How Hospices Can Support Families Seeking ‘Green’ Burials

By Holly Vossel

Hospices can assist terminally ill patients and their families who have questions about “green” burial options by connecting them with services like death doulas or by educating staff on those practices.

Interest in natural or green funeral and burial options has been growing year-over-year, according to the National Funeral Directors Association (NFDA). Around 60.5% of respondents in a NFDA 2022 consumer awareness and preferences survey indicated that they would be interested in exploring natural funeral options, a rise from 55.7% in 2021.

Respondents cited cost savings and potential environmental benefits as leading drivers of their interest.

Demand for natural burials also has grown among hospice patients and their families, according to Lee Webster, director of New Hampshire Funeral Resources, Education & Advocacy.

“I’ve definitely seen a growing trend of natural burials really appealing to a lot of people who are on hospice,” Webster told Hospice News. “A lot of people on hospice services want to run the whole spectrum of that holistic care and tend to be more open to the idea. They are finding a different way to do the disposition, recognizing that natural burials are less expensive than the traditional funeral burial or cremation services most of the time.”

Webster has co-founded organizations such as the National End-of-Life Doula Alliance (NEDA), the Conservation Burial Alliance and the partnership. Additionally, she has served in leadership positions at the National Home Funeral Alliance and the Green Burial Council.

Natural burials are another way for families to take care of the dying in “the least invasive way possible,” according to Webster. “Much like hospice, it’s a continuum of creating a seamless transition to death” she said.

Though natural burials represent roughly 5% of all funerals nationwide, nearly three-quarters (72%) of cemetery operators have reported increased demand for these services, according to NFDA.

The global green funeral market reached $571.54 million in 2021 and is anticipated to reach an 8.7% growth rate by 2030, according to 2022 projections from Emergen Research.

As more hospices partner with death doulas, they can leverage those collaborations to help families and staff understand the four pillars that define a natural burial, Webster said. Death doulas also can help hospices connect families with natural burial resources and services.

One pillar is the use of biodegradable materials or containers that are designed to reduce carbon emissions and deforestation associated with traditional caskets made of wood, plastic and cement mixtures.

The other three pillars include the use of natural, noninvasive preservation methods instead of chemical embalming practices; avoiding the use of vaults and completing burials at 3 ½ to 4 feet.

Patients and families seeking these also need to understand state laws and limitations around natural burial methodologies.

Human composting, for example, is only legal in six states, according Lauren Carroll, co-one of the founders of Deathwives, a death doula provider. Additionally, water cremation is only available in 26 states, she added.

Death doulas can help expand hospices’ knowledge around their local natural burial options that they otherwise might not have built into their staff education and training, Carroll said.

“[The] knowledge aspect of understanding that comes from death doulas isn’t something a hospice necessarily has a place for in its staff education,” Carroll told Hospice News. “That education aspect is the biggest part of communicating all these different burial and funeral options to families so they have a better understanding.”

Hospices can help the family by preparing the necessary documentation bereaved families will need to arrange a natural burial, according to Webster.

“Each state has different requirements about when death certificates need to be filed and when families are able to bathe, dress and prepare their loved one for a natural burial,” Webster said. “Another important thing to know is that the hospice is not liable for anything that the family does with the body after they’ve signed that death certificate.”

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