With its queen gone, Britain ponders how to discuss death

A woman reacts next to flowers and messages for Queen Elizabeth II at the Green Park memorial, near Buckingham Palace, in London, Sept. 10, 2022. Because she reigned and lived for so long, Queen Elizabeth II’s death was a reminder that mortality and the march of time are inexorable.

By John Leicester

Where goes Queen Elizabeth II, there — inevitably — go each of us and all those we love.

Because she reigned and lived for so long, seemingly immutable and immortal, the death of the British monarch after 70 years on the throne and 96 years of extraordinary life was a reminder, in Britain and beyond, that mortality and the march of time are inexorable, waiting for neither man nor woman, even a royal.

That kernel of wisdom from Elizabeth’s passing, the last of many she dispensed during her lifetime, is uncomfortable, even difficult, for the living. The reality of death — the queen’s being, by extension, a glimpse at the eventuality of their own — is part of the reason why some Britons mourning the only monarch most have known are feeling a complex soup of emotions.

Some have called bereavement counselors for solace and said her departure has rekindled grief for others they loved and lost. And Britons acknowledge that they sometimes struggle with the emotions of loss. “We don’t necessarily do grief and bereavement that well,” says Lucy Selman, a professor of palliative and end-of-life care at Bristol University.

British bereavement experts are hoping, however, that the queen’s death and its manner — at home, with family, in her beloved Balmoral Castle — might also spur a national conversation about the sometimes awkward relationship that Britons have with dying. In the process, the experts hope, it might prompt them to better prepare for the inevitable.

“If we are going to die in a way that we hope is peaceful, comfortable, and satisfying for us, we have got to do what the queen did: Recognize that it is going to happen at some point and put some plans in place for what we want and what we don’t want to happen,” says Kathryn Mannix, author of “With the End in Mind: How to Live and Die Well.”

Mannix has witnessed thousands of deaths in her 30-year career as a palliative care physician. She says it became clear in the last two years of Elizabeth’s life that she was dying. She recognized familiar patterns — in the slowdown of the habitually frenetic queen’s schedule and the preparations she made.

In her final months, Elizabeth made it known that when now-King Charles III succeeded her, she wanted his wife, Camilla, to be known as “Queen Consort.” And she lingered to see her grandson, Prince William, and his wife, Kate, relocate their family from central London to a royal cottage in Windsor.

One of her very last actions as queen was to ask Conservative Party leader Liz Truss to become her 15th and, as it turned out, last prime minister. That audience was last Tuesday, Sept. 6. It was the first time in Elizabeth’s reign that she’d been away from her official London residence, Buckingham Palace, for a prime ministerial appointment. Instead, she stayed in Balmoral, her Scottish vacation home, and Truss traveled to her.

Duty done, the queen died two days later. Mannix was reminded of other deaths she encountered in her medical career, of people who clung to life “to hear the news that a baby has been born or an exam has been passed” and who then relaxed “very quickly into dying.”

“There is nothing at all disrespectful about recognizing that even our monarchs are mortal and that what happens at the very ends of people’s lives is a recognizable pattern,” Mannix says. “We perhaps can use this as an occasion to start to think about knowing the pattern, being able to recognize the pattern, being able to talk to each other about the pattern — not being afraid of it.”

>Described by the government as “a period of time for reflection,” the 10 days of national mourning decreed for Elizabeth’s passing are also, unavoidably, giving dying, loss and bereavement starring roles in the wall-to-wall media coverage of the queen’s life and times.

Bereavement experts say the rituals of communal grieving and the mourning period — practically an age in the swipe-and-tap era of short attention spans — are an exceptional and important opportunity for Britons to adjust to the loss of a queen and the gaining of a king, and to process the emotions and anxiety that enormous change sometimes brings.

For young people, “this might be first time that they learn about the finality of life and what that means,” says psychologist Bianca Neumann, the head of bereavement at Sue Ryder, a British charity that offers support through terminal illness and loss.

“We never really look at the end of life like that, unless we have to,” she says. “It would be nice as a nation if those conversations could become more mainstream.”

Psychotherapist Julia Samuel, who was a close friend of the late Princess Diana, is urging Britons to pause and digest their loss. Posting on Instagram, she said that “if we just keep going and doing what we normally do, our brain isn’t given the information to let us know that something very big has happened.”

“The task of mourning is to adjust to the reality of a death,” she says. “To do that, we need to let our brain kind of slow down.”

To be fair, British conversations about death and loss have taken place for centuries. In “Hamlet,” Shakespeare had his prince muse famously about the human condition, clutching the skull of Yorick, a court jester.

“Alas, poor Yorick! I knew him,” Hamlet mourns. “Where be your gibes now? Your gambols? Your songs?”

>Britons also surprised themselves and the world, casting off their reputation as a nation of stiff upper lips, with a deluge of public tears over the death of Princess Diana in 1997.

“The pendulum went from the one side to the other,” says Adrian Furnham, a London-based professor of organizational psychology at the Norwegian Business School and author of “Psychology 101: The 101 Ideas, Concepts and Theories that Have Shaped Our World.”

“It’s now much more acceptable, and indeed a lot more healthy, to ‘let it out,’” he says. “That has changed in this country, because there was a time when that was distinctly a sign of weakness.”

Still, Britons concede that they could do better in helping others and themselves through bereavement. Sue Ryder last year launched a “Grief Kind” campaign, to help people find words when those around them lose loved ones.

Selman is a founding director of the “Good Grief Festival,” started during the COVID-19 pandemic to break taboos around dying. She hopes mourning for the queen will produce “a bit more awareness and an ongoing discussion about bereavement and loss and our social attitudes towards it.”

“There’s a conversation to be had about what a good death is,” she says. “And what we can do to try and ensure that we have the death that we want.”

Complete Article ↪HERE↩!

September 15, 2022September 14, 2022

No Will?

You’re Putting Your Kids at Risk

By Natasha Meruelo

Many people delay the conversation or thoughts of having to prepare a will. Confronting the possibility of one’s death is not easy. However, as the recent death of Anne Heche shows us, not having a will can place a significant burden on your children and cause undesirable complications. Even if difficult, planning ahead may be a better solution than the alternative.

What Happened With Actress Anne Heche?

Anne Heche’s case is a good example of why a person may want to consider creating a will sooner rather than later. Heche was divorced with two children from different relationships when she passed away. Her eldest son is 20 years old, but her younger son is still a minor.

Although they are assumed to be her sole heirs, only her oldest son is of age to administer her estate. He has filed a petition for a guardian ad litem to be put in place to protect his younger brother’s interests. The guardian ad litem may be a financial burden to Heche’s estate, and the costs of securing this professional will potentially reduce the assets available to her sons.

Even though her eldest son is dealing with his mother’s estate, this is undoubtedly very difficult for a person to go through at such a young age. Heche’s eldest son likely will not be able to do this all on his own and will need the services of a probate attorney — likely further increasing the costs of administering her estate and depleting how much is left for her children.

It has also been reported that an inventory and appraisal of her estate is needed to determine its worth and what assets she had. This process requires further professional involvement and fees that her estate must pay. In addition, it is possible that the father of her youngest son may seek to intervene in the estate’s administration to ensure he is treated fairly. Litigation costs could rack up quickly if there is any disagreement related to this.

Preparing a will and other estate planning documents can make legal proceedings significantly less complex and expensive and keep your situation as private as possible. It can also make it easier for your loved ones to know exactly what you want to happen to your assets and possessions.

Who Inherits When You Die Without a Will?

Many people do not realize that if you pass away without a will, your local state laws on intestacy will determine who qualifies as your heirs and inherits your property.

For example, in many states, if a person passes away unmarried but with children, the children will inherit everything. But what if the person had a long-term partner or was engaged to be married? They may have wanted their significant other to inherit some of their assets, but a “default” state law may lead to a different result. Or, what if you have no living children, siblings, parents, or spouse? Your property may go to the government instead of friends, grandchildren, nieces, or nephews. Having a will prevents these scenarios from happening.

Choose a Guardian for Your Children

Another benefit parents should consider is their ability to choose a guardian for their children in advance.

This matters, for example, when the other parent is not living or cannot be located. If a person does not set forth their wishes ahead of time, multiple parties may step up after a person’s death and argue over who should care for any minor children.

A court may be tasked with making this decision, and it may not be what you would have wanted. This can be expensive, traumatic for all involved, and a long process. Courts will generally try to appoint the individual a person has selected if your wishes are in a will or other planning document.

The Bottom Line

The bottom line is that having estate planning documents in place makes your wishes more likely to be honored and less likely that a court will decide what happens. This is also true where you may be incapacitated and unable to voice your wishes. While Anne Heche’s situation is not unusual, it is avoidable.

Complete Article ↪HERE↩!

September 14, 2022September 13, 2022

How to Cope With Anticipatory Grief

Knowing that a loss is coming doesn’t make grief any easier to handle.

By Rachel Fairbank

Grieving is hard and complicated after a loss, but some people may find themselves dealing with anticipatory grief, which is grief that comes before a loss. Anticipatory grief can happen in situations such as when a friend or family member has been diagnosed with a terminal illness—when a loss is known to be coming, but it hasn’t happened yet.

Why anticipatory grief can be so complicated

Although anticipatory grief happens in situations where the impending loss is known and expected, it still prompts a complicated grieving process—one that can be every bit as hard as the actual loss itself. It’s the uncertainty of being in this in-between state, where there’s still hope that the loss might not happen or optimism about finding closure in a relationship that makes anticipatory grief so complicated.

“Even though you might expect it, it still feels unexpected, no matter how much we feel like we’ve had time to prepare for it,” said Alexandra Cromer, a licensed professional counselor with Thriveworks. “It’s almost like there are multiple deaths or multiple grieving periods.”

For example, if a person is caring for a parent with dementia, there’s the grieving period associated with the loss of their mental capabilities, which is then followed by the grieving period associated with the loss of their physical presence. “There is never uncomplicated grief,” Cromer said.

There are many emotions associated with anticipatory grief

“In some instances, anticipatory grief can serve a function of helping you feel prepared,” Cromer said. In the example of a parent who has been diagnosed with a terminal illness, this may be a time for talking with them about their will and their end-of-life preferences. But it still comes with an enormously complicated set of emotions, many of which can be confusing and painful. “It’s sadness, but it’s also anxiety, frustration, denial, blame. This is something that can wreak a lot of havoc,” Cromer said.

It can be especially hard to acknowledge those emotions when the loss hasn’t happened yet. “A lot of people, when they’re experiencing anticipatory grief, they don’t give themselves permission to feel all of these emotions,” Cromer said. “They’ll say, well, my mom’s not dead yet, why am I upset? Or, okay, she has two years to live, why am I anxious all the time and can’t enjoy the time I spend with her?”

What to do about anticipatory grief

If you are experiencing anticipatory grief, which is making it hard to function in your daily life, then it’s important to seek professional help, preferably from someone who has experience with different types of grief. “If it feels like you are wearing ankle weights, that life just got extra hard, and is requiring so much more energy, that’s when it might be a good time to seek help,” Cromer said.

However, as Cromer notes, even if your grief isn’t impacting your daily functioning it can still be helpful to seek out help, as that can help it from getting worse. “Early intervention can help,” Cromer said. “The sooner we get ahead of something, the sooner we have that trusted professional, typically, the better the outcomes are.”

Complete Article ↪HERE↩!

September 13, 2022September 13, 2022

I’m Having My Body Turned to Compost After I Die

Turning in your grave is the newest alternative to burial or cremation.

By Becky Garrison

As a child of an Episcopal priest, I grew up hearing the phrase “ashes to ashes, dust to dust” at more Ash Wednesday services and funerals than I care to count. I was too busy either squirming out of boredom or trying to wipe ashes from my forehead to give the implications behind this phrase much thought.

Before my hippie parents died from their addictions in the late 1970s, they explained to me how they intended to put the spiritual concept of “ashes to ashes” into practice by choosing cremation. My teenage mind envisioned all kinds of bizarre scenarios of what I could do with their ashes, my gallows brand of humor predating Weekend at Bernies by well over a decade.

Their choice of cremation proved to be one of their few sound lifestyle choices. They made this decision because they believed this practice was more in line with their earth ethics than a commercial traditional burial. According to the Green Burial Council, annually traditional burials in the United States use approximately:

4.3 million gallons embalming fluid, 827,060 gallons of which is formaldehyde, methanol, and benzene
20 million board feet of hardwoods, including rainforest woods
1.6 million tons of concrete
17,000 tons of copper and bronze
64,500 tons of steel
Caskets and vaults leaching iron, copper, lead, zinc, and cobalt

While modern traditional cremation may be less toxic, experts say the energy and emissions are equal to two tanks of gas in an average car. Simply put, that’s too much noxious residue to suit my soul. This is one road trip I’d prefer to avoid—and I decided to go a step further than my parents by giving my body back to the earth in a more natural manner.

The question was how exactly I could do that. When I turned the big 4-0, I found myself drawn to the concept of a green burial as a way to leave no trace behind when I depart. But eco-friendly burials were a service only available in select locations, and any burial expenses cost more than what I could afford to set aside. So I deferred any decisions regarding what would happen to my body after I died. After all, I was young and so far had avoided overindulging in those vices that destroyed much of my extended family.

Then COVID hit, along with wildfires impacting Portland, Oregon, where I live—not to mention the arrival of my 60th birthday. The uptick in mailings from AARP and others marketing to the “silver hairs” (sounds more upscale, I suppose, than old farts) told me I needed to make some key life decisions, including what would happen to my body upon my demise.

So I began researching natural burial options, and soon learned I am among the majority of Americans intrigued by this option. According to the National Funeral Directors Association’s (NFDA) 2022 Consumer Awareness and Preferences Report, 60.5 percent of respondents would be interested in exploring “green” funeral options because of potential environmental benefits, cost savings, or some other reason, up from 55.7 percent in 2021.

While the association supports eco-friendly burials, as NFDA spokesperson and funeral director Stephen Kemp explained, state and federal laws limit the options they can provide to families. For example, he finds the Hindu method of natural burial—where families do the cremation themselves—to be a wonderful process. “I wish we could do it like they do in India but some of the EPA rules forbid that here in the United States,” he said.

According to Kemp, the most popular request he receives from families looking for a greener burial is a natural burial in a green cemetery. I already ruled this option out as my estranged family has no communal plot where I could rest permanently. I figured no one would bother to visit, let alone ensure my grave doesn’t get overrun with weeds, varmints, and too-horny Goth kids.

In looking over the other greener choices, the water lover in me felt drawn to alkaline hydrolysis. Practitioners say this water-based process of cremation results in over 90 percent energy savings compared to flame-based cremation. But I wondered what would then happen to my remains. Did I want them turned into stones, placed in a water-soluble urn such as a papier-mâché turtle that would be sent out to sea, or used to help create an artificial reef formation? These options looked pretty on paper but were either too impractical or way out of my price range.

As an avid hiker, fly-fisher, cyclist, and gardener, I felt a strong tug to go back into the earth as living soil. So I found myself attracted to human composting, a method of accelerated human decomposition known scientifically as Natural Organic Reduction (NOR). After this process is completed, my remains could be placed in a plantable urn or converted into soil that could be returned directly back into the earth.

When I mentioned the process of human composting to a few friends, the responses I got ranged from morbid curiosity to outright disgust, with a smattering of jokes about how my soil would provide the perfect growing conditions for cannabis plants. Undaunted, I continued my research and learned that NOR was legalized in Oregon, Washington State and Colorado, with laws under consideration in New York and California.

After weeding out some for-profit human composting centers that came off as too commercialized and cold for my spiritual sensibilities, I discovered Herland Forest, a non-profit natural cemetery located on the eastern edge of the Cascadian wilderness. For starters, their price of $3,000 was at least half of what the other outfits charged.

In my phone conversation with Senior Steward Walt Patrick, I found their philosophy towards nature in sync with my soul. He describes the difference between traditional burial practices and their practice: “Commercial death care does what it can to keep the decedent from returning to the natural world and reentering the cycle of life. In contrast, we do what we can to help the decedent become a dynamic part of the cycle of life. NOR offers a way to transition from the path one walked in life to becoming part of the larger circle of life.”

Patrick detailed the process to turn a body into soil:

An insulated coffin configured as a cradle is prepared with a layer of 80 gallons of moist wood chips, and the body is then laid in the cradle on top of the wood chips and covered with another layer of wood chips. The cradle lid is put in place and bolted down, and every few days, the cradle is rolled back and forth.

Herland Forest

The temperature inside the cradle is monitored. As decomposition gets underway the internal temperature will climb to above 130 degrees Fahrenheit. and then slowly come down. When the internal temp falls to below 80 degrees, the initial process is complete. The cradle is then opened and the composted remains are removed, processed, and stored in 55 gallon drums.

The resulting soil is either picked up for distribution on private property or added to Herland’s living sanctuary filled with native pine, fir, and oak trees, along with non-native varieties such as chestnut, walnut, gingko, cherry, apple, and hazelnut. So I have the option of either letting a buddy grow buds with my remains so they can smoke my spirits or having hikers walk all over me now that I’m part of the PNW landscape.

This venture represents an outgrowth of the Windward Education and Research Center, which for decades has utilized forest products to transform the remains of large farm animals into nutrient-rich compost. After Washington State legalized NOR, they continued composting the remains of the animals they work with in their sustainability research. But as Patrick noted, “the change in the law just allowed us to apply the skills we’d been developing for two decades to the disposition of human remains.”

Herland Forest

After the decomposition process is completed, the compost is the property of the family, and they can do whatever they wish with it. The photos on their website of their permaculture forest told me I’d be at home in their living sanctuary—helping to feed the native trees.

Having made the decision to participate in Herland Forest’s program, I’m filled with a sense of peace knowing I will leave behind a living and lasting legacy. More importantly, as I emerge from an extended period of isolation as a result of this global pandemic, I’m filled with an intense burning desire to connect with nature. Right now, I am ready but not eager for that time when I will become a part of the Pacific Northwest wilderness.

Complete Article ↪HERE↩!

September 12, 2022September 11, 2022

I have terminal cancer.

A houseplant is helping me confront mortality.

David Meyers has placed his lucky bamboo in a living room window. He has found comfort in caring for the plant since his brain cancer diagnosis.

Watering the bamboo, as small an act as it was, connected me to a core part of my old identity and taught me I could still be a caregiver

by David Meyers

My wife and I usually don’t keep houseplants. Anything in pots gets either overwatered or underwatered. After my diagnosis with glioblastoma — a terminal brain cancer with a prognosis of little more than a year to live — I loved the idea of having something new and green and alive around us.

When my friend Mitch gave me a lucky bamboo plant in a deep-green pottery bowl with three pencil-size stalks braided together, we decided to place the plant in the living room window across from the couch where I spent much of each day.

I smiled when I looked over the rim of the mug of coffee Hannah brought me each morning.

I told Hannah I wanted to care for the plant myself. When it didn’t immediately turn yellow or brown or lose all of its leaves, I was pleasantly surprised.

Tending to the plant gave me a sense of accomplishment at a time when I sometimes felt useless. Glioblastoma limited my ability to walk, and the treatment left me fatigued, making it hard for me to accomplish everyday tasks.

Being dependable again

As a physician, I was used to being the one who provided care, not the one who received it. Since my diagnosis in August 2018, far too often, it seemed, I had to rely on help from other people. The enormous change left me feeling adrift and unsettled. Watering the bamboo, as small an act as it was, connected me to a core part of my old identity and taught me I could still be a caregiver. Plants and people could still depend on me.

Over the next few months, I recovered from surgery and completed radiation and the first round of chemotherapy. Even after I returned to work, I continued to care for the plant. Soon, it had nearly doubled in height and its leaves were shiny and lush. Both the tree and I were thriving.

Then, mysteriously, it began to show signs of stress. I increased my watering, then decreased it. I nestled coffee grounds into the soil. I fed it commercial plant food. No matter what I did, the leaves kept browning and dropping to the floor. I grew more and more frustrated and uneasy.

“I can’t even care for a simple plant!” I yelled. “I’m failing!”

Hannah reminded me that we’d seen houseplants die before. She asked me why I was getting so worked up about this particular one.

“If my lucky bamboo dies,” I blurted out, “I might die, too!”<

I couldn’t shake the feeling that the plant had become a symbol of my own precarious health.

Solace and control

Identifying with the green and growing plant had offered me solace. Now that the tree was struggling, I felt increasingly fearful. Its shriveling leaves, I worried, might signal the recurrence of my brain tumor.

I realized I had wrongly connected my careful nurturing of the plant — something over which I had at least some control — with my own survival — something over which I had no control.

When my tumor inevitably returned, it would not be because of any failure on my part — not because I didn’t atomize essential oils in my office, not because I ate sugar occasionally and certainly not because I failed to keep this plant alive.

As my anxiety lessened, I began to pore over online tutorials to help me figure out how to care for my bamboo. Following the instructions, I transplanted the tree to a larger pot, untangling its roots to give it room to grow. When it was back in the sunny window, we both began to thrive again.

Whenever I look at the tree with its braided stalks in its new pot, I make a point to think of Mitch and the other people who have cared for and supported me. If the lucky bamboo outlives me, I hope it will comfort Hannah and remind her that our large community will continue to nurture her after I am gone.

Complete Article ↪HERE↩!

September 11, 2022September 10, 2022

How to Avoid Being Overcharged for a Funeral

by Carson Kessler

For the funeral industry, the COVID-19 pandemic has meant flush times. Revenues have surged at Service Corporation International, the largest such chain in the U.S., with more than 1,500 funeral homes and 400 cemeteries. And “COVID impact,” according to a recent investor fact sheet, helped SCI more than double its earnings per share between 2019 and 2021.

Prices for funerals have always been steep. Funeral homes charged a median of $7,848 for a viewing and burial last year, according to the National Funeral Directors Association, and $6,970 for a cremation. Those costs don’t include the charges from cemeteries, which can add thousands more. ProPublica recently investigated one cemetery whose charges could run into the tens of thousands of dollars.

The federal government has done little to regulate the industry. Thirty-eight years ago, the Federal Trade Commission tiptoed into this realm, mandating that funeral homes disclose their prices. But cemeteries, some of which are overseen by states, were exempted from those rules. For two years now, the FTC has been conducting a rare review of its rules and examining a wide series of proposals, including extending its rules to cemeteries, requiring that prices be posted online, and disclosing that embalming is not legally required. Presented with a series of questions about the status and timing of the process, an FTC spokesperson would say only “the review is ongoing.”

Joshua Slocum, executive director of the Funeral Consumers Alliance, the only national consumer organization that monitors the funeral industry, has been advocating for changes to the FTC’s Funeral Rule for decades. Regardless of what the agency decides, Slocum wants consumers to know their rights, as well as have a few tips at their disposal when preparing to put a loved one to rest.

This conversation has been edited for length and clarity.

Many people might be surprised to know that at least part of the death industry is regulated. What is regulated and what isn’t?

Let’s talk about the federal [rules] because that’s most important to the basics of what people need to know. There’s something called the Funeral Rule, a regulation from the Federal Trade Commission, which gives consumers particular rights, and they would be very wise to exercise these rights.

One, they have a right to get price quotes by phone.

Number two, when they go to a funeral home in person to talk about a funeral arrangement, they have a right to a printed, itemized price list — think of it just like a menu at a restaurant.

Number three, they have a right to pick and choose item by item. Funeral homes are not allowed to offer you only a package. They will try to offer you a package and they will often say, “You save money if you buy everything together in a bundle.” But just like all bundles, you have to take a look and see, is this actually something I would have spent money on, on its own? Am I really saving money? Or am I just getting a bunch of things that I wouldn’t have picked anyway?

What are the first steps to take after a loved one’s death?

Number one, remember that death is not an emergency. When death occurs, by definition, that means the emergency is now over. The worst thing that can happen has already happened. The person isn’t going to get any deader, to put it plainly.

Get on the phone and call at least five different funeral homes within a 20- to 30-mile radius of where the dead person is. Get price quotes. Take the time to at least look it over and compare some of the prices before you commit to having the funeral home remove the body. If the person dies at a hospital, which is more common, you have more options. Ask the hospital if the body can stay in the morgue for a couple of days while you make a considered decision about which funeral home to call.

Two, take stock of your budget. You need to know that figure. Decide ahead of time what you can comfortably afford. And for God’s sake, please don’t do this: “Oh, money is no object. It’s my mother. She deserves the best,” and then three months from now, you’ve got a $15,000 bill that you can’t pay.

What happens when you comparison shop?

Anytime you pick five or six funeral homes, all within the same city or region, and you canvass them, you will find that there’s a price difference of thousands of dollars for exactly the same service all within a service area available to you. And you will not know this because the vast majority of people will say, “Oh, well, we just use our family’s funeral home.” And I will ask them, “Why is that the one you always go to?”

The bottom line is nobody has a family car dealer, nobody has a family utility company, nobody has a family anything else. They compare prices and services. The problem here is that because this is the death transaction, and it’s a transaction we’re only going to sign a check for on average once in our lives, we don’t have practice with it. And because it is the most emotional business transaction we will ever encounter, many make the mistake of thinking of the funeral home in the same emotional category that their church lives in. That’s a mistake. Your funeral home is not your minister. Your undertaker is not your counselor. Your undertaker is your car dealer for death. And I do not mean that in an insulting way. I mean it in a straightforward business way.

How did it come to be that funeral homes are governed by some federal regulation, but cemeteries aren’t?

The cemetery regulation is so poor that I consider it an unregulated industry, even if it is technically regulated under state law.

Cemeteries before the 20th century were never considered a capitalistic, profit-making venture. They were, either by law or by community consensus, conceived of as doing a public good, something closer to what the church does. So they were seen as nonprofit community service entities that weren’t subject to regular business regulation. That changed in the 20th century when it did become possible in many parts of the country to run a for-profit cemetery.

But the regulations never caught up. The same kinds of deceptive practices that were documented that led to the Funeral Rule have always been going on at cemeteries.

I think there’s very little chance that the FTC is going to bring cemeteries under the funeral rule this time around. We’ve tried many times. There are complicated reasons for it. One of the reasons is that many cemeteries in many states are organized under nonprofit corporation law. The FTC does not have jurisdiction over that, which is an actual genuine, systemic problem.

What kind of deceptive cemetery practices are you referring to?

The same things as what funeral homes did before the law changed. The FTC rule doesn’t apply to cemeteries, so they don’t have to give out a printed price list. They don’t have to let you pick a la carte. Many cemeteries get up to nonsense games, like if you don’t want to buy that cemetery’s headstone, they get sore that they’re not getting that profit out of you. So if you go to a third-party monument dealer, the cemetery will tack on what they will call an “inspection fee” that just happens to be the exact difference in cost that they lost if you didn’t buy their stone.

What has changed now for the FTC to consider amending the Funeral Rule and what needs to happen for some of these proposals to be implemented?

Well, the FTC needs to act. It’s been two years since the FTC announced that they were reviewing the rule, and a review means considering changes. I don’t have a lot of inside knowledge, but what I can say is in communicating with the staff, I believe that they are taking this issue seriously. I believe that they are seriously considering updating the rule to mandate online pricing for funeral homes.

The current federal regulations entitle you to a paper price list if you show up in person at the funeral home. We believe that funeral homes should have to post their prices on their website. But until they do, you are probably going to have to telephone shop.

Do many funeral homes post their prices online, even though it’s not legally required at this point?

We, the Funeral Consumers Alliance and our partner organization, Consumer Federation of America, have done two surveys on the rate of online price posting. We did one in 2018, sampling 25 cities. We found only 16% of funeral homes posted their price lists online. We just did a new version of the survey, which was greatly expanded to a sample size of 1,046 funeral homes in 35 different states, and we only found 18% of them posting their prices. So no, most funeral homes hide their prices online.

Do you think the industry’s profits from COVID-19 will affect the FTC’s decision?

I think our perception and reaction to COVID has played roles in most things. One of the things that was really unfortunate for funeral consumers is that COVID was exactly the period when an online price list would have been most helpful to grieving families and we didn’t have it. People were afraid to go into businesses in person, or there were actually state-based restrictions about transacting business in person. So a lot of people were making arrangements over the phone or in some long-distance way.

The big corporations, which own hundreds of funeral homes and cemeteries across the country, are opposing changes to the rule — what’s their stated reason? What’s your take?

Things like, “We believe that this is a very personal transaction, and we believe it’s most appropriate for the price discussion to be had in the traditional manner, and consumers aren’t shopping for price anyway, so there’s no need for this.” That’s what they say. It’s not complicated. It’s simply that they don’t want to be regulated. From my point of view, they have a very weak case. First of all, requiring online posting of price lists literally costs the funeral industry $0. Do you know what it costs them? It costs them the time it takes to click that button that says “upload PDF.”

ProPublica asked SCI to comment on the FTC’s rules and Slocum’s characterizations of the company’s position. In a statement, an SCI spokesperson acknowledged that “we oppose additional federal regulations.” The company asserted that “the Funeral Rule has worked well at the federal level” and that “our industry is primarily regulated at the state level, and additional regulation at the federal level is unnecessary.” It emphasized the importance of “having a personal conversation with a licensed funeral director, who acts as the consumer advocate” and said that its research shows consumers believe “price is the least important consideration when comparing service quality, reputation, convenience of location and price.” It also stated that SCI’s pricing is “competitive and reasonable.”

Asked about its profits, SCI said, “As the largest provider of funeral, cemetery and cremation services in North America, we served many families who lost loved ones in the pandemic. The growth was driven by elevated COVID-19 mortality, which resulted in an increase in both funeral services performed and burials in our cemeteries.” The statement added that “we had to scale to serve our communities, often when other funeral homes were overwhelmed and simply could not do so.”

More broadly, how have multibillion-dollar conglomerates like SCI changed the funeral industry?

Here’s the reality: They still only have about 12% of the funeral homes in this country. And that’s been pretty steady over 20 to 30 years. In some cities, places like Seattle, many cities in Florida, where there’s a heavy concentration of elderly people, then SCI has a much greater percentage of the market share. That is true. In those places, SCI particularly tends to be the highest-priced funeral home in any market. So if it matters to you, find out who owns your local funeral home. Just because it still says McGillicuddy on the sign doesn’t mean Mr. McGillicuddy still owns it.

Are there practical things that consumers can do to bring the cost of a funeral down?

The most cost-effective thing is to choose a funeral home that already has reasonable prices. Your choice of funeral home is the No. 1 driver of cost. Once you choose a funeral home, look carefully at their offerings and see how much of it you can afford that’s within your budget. Remember that you can shop a la carte. So if your budget says $2,000, you need to face reality. $2,000 is not going to buy you a traditional funeral with embalming, public viewing of the body, metal casket, graveyard burial. You are not going to get that for $2,000 anywhere in the United States. That means your choice is going to be something like simple cremation, even if that’s not your favorite. People have to be realistic.

Is price negotiation ever an option? How would that work?

Yes, just the same way you would do it with any other business that you were negotiating with. They don’t have to haggle with you, but you have the right to do so. We get people who are like, “Well, the funeral home has already picked up the body and we do like this funeral home, but they’re more expensive than another one we found in town, we simply can’t afford it.” And my suggestion is talk to the funeral director and say, “Listen, you’ve taken good care of us before, we appreciate that you came to pick our grandmother up, but we literally cannot afford your price on this direct burial. We would love to give you our business. Can you meet your competitor’s price? We realize you don’t have to lower your prices. But we would like to do business with you. If you can’t lower your prices, we’ll have to have her body removed to a different place.”

And that’s OK to do?

Well, why wouldn’t it be OK? Here’s what I hear underneath this, and I think you’re channeling it correctly from people: What people are doing is asking for permission. But you’re not breaking a social rule. You’re not being cheap. I know what people are thinking: “I don’t want to do that. It’s gauche. It means I don’t care about my mother.” Stop that. That’s nonsense talk. If you showed how much you loved your mother by how much you spent on her funeral, you’d go bankrupt. Love cannot be expressed by money.

Lastly, what are some of the biggest misconceptions about navigating this process?

Most of what people think they are required to purchase is not true. For example, many people think embalming is legally required if you’re going to view the body. That is not true in any U.S. state. It’s also not true that embalming is required as a condition of being buried in the ground. These are in-house funeral home policies, not laws. So there’s very little that you are legally required to purchase. Basically, the only thing that has to happen, when a person dies, in order to satisfy the laws, there has to be a death certificate signed by a doctor, the body has to be buried, cremated or donated to anatomical science within a certain period of time, and that’s literally all that is required. Everything else is optional.

Go into this transaction knowing that although it’s emotional, you are a consumer, you get to decide what you put in your cart. You’re not obliged to buy these things. These are choices and you should make choices that fit your family’s budget and your family’s emotional preferences.

Complete Article ↪HERE↩!

September 10, 2022September 9, 2022

‘So many people are terrified of death.’

Death doulas provide end-of-life support.

Need emotional or spiritual support at the end of life? Hire a death doula.

By Jessica Hall

When Diane Button’s grandfather died at 85, he had a smile on his face and a sense of peace that made her want to learn his secret.

Being with him in the final hours of his death after watching his life caring for others as a doctor inspired Button to get a master’s degree in counseling and start volunteering with hospice programs. She then trained as a ‘death doula,’ wrote books about living well, and now teaches at the end-of-life doula professional certificate program at the Larner College of Medicine at the University of Vermont.

“It wasn’t so much to learn about dying as it was to learn about living well and ultimately dying well,” Button said.

Button is part of a growing number of so-called ‘death doulas’ who provide nonmedical care and support for people who are dying. Similar to the dynamic between a midwife and a birth doula, a physician or hospice caregiver would provide medical care at the end of life, while a death doula provides emotional and spiritual support and help to the patient and the family and friends.

There’s currently no licensing, no industry standards and no insurance reimbursement for death doula services. Doulas can be volunteers or get paid out of pocket.

Without licensing requirements, it’s difficult to track the number of people providing end-of-life support doula services. But since its inception in 2017, the National End-of-Life Doula Alliance has grown to 1,350 members in 49 states (all except South Dakota) and 13 countries.

Karen Reppen, an end-of-life doula and a member of the board of the National End-of-Life Doula Alliance, attributes the growth in awareness and numbers of doulas, in part, to COVID, when people often died alone, as well as the growth of the hospice movement and the sheer numbers of people closer to dying as baby boomers age.

“More people are willing to explore options beyond the hospital and what the medical system can provide,” Reppen said. “We no longer have multigenerational homes, communities may not be as tight knit as they once were, everyone is working – caregiving is a huge, huge challenge. Nonmedical support is needed to survive death with some grace.”

“There’s incredible need for support when you’re a caregiver and your loved one is dying. Whether it’s to simply walk the dog, go grocery shopping, get a few minutes to yourself, get help in navigating the medical information – there’s so many reasons to have some support,” Reppen said.

“Caregivers are very strained. The need for compassionate, skilled people to hold that space in our progressively isolating society is so valuable,” Reppen said. “So many people are traumatized and terrified of death. Even people with family and friends surrounding them may need help. Really, there is no other thing that we’re all guaranteed to share than the fact that we’re going to die.”

Robert Gramling, a palliative care physician and a core faculty partner for the University of Vermont doula program, agreed that the pandemic created an opportunity to talk about death in a way society hadn’t before.

“It can be terrifying to be sick. The COVID pandemic brought into sharp relief that death is part of life. The tragedy of social distancing has sharpened our focus on the space of being alone and isolated. It catapulted us into a public health crisis of loneliness and isolation. Our world is thirsty for this,” said Gramling.

The program at University of Vermont, which is online, is just one certificate program offered around the country. It attracts people from all stages of life, from diverse backgrounds – social workers, chaplains, hospice workers, family caregivers – all with the central desire to learn about death and dying.

“There will be a tipping point where it becomes more accepted. I think with the pandemic the world is valuing more this idea of ‘I want to be known. I want to be dignified and accepted,’” Gramling said. “We’re bubbling toward a tipping point that talking about death becomes part of life. Our world is becoming more open.”

“The doulas’ role is to fill the gaps any time people are feeling lonely or not heard. Anywhere along the course of a serious illness doulas can provide space with nonjudgment,” Gramling said.

Doulas can help younger, healthy people with advance directives, sit vigils for the dying or create legacy projects of stories to pass down to other generations.

Button said more doctors are referring patients to end-of-life doulas once medical needs can’t be met anymore.

“The time has come for doulas to emerge. The pandemic opened up the conversation about death and dying. So many people were impacted by it. The pandemic opened the door a crack and gave them a glimpse of mortality,” Button said.

“It’s an honor to be invited to the bedside of the dying,” Button said. “It’s emotional. It’s deep work of the heart.”

Complete Article ↪HERE↩!