dry ice. The family then held a three-day vigil at her home dance studio, inviting people to play music and see and touch her face for the last time.

In Woburn, a carpenter with a degenerative brain condition is set to be buried in a suit embedded with mushrooms, which will neutralize the toxins in his body as it decomposes into the earth.

In Seattle, plans are underway for a facility to turn corpses into compost; in Italy, a pair of designers is working on a biodegradable burial seed pod that will allow a person’s decaying body to provide nutrients for a tree planted on top of it.

But the number of alternatives to caskets and cemeteries is making life tough for undertakers and monument makers.

At Woodlawn Monuments Inc. in Everett, sales have been in a “freefall” over the past 10 years, said co-owner David DeFilippo. His family has been making tombstones since his great-grandfather opened a shop in 1907, but DeFilippo, 50, said the company – which also employs his mother, aunt, and uncle — is likely to end with him.

“People always say to me, ‘You’re set, people are always going to die,’” said Jeff Hardy, of the Chelmsford burial vault company Hardy Doric Inc. “Well yeah, it’s what happens to them after that keeps changing.”

Death rates are rising as America’s population ages, but with some estimating that cremations surpassed burials for the first time last year, and other cheaper alternatives becoming more popular, profits are being tamped down.

Lewis Funeral Home on Nantucket closed its doors in 2013 after 135 years in business, citing the rise in cremation as a cause. Families who opt for cremation spend 42 cents on the dollar compared with those who have traditional burials, said Teresa Gyulafia, strategic communications director at Batesville, a funeral product manufacturer in Batesville, Ind. — “a big economic burden to the industry.”

Interest in cremations has risen swiftly in recent years, particularly among the growing ranks of the nonreligious. In the 1960s, less than 5 percent of deaths resulted in cremations, according to the Cremation Association of North America. But after the Catholic Church lifted the ban on cremations in 1963 and started allowing cremated remains at funeral Masses in 1997, the practice has become more common. In Maine, which has one of the country’s highest cremation rates, 73 percent of deaths resulted in cremations last year. In Massachusetts, it was 45 percent.

By 2030, the national cremation rate is expected to be 71 percent.

The movement toward cremation and natural burials harkens back to the way things used to be done. Cremation was big during the Roman Empire, before the practice became associated with pagan rituals. Embalming arose during the Civil War as a way to preserve the bodies of fallen soldiers being shipped home from the battlefield.

In response to a shifting market, traditional funeral providers are branching out, offering more custom products and personalized service. To counter a drop in domestic sales, Dodge Co. in Billerica, the world’s largest supplier of embalming fluid, has been selling more sports-themed urns and video tributes. New England Casket Co. in East Boston, founded by an Italian cabinet maker in the 1930s and now run his grandson, makes a casket with a camouflage lining and a rifle holder, among other unique offerings, and has started making more oversized caskets for an increasingly larger clientele.

At Magoun-Biggins Funeral Home in Rockland, owner Bob Biggins offers concierge services: making arrangements with caterers, helping plan dinners at country clubs, and arranging bereavement rates at hotels for out-of-town guests.

Biggins coordinated the golf course memorial. He also put together a funeral procession for an ice cream man led by his iconic truck, complete with popsicles for guests at the grave site, and had a body shop paint a casket to look like a school bus for a local driver.

“You have to adapt to meet what your clients’ needs are,” Biggins said, “and it’s not the old-fashioned cookie-cutter funeral.”

As death becomes less of a taboo topic — at “death cafes” the end of life is discussed over tea and cake — people are also increasingly looking for unique ways to memorialize the dead. Off the coast of Florida, a manmade reef serves as an underwater mausoleum for cremated remains. The Daytona International Speedway considered creating a place to house urns, known as a columbarium, to accommodate NASCAR fans who had been scattering ashes inside the track.

The burgeoning natural burial movement is also changing the industry. The Green Burial Council, which certifies environmentally friendly providers, started with a single funeral home in New Mexico in 2006; today, there are more than 300.

When Mount Auburn Cemetery in Cambridge held a workshop on green burials two years ago, on a sunny Saturday in June, 150 people showed up. “It was the first beach day of the summer, and all these people came to hear about death and disposition,” said Candace Currie, director of planning and cemetery development.

Mount Auburn has sold about half of its 50 natural grave sites in the past two years, and the nonprofit Green Burial Massachusetts Inc. is working to establish the first all-natural cemetery in the state. Mourning Dove Studio in Arlington has seen a sharp uptick in demand this year forbiodegradable caskets made of recycled paper, woven banana leaves, cardboard, and pine.

The process of alkaline hydrolysis, in which bodies are dissolved in a lye-like solution with the help of heat and pressure — seen as a more environmentally friendly alternative to cremation — is legal in a handful of states, including Maine and Vermont.

Some question the movement toward scattered ashes and unmarked graves as too ephemeral.

“How are we going to record our existence?” said Jacquelyn Taylor, a former professor of funeral service education at Mount Ida College in Newton who works as a data analyst for the Dodge Co.

But just because people want a natural burial doesn’t mean they don’t want a place to be remembered.

Dennis White, the Woburn carpenter with a degenerative brain disease, will be the first person to be buried in a Coeio mushroom suit. White, 64, liked the idea of returning his body’s energy to the earth, free of toxins, but wanted a plaque to mark his final resting spot. In Limington, Maine, he and his wife found a cemetery that would let them do both.

Ann-Elizabeth Barnes, the Western Massachusetts woman who held a home funeral for her mother and helps others do the same, said the experience helped bring her closure.

“The first day she looked like herself. She had a little smile on her face. She looked quite peaceful,” she said. “The next day she was just a little bit caved in. The next day she was definitely a cadaver.”

At that point, Barnes knew, “It’s time, she’s gone, we can really say goodbye.”

Complete Article HERE!


Woodlawn Cemetery Memorial Tells A Coney Island Story Of Unusual Death


Brighton Beach Lightning Strike Felt By Thousands, Kills Six – July 30, 1905


When walking through Woodlawn Cemetery in the Bronx, you can come across fancy mausoleums and simple grave markers of the famous and infamous. F.W. Woolworth, Fiorello LaGuardia, Duke Ellington, Bat Masterson and Herman Melville are among the half million souls interred in this historic place.

Then out of the blue you may stumble across the lives of ordinary New Yorker’s memorialized in an extraordinary way. Such is the Demmerle monument.

Unlike many other tombstones which record a name and birth and death years with a short epitaph, the Demmerle memorial is an ornate series of carved monuments which tells and shows the story of one family’s tragedy.

Demmerle-1110355-Charles-EmilieSunday July 30, 1905 started out as a beautiful, sun-filled, hot day and an estimated 250,000 New Yorker’s sought out the seashore of Coney Island for pleasure and a refuge from the heat. Charles Demmerle age 51, his wife Emilie age 49 and their two sons, Frank C. age 23, and Charles R. age 22 all residing at 372 East 16th Street Flatbush, spent the day with their cousin Robert T. Wasch age 16 at Brighton Beach.

After a day of swimming the weather started changing. At 4 pm the sky darkened and swimmers left the water as rain began to fall, coming down heavier and heavier as the minutes passed. Many took refuge near the Parkway Baths on the beach at Ocean Parkway.

As the rain fell, thunder and lightning approached the beach, a large flagpole topped by an eagle on the Boardwalk near the Parkway Baths became a gathering spot for thousands of beach goers seeking shelter. They congregated around the pole, on the boardwalk and under the boardwalk which covered the beach.

There were a few vivid flashes accompanied by thunder cracks before the big one came.

John Manzer, a witness standing on the boardwalk and looking up  described what happened next. “A ball of fire seemed to start right up at the eagle’s beak and travel downward around and around the pole. Right at the crosstrees it spread out and seemed to drop into the earth with a noise I will never forget.”

The flagpole was split in half. Everyone on or under the wet conductive boardwalk and sand beneath it was given a jolt and those nearest the flagpole were literally thrown to the ground. Thousands of people felt the electrical shock.  After the screaming subsided, it was noticed that five people were blue from head to toe and stone dead. Frank and Charles Demmerle, their cousin Robert and two others, all near the base of the flagpole were killed instantly. At least nine others suffered serious burns. Simultaneously, a sixth man standing under a tree in nearby Gravesend was killed by what was believed by some to be the same bolt that had struck in Brighton Beach.

The dead were taken to a nearby room when Mrs. Demmerle came by looking for her missing boys.

The New York Times reported that she took one look at the bodies stretched out on the floor and fell forward crying “Oh, my boys! The dear boys to whose future I had looked forward with so much pride. I warned them not to go into the water when the storm came up. I feared even then that some evil was about to befall”

The Demmerle’s put up this poignant monument to commemorate their loss. The large memorial stone has three bronze reliefs showing the young men. The monument also has set into the stone in bronze relief  the depiction of the lightning bolt striking the flagpole and the boardwalk.

The words on the front of the monument read simply “Our Fondest Hopes Lie Buried Here!” with the names and ages of the three young men. Beneath that it says “TAKEN SUDDENLY IN AN HOUR OF HAPPINESS. STRUCK BY A BOLT OF LIGHTNING.” The rear of the monument contains a long anguished poem.

Parents, Emilie and Charles’ Demmerle’s monument to the left of their sons and nephew depicts a life size statue of mother Emilie, sitting on a tree stump, offering flowers, her head cast down in mourning, with a broken tree limb above her.

It is truly a magnificent work of funereal art and it certainly calls attention today to the fact that this family’s anguish is worthy of remembrance and a retelling.

Complete Article HERE!





For 75 years, Colma, Calif., has been steadily collecting bodies and it’s constantly getting deader. As of 2009, the city had 1,500 living residents and 1.5 million marked graves. Seventy-three percent of Colma’s land belongs to the dead with the rest occupied by people who have a great sense of humor. The town’s motto: “It’s Great To Be Alive In Colma.”


Complete Article HERE!


9 Most Haunting Graves in Paris’s Pere Lachaise Cemetery


By: Olga Kirshenbaum


If every cemetery tells a tale, then Père Lachaise speaks volumes. Anywhere from 300,000 to 1,000,000 souls are interred within the walls of Paris’s grand burial ground. Along its winding tree-lined paths rest some of the most influential writers, painters, musicians, and politicians in history–many of whom continue to fascinate even in death.


Balzac was a famous French writer from the 19th century. One of his most well-known publications is La Comédie Humaine or The Human Comedy, a multi-volume collection of 90 works depicting the life of the bourgeoisie. Balzac’s headstone consists of a bronze bust placed upon a pillar with a quill at its base. The tomb rests in a peaceful spot of the cemetery, with trees and smaller graves surrounding it.


Alphonse Bertillon was a French criminologist from 1853 who established an intricate forensic method used to identify criminals–much of which is still in use today. One facet of the Bertillon system involved taking profile photographs of criminals, now known as the mugshot. Bertillon’s tomb, covered in intricate carvings, has suffered from years of exposure to the elements. Moss blankets the top of the tomb, while a twisted bed of tulips (unfortunately not in bloom here) sprout up from the bottom.


Bizet was a French operatic composer from 1838. The opera “Carmen” is one of his most famous works. He was a gifted child, entering the Paris Conservatory at age 9. In 1857 he won the Prix de Rome, a prestigious scholarship that allows students to study their art in Rome. Bizet’s grave overlooks a steep hill dotted with gorgeous trees. His tomb rests in the shadow of a much larger mausoleum, but its simplicity is what draws your eye. Overlooking the grave is a stone marker crowned with an intricate bronze sculpture of wreathed harp.


Géricault was a gifted French Romantic painter who died in 1824 at the age of 32. Even if you’re unfamiliar with the young master’s work, there’s no doubting his grave contains an artist. A relief of Géricault’s “Raft of the Medusa,” which currently hangs in the Louvre, adorns the side of this tomb.


Félix Galipaux was popular musical hall actor in 1880s France. He moved into film around the turn of the century, starring in some of the first sound films ever produced. Galipaux’s tomb is crowned with a bust of the man. It’s a simple grave but it has a distinction to it.


A Polish composer and a prodigy on the piano, Chopin studied at the Warsaw Conservatory. Although he was a virtuoso performer, Chopin preferred to teach and compose for the stage. Chopin’s tomb is nestled on a hillside and often difficult to track down–but once you’re on the right path it’s hard to miss. The intricate fence surrounding Chopin’s tomb is covered in flowers.


Doors frontman Jim Morrison died in Paris in 1971. He was buried in Père Lachaise, where the party followed the 60s singer even in death. Empty liquor bottles, handwritten letters, and bouquets of flowers littered the unassuming grave throughout the seventies and eighties. Graffiti covered Morrison’s headstone and the graves surrounding his burial plot. A bust of the singer, installed upon the grave in 1981 to commemorate the 10th anniversary of Morrison’s death, was stolen in 1988. Today, a security guard stands watch over the tomb, curtailing such rowdy behavior.

EDITH PIAF – SINGER (1915 – 1963)

Edith Piaf was a French cabaret singer from 1915 whose soaring voice earned her the title of one of France’s greatest stars. Taking a small path off a main road of the cemetery, Piaf’s burial plot rests among many other graves similar to it. The simple tomb is adorned with a crucifix and decorated with red roses left by visitors. Standing graveside, it’s hard not to hear one of Piaf’s moving songs playing in the distance.


Belgian-born poet and novelist Georges Rodenbach moved to Paris toward the end of his life, where he contributed to the Belgian literary renaissance movement. His famous works include novels Bruges-La-Morte and Le Carillonneur. The author’s tomb immediately catches your eye, as there’s nothing like it even in the grand Père Lachaise. Similar to the dramatic style of Rodenbach’s writing, the tomb is of a man said to be Rodenbach emerging from the grave and grasping a rose.

 Complete Article HERE!


Dollhouse Graves


By By Charlie Hintz

These grave markers are as sad as they are sweet. These dollhouses were built by grieving parents for their beloved daughters, complete with favorite toys and other significant items. Though they are plagued by vandalism through the years, they continue to be kept up and restored when need be.

Dorothy Marie Harvey (1926-1931)

Dorothy Marie Harvey and her family were passing through Medina, Tennessee on their way North to find work. When Dorothy got measles and died, the townfolk helped her family bury her in Hope Hill Cemetery.

Her parents left her behind and continued on.

Vivian Mae Allison (1894-1899)

The dollhouse of Vivian Mae Allison is located in the Connersville City Cemetery in Connersville, Indiana.

Lova Cline (1902-1908)

Lova Cline’s dollhouse memorial is in the Arlington East Hill Cemetery in Arlington, Indiana.

Nadine Earles (1929-1933)

The grave of Nadine Earles is in the Oakwood Cemetery in Lanett, Alabama.

The story goes that Nadine wanted a dollhouse for Christmas. Since she died just before the holiday, her parents built her a dollhouse on her grave and filled it with her toys and personal belongings.

Complete Article HERE!


Doulas ease transition for patients, families as death nears



Henry Fersko-Weiss working as an end-of-life doula for Gloria Luers, 92, of Cliffside Park. Fersko-Weiss helped start a doula program at The Valley Hospital and is beginning another at Holy Name Medical Center.

Henry Fersko-Weiss working as an end-of-life doula for Gloria Luers, 92, of Cliffside Park. Fersko-Weiss helped start a doula program at The Valley Hospital and is beginning another at Holy Name Medical Center.

At 92 and with cancer spreading through her body, Gloria Luers knew she didn’t have much time. She began contemplating her final days, saying she wanted to be surrounded by family and to listen to stories and her favorite music.

But in those last days, she would also have strangers join the round-the-clock vigil at her bedside, people she had never met but who would nevertheless walk into her room knowing that she liked Italian tenors and the lumbering sounds of her great-grandchildren at play.

Henry Fersko-Weiss working as an end-of-life doula for Gloria Luers, 92, of Cliffside Park. Fersko-Weiss helped start a doula program at The Valley Hospital and is beginning another at Holy Name Medical Center.

Robert Gutenstein of Ridgewood in his bedroom, which he shared with his wife, Ellen, who died nearly a year ago after battling cancer.

These strangers, all volunteers, would be there to comfort and console Luers and her family as death neared, making sure her final wishes would be followed and that her dying days paid homage to her living ones.

While hospice workers would manage her physical pain and guide her care, the volunteers, known as end-of-life doulas, would be there so family members could sleep and take a break, supporting everyone through what would be a long, exhausting experience. Their mission would be to help Gloria Luers and her family remain focused on her life instead of her illness and, in the process, gain some peace.

When the family decided to accept the offer by the hospice program to provide the doulas, her daughter, Denise Rich, said she was comforted to know that she wouldn’t be alone if her mother’s death came at a time when her husband was away at work and other family members couldn’t get there quickly enough.

“A big fear of mine is that I’ll be by myself and I won’t know what to do or what she needs,” said Rich, a Cliffside Park resident. “Now I know that there is someone out there who I can call when the time comes.”

The word “doula,” evolved from its ancient Greek meaning of “woman who serves,” has most often been used to refer to someone who coaches a mother-to-be through childbirth, providing emotional support through what can be a scary experience. Henry Fersko-Weiss, a longtime social worker, said it’s a concept that can be applied at the end of life.

Five years ago, he helped start an end-of-life doula program, a free service, at the hospice run by The Valley Hospital in Ridgewood, where the doulas are trained to recognize the signs of approaching death and schooled in easing the stress of a dying person and their families. He is now launching a second program, this one based at Holy Name Medical Center in Teaneck. Paid hospice staff supervise the two programs, but volunteers provide all the bedside support.

Fersko-Weiss, who also founded the International End of Life Doula Association, said he hopes doulas will one day become part of the standard of care at hospices, assisted-living residences and nursing homes around the world.

“We help people be born into the world, why wouldn’t we also want to help as they transition out of this world?” said Janie Rakow of Wyckoff, a doula with Valley.

Rakow and other doulas were there in the final days of Ellen Gutenstein’s life last April. Her husband and daughter often look back on what it meant for them to have seven strangers come in to help when she began to drift away.

By then, the 77-year-old Gutenstein’s physical world had shrunk to the bedroom she and her husband had shared for decades in their Ridgewood home, her hospital bed wedged next to the couple’s wood-framed, king-size bed. The room was crowded with medical equipment, and the tops of dressers and bureaus were filled with medicine bottles and the other detritus of terminal illness. But it was brightened by pictures of the grandkids and beloved collectibles.

As much as possible, for as long as possible, members of Gutenstein’s family wanted her to remain a part of their lives. But even with her husband sleeping in the bed next to hers, her daughter staying over most nights, and her two sons and grandchildren making regular trips in from out of town, it was hard for one of them to be awake and at her bedside every minute of her last days.

In the blur of that emotional time, Robert Gutenstein has forgotten the names of the doulas who spent three or fours hours each keeping watch while sitting in the chair next to his wife’s bed, including the one who was there at the end. But the family hasn’t forgotten the works they performed.

There was the one who lifted their spirits with her beautiful singing voice. There were the others who read aloud to Ellen from the “legacy book” the doulas had encouraged the family to assemble, an album of photos from vacations and major life events as well as letters and written reflections from her children, grandkids and friends.

“What stands out most to me about the doulas is that they were all so loving with someone they had just met,” said the Gutensteins’ daughter, Lisa Silvershein. “Somehow, they all seemed very familiar, like they just understood and were helping us to be prepared for what was coming.”

Kristen Tsarnas, a volunteer doula, said death is a subject in which society has not advanced for the better.

In the frontier days, when hospitals were few and far between, a family brought a loved one home to die and the community came to bear witness to the leave-taking. “This kind of tending to someone at the end of life is really an old thing that kind of disappeared from our modern society,” said Tsarnas, who lives in Allendale.

In describing her role as a doula, she often uses the word “witness.” “It’s sort of a way for the family to feel the significance of the moment — that this is an important enough event that some stranger came to my house to be there for the end of my mother’s life,” she said.

Her view is shaped by the sudden death of her stepfather when she was 18. He was hospitalized, but not expected to die. So she didn’t return home from college and her mother didn’t stay the night at the hospital. More than two decades later, both are burdened by his being alone when he died.

“No one should be alone in a hospital in a cold room when they die,” Tsarnas said.

Fersko-Weiss sees the companionship and comfort the doulas offer as “the missing piece of the hospice mission.”

Hospice programs provide dying patients and their families with a host of services — nurses, social workers, grief counselors, medicine and medical equipment — intended to ease pain and suffering. But hospices can’t offer round-the-clock staff and while their social workers and grief counselors attempt to prepare families for the final days, he said, many still find themselves overwhelmed by the changes that can unfold quickly at the end of life.

“In my years in hospice, I saw a lot of cases where people are kind of unprepared for the final day,” he said. “I think people don’t take it all in until it’s happening, and by then they are emotionally and physically exhausted.”

The doulas are trained in calming and soothing techniques, such as meditation, aromatherapy and therapeutic touch. Most don’t come from medical or counseling backgrounds, and they are not expected to take on the direct caregiving tasks that hospice staff and home aides perform. Their job descriptions are more amorphous — some see it as akin to social work, nursing or ministering. Others say the mission is simply to be present and ready to serve.

“A lot of our doulas are very spiritual, holistic kind of people who just have a calling to do this,” said Bonnie Schneider, who manages Valley’s doula service, which is offered as a no-cost service to patients in the hospice program.

At a recent training session for the 19 volunteers learning to be doulas for the Holy Name program, Fersko-Weiss stressed the importance of a lead doula paying early visits to a dying person to help create a “vigil plan” that spells out what that individual wants — candles burning, their hands held, poems read and the like. Such plans are shared with all doulas assigned to the case. The doulas need to be sensitive, Fersko-Weiss told the trainees, to the fact some families may have conflicts still playing out, so they should try to encourage family members to express their feelings of loss and to both seek and offer forgiveness.

Since Valley began its program in the fall of 2009, the doulas have participated in more than four dozen vigils, many in private homes, but some in nursing homes or in-patient hospice centers. The typical vigil lasts 24 to 48 hours, Schneider said, and the longest went eight days. Valley’s 40 doulas have worked with many other terminally ill patients and families, helping them to think about how they want the final days to play out.

The doulas are called in at the onset of what’s called the active dying stage, when they exhibit symptoms such as slowed breathing, a drop in blood pressure and a third day of refusing to eat.

For Bob Eid, a doula from Mahwah, being at a death is a profoundly moving experience.

“I think death is a very sacred moment,” he said. “I’m not uncomfortable around it.”

Before Coleen Shea made it her official calling to sit with the dying, family circumstances put her at the bedsides of three of her own.

The first was six years ago, when her 92-year-old grandmother died and the scene at the bedside was like something out of a Hallmark special, children and grandchildren lined up three deep around her bed.

“Everybody was able to lay a hand on her and to tell her what she had meant to them,” Shea said. “Her whole bedside was surrounded. It was exactly how anyone would want it to be. I left there thinking it was an immeasurable privilege to have been there.”

Shea also spent time with two uncles in their final days. Those deaths were less peaceful, but no less moving. She recalls when one uncle suffered a painful seizure a few days before his death. She comforted him by telling him that he had fought bravely and that it was all right to let go.

“I sort of felt like I had made a difference,” she said.

The Glen Rock mother of two compares her doula position to that of a nurse who must move from room to room, tending to different tasks and needs in each.

She doesn’t expect a family to get to know her. Instead when she walks into a new home, she scans her surroundings for the things that most need doing — someone in need of a break or a comforting word, or a patient with arthritic hands who might enjoy a massage.

“I’m just as afraid of dying as anybody else,” she added. “But for whatever reason, I don’t shy away from being there.”

Rakow, who volunteers for both the doula and hospice programs at Valley, said she is routinely asked whether being present at so many deaths makes her sad.

“It’s actually the opposite. We feel humbled to be there and uplifted by the expressions of love we witness,” she said. “There are times when family members have had tough times with each other throughout their lives, and you’ll see how that just strips away at the end, and how they come together. It’s incredibly moving.”

Nearly a year after his wife’s death, Robert Gutenstein still regularly pages through her legacy book. The last picture, taken just a few days before her death, is of Ellen celebrating Easter dinner with her family and friends.

“The doulas were just wonderful to her,” he said. “They engaged her in life so that she wasn’t a body sitting in a corner isolated from things.”

The family came to rely on the ever-present doulas in Ellen’s final days. “At that point, you don’t want to leave her alone,” said Silvershein, Ellen’s daughter. “Because the doulas were there, we were able to sleep. It was just kind of nice to put somebody else in charge.”

Silvershein was headed to bed a little after 11:40 on Friday, April 25, when she stopped into her parents’ room to say good night. She and the doula noticed a change in her mother’s breathing pattern and woke her father, who had been asleep for a few hours in the bed next to his wife’s.

“I’m half-asleep,” Robert Gutenstein recalled. “I put my hand on her hand, she gives me a squeeze, and that was it. She stopped breathing.”

Rakow, who had served as the lead doula on Ellen’s case, arrived at the home with bagels for breakfast the next morning. Several doulas attended the funeral. A month later, Rakow and Silvershein together talked about the shared experience.

Silvershein credits the doulas with helping her find her way in those emotional days. Because a person’s hearing can be the last sense to go, the doulas encouraged her to keep reassuring her mother, even after she drifted out of consciousness.

“They told me, ‘Tell her you love her, tell her that Dad is going to be OK, and that we’re all going to be OK,’Ÿ” Silvershein said. “I don’t know that I would have thought to say all of those things without the doulas being there. I feel like they just guided us through the whole experience.”

A month ago, on a visit with Gloria Luers to plan what she and her family might need from the doulas, Fersko-Weiss asked about the sights and sounds that bring her comfort. In addition to music, she talked of the frequent visits of her young great-grandchildren, who call her “GGMa.”

Her memory still firm and clear, she regaled him with anecdotes from a girlhood living without a mother, her husband’s war years and the years she spent tending to children and grandchildren. “I am good at telling stories, and I have some good ones to tell,” Luers said. Fersko-Weiss pledged to write them down and help her family assemble a legacy book for her loved ones.

Luers began to decline a week ago, no longer able to speak and unable to get out of bed, and was moved to the Villa Marie Claire hospice in Saddle River. Her daughter stayed over most nights and her son and grandchildren visited often.

On Wednesday, five doulas began taking shifts, playing songs sung in Italian by Andrea Bocelli and sitting with family members as they shared stories and talked about the Fort Lee home where Luers raised her family.

“It was a lot of reminiscing and talking about the things that stood out about her in life,” Fersko-Weiss said.

About 9 a.m. Friday, as Gloria’s breathing became shallow, Fersko-Weiss woke her daughter, who was sleeping in another room after being up much of the night with her mother.

Gloria Luers died about 15 minutes later, with both of her children, a grandson and Fersko-Weiss — not a stranger anymore — at her bedside.
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