Richard Wagner

November 7, 2016November 3, 2016

BEARING BAD NEWS

The way doctors give patients bad news can teach us all something about how to have hard conversations

[I]t’s not uncommon for Andrew Epstein to spend sleepless nights replaying scenes from his day and wondering what more he could have done for his patients. Often, the answer is nothing—but that still doesn’t help his insomnia.

Epstein is an oncologist at the Sloan Kettering Memorial Cancer Center in New York. His job requires conversations with patients who are extremely sick. Sometimes, he’s breaking the news of the severity of their illness to them; other times, he’s telling them the treatment they thought may work has failed, and it’s time to begin preparing for end-of-life care.

Each encounter is so emotionally draining, he can only do it for about half of the week; he spends the rest of his time preparing for future conversations with new patients, or recovering.

Telling patients and their families that they must face their own mortality is one of the most difficult things that has to get done in the medical profession. Most patients want to have conversations about care at the end of their lives, but often don’t end up having them—probably because many doctors are not prepared to do so, despite training as part of medical school.

Not all of us will have to have these kinds of grim conversations, but we will all have to disappoint people at some point. Maybe you won’t ever have to tell someone they are going to die, but you might have to deliver a bad performance review, let someone go, or break up with a partner. It will never be seamless, but there are ways to be a better bearer of bad news, and lessen the emotional pain for others.

“It’s all about self-awareness, preparation, respect for others and inquiry into [their] perspective,” Epstein says.

First, you have to actually call a meeting—don’t wait for a chance encounter to deliver of bad news, and don’t put it off. “You want to have a comfortable, private setting, arrange for the meeting, and don’t meet any later than necessary,” says Jayson Dibble, a communication specialist at Hope College in Holland, Michigan. Delaying bad news means the recipient has less time to react and move on.

Setting the appointment shows that you are giving your full attention, and allows whoever you need to talk to the time to prepare themselves emotionally for the news, even if they don’t know exactly what that news is. It shows that both you are willing to commit your time to them, and that you respect the time they are giving up for you.

Once you’ve set the meeting, you need to get fully prepared. Epstein pours over his patients’ charts and imagines himself in their shoes, trying to figure out the questions they are most likely to ask. He also makes sure that he’s ready to translate medical jargon into practical facts the patient can use to make a decision about their care.

“Doctors are explain-a-holics,” he says. Understandably, medical professionals don’t want patients to lose hope, so they’ll start going through all the additional tests they could run and explaining all the experimental treatments available the patient could try. This, though, is a form of stalling, and doesn’t give the patients the information they actually need to hear.

To avoid being overly optimistic, take time to think about why you need to have this particular conversation, Dibble says. In most cases, the goal is to give the person you’re talking to what they need to take control of their situation.Compassion is important, but being too hopeful may give the impression that the situation is not as serious as it actually is—which may lead whoever you’re talking to react improperly, and end up worse off later on.

Keeping these end goals in mind can help frame the discussion. Consider breaking up with a partner: It’s never to hurt his or her feelings. The end goal of dating is to find someone you want to pursue a deeper relationship with. Both people deserve to feel respected and loved, and if one person can’t give that to the other for whatever reason, both are missing opportunities to find someone else who can. Or think about the workplace: if your job is to give a negative performance review to an employee, it’s not to make her feel incompetent; it’s to figure out how to make her (and the company) better.

Epstein has found that one of the keys to successfully communicating the most grim is getting to know the patient’s values in advance. As surgeon and writer Atul Gawande notes in the New Yorker, “People have concerns besides simply prolonging their lives.” Patients often prioritize the quality of their remaining time, making decisions based on how long they’ll be able to care for themselves, converse with loved ones, or keep up certain hobbies.

Once you have a plan of the information and its framing, there’s the actual delivery. When actually speaking, “be polite, but clear,” Dibble says. “If you don’t know the answers, it’s okay to say ‘I don’t know.’”

As much as you may want to speak to fill the silence after saying your piece, you shouldn’t. “After the bad news, we [tend to] fill the silence with a lot of words, and instead what we should do is shut up,” says Epstein. When doctors continue to spew out medical jargon, he says, it’s a way of making an uncomfortable situation more comfortable for them, rather than those they’re caring for. “In the end, we do the patient and family a disservice.”

In fact, you should take advantage of pausing, Dibble says, because it gives you and the receiver an extra moment to digest and prepare for the next bit of info. Often, we can’t fully comprehend new information when our brains are occupied with too much emotion. It’s one of the reasons that eye-witness reports for crimes are often unreliable: when stressed, we can’t store new facts thrown at us.

In order to help the recipient process information, you should acknowledge and validate some of those initial emotions. When patients are faced with devastating news, they won’t be able to digest practical information right away, Epstein explains. “They need quiet, and then some phrase to address their emotion, to empathize,” he says.

There’s no one way to go about this part, though. Not everyone reacts to bad news the same way. Some people cry, others get angry, and others remain stoic as shock sets in. Others will demand a reason why they’re hearing this painful news. Depending on the person you’re speaking with, you may have to adapt your strategy as you go along to address their needs while keeping the end goal of the conversation in sight.

There are some mnemonic devices that health care professionals use to navigate these situations. For example, NURSE stands for Naming an emotion, Understanding and Respecting the patient’s reaction, offering Support, and asking him to Explain what they’re feeling further. There’s also SPIKES, which stands for Setting up an interview, assessing the patient’s Perception, obtaining the patient’s Invitation, giving Knowledge and information, addressing the patient’s Emotion, and Summarizing the conversation” But, these should be guidelines—not a strict framework. “If used badly, it would sound robotic,” Epstein says.

In order to be fully present, empathy is key—continually imagining yourself on the other side of the conversation will help you be as generous and respectful as possible. But it’s also important, Epstein says, those delivering bad news need to know their own emotional limits. “If you get too emotionally mired in it, the care of other patients will suffer and you’ll burn out,” he says.

Complete Article HERE!

November 6, 2016November 2, 2016

A 9,000-year-old axe sheds light on burial practices

Ireland’s earliest burial site gives up the secrets of our hunter-gatherer ancestors

By Fiona Gartland

Situated on the banks of the river Shannon at Hermitage, Castleconnell, the burial site

[A]nalysis of an axe that is more than 9,000 years old, found at Ireland’s earliest burial site, in Co Limerick, has shed light on the ancient burial practices of our hunter-gatherer ancestors.

Archaeologists believe the highly-polished stone axe, known as an adze, was made especially for the funeral of a very important person, whose remains were cremated and then buried at the site.

Microscopic analysis has revealed the shale tool, believed to be the earliest fully polished adze in Europe, was only used for a short time, and then deliberately blunted.

Situated on the banks of the river Shannon at Hermitage, Castleconnell, the burial site, dating back to between 7,530 and 7,320 BC, is twice as old as Newgrange.

It was discovered 15 years ago, and contained burial pits holding the remains of individuals who had been cremated.

Artefacts recovered from the earliest pit were recently analysed by a team from the Department of Archaeology at the University of York, led by Dr Aimée Little. Their paper on the subject has been published in the Cambridge Archaeological Journal.

Speaking to The Irish Times, Dr Little said the discovery showed the general perception that people living in Ireland during the Mesolithic period were “just hunter-gatherers roaming around the island, chipping away at bits of stone” is completely incorrect.

Very complex behaviour

“You have really, very complex behaviour at play here, in terms of the making and treatment of the adze as part of the funerary rights,” she said.

“We make the argument it was probably commissioned for the burial and was probably used as part of the funerary rights, possibly to cut the wood for the pyre for the cremation, or to cut the tree used as the grave post marker.”

Dr Little said there were examples of other adzes partly polished in Europe which date from earlier, but nothing completely polished to such a high degree and with such a high finish.

Highly polished stone axe, known as an adze, especially made for the funeral of a very important person.

“It is found on an island, which is incredible in itself . . . and it is actually found in a burial, which is even more remarkable,” she said.

She said it offered a rare and intimate glimpse into the complex funerary rituals taking place on the banks of the Shannon and how people were grieving their dead at this time.

Dr Little also highlighted the skill involved in the cremation itself, which would require temperatures of between 645 and 1,200 degrees.

“To achieve that level of cremation takes a lot of fuel and a lot of understanding of how to actually perform a cremation,” she said.

“A lot of time, and care, and effort went into collecting every single fragment of bone to put into the burial.”

Complete Article HERE!

November 5, 2016November 1, 2016

‘Grief is so overpowering – it consumes you’: readers on death and dying

From grieving to dying well, readers from around the world tell us what death means to them

By Rachel Obordo

Keely Dowton (right) and her mother who died last year.

[D]uring this time of the year death appears in a guise of make up, costumes and candied treats. Often portrayed by colourful eccentric images, celebrations such as Halloween and the Day of the Dead were traditionally about remembering the dead and the memories of lost loved ones.

But talking about death is not easy if you’re British. When broached, the topic seems to make people feel uncomfortable and can even be judged as a morbid conversation subject. But death is part and parcel of what it means to live. We talk about having the ‘time of our lives’ or ‘living life to the full’ but often try and forget what inevitably follows.

We wanted to talk more about death so asked readers for their experiences of grieving and what death means to them. Here’s what some of them said.

‘Grief is so overpowering – it consumes you’

Having lost my mother 17 months ago the experience of losing her is still very raw for me. Mum went to her doctor with a minor stomach upset and died four weeks later with an aggressive bowel tumour. She had no previous symptoms and wasn’t even unwell. It came as a complete shock with total devastation to her family.

Grief is so overpowering – it consumes you. First the numbness and autopilot mode then the heaviness of despair, then the oceans of tears, then the questions of the pointless, futility of life. Then anger, then deep despair, then numbness and repeat. Repeat. 17 months on and I still question all of it; but I cope by leaning on my loved ones and I cope by using my mum’s strength to spur me on. Ironically, she is the one that gets me out of bed in the mornings.

My life has changed drastically. After mum died I resigned from my job, married my partner of 22 years (we married on mum’s birthday as a gift/gesture to her), I got a dog and am now planning a move with my husband to Sri Lanka for a few years. I see my life in two parts; my old life with mum and my new life; one I didn’t want or choose but one that I’m trying to embrace. I try to live my life as my mum wanted; with gusto and enjoying the little things. I’m trying at least.

Keely Dowton, 44-year-old teacher living in Essex

‘I said ‘Good morning’ to a photo of him each day’

I lost my father seven years ago. It was totally unexpected and at the time I could not deal with it. I said ‘Good morning’ to a photo of him each day as I did in person before. I threw myself into planning the funeral, keeping busy meant not thinking about what had happened.

Just after he passed away, I noticed a robin that would watch me when I was gardening. The robin visited the garden most days and would look towards the house. There are some people who think that symbolises that a loved one who has passed is okay. That brought me some comfort even if I don’t completely believe it. I like seeing robins in the garden, even when they are being fiercely territorial. Seeing them is associated with my dad now. I talked about my dad in the present tense for a long time, maybe a year after he had died. Even now it feels incorrect to talk about him in the past because he lives on in my heart and mind. He always will. That’s love.

Anonymous, 39-year-old teacher living in the Midlands

‘Dealing with death is relatively easy compared to getting on with life without them’

Death means my husband. It is something I’m familiar with now as I have lived through his. I lay with his dead body for half an hour and felt peace. Other people’s death isn’t scary for me anymore but mine is as I fear for my children.

I think it’s more difficult to talk about death if you haven’t had any personal experience of it. A lot of the time it’s very clinical, with the funeral director taking the body away fairly swiftly. There’s not often the chance to spend time with the dead and say goodbye. It’s almost frowned upon. I took some pictures of my husband dead; before and after he was embalmed. It doesn’t feel right sharing that fact with people as I’m worried they’ll think it weird. It didn’t feel weird to me.

Even though my husband suffered with all the indignities of cancer I believe in the end he had a good death. He’d put his affairs in order, planned his funeral, said goodbye to loved ones and ultimately died in my arms. If if wasn’t for the fact that he was only 48 it would have been perfect.

Dealing with the death was relatively easy compared to getting on with life without them. That’s the hardest bit. When the funeral flowers and cards stop coming. When friends no longer bring cooked dishes round. That’s when the shit hits the fan and you see the size of the hole they have left.

Joanne Baker, 47-year-old full-time parent of two children living in Guiseley

‘I gave her a bag of popping corn – she was being cremated and would have loved that!’

The death of my mother last year was like watching a transition from pain to peace. I miss her so much. The horror of the last 12 hours in A&E and hospital side ward as she slipped into unconsciousness will never leave my memory. The nurses were kind but no one could save her from her journey. As she took her last breaths, I told her to go find her mum now and that we would be OK. It was a privilege to share those moments but terrifying.

I’m a Christian. My mother pre-paid for a cardboard coffin, and at her request we pasted all the grandchildren’s art work on it. Her lid was open and we spent an hour talking to her. Her spirit felt close. I placed momentoes in her coffin and a bag of popping corn just for fun in her hand. She was being cremated and would have loved that!

Jayne Gale, 47-year-old nurse

‘I did not cry at the funeral, nor did I go to view his body’

I experienced my dad’s death at the tender age of 13, in June 2003. I did not cry at the funeral, nor did I go to view his body. I couldn’t believe he was gone for good. Many times I dreamt of bumping into him on the street. I thought he would come back, even though I knew and understood that he wouldn’t.

I think most people find it hard to talk about death either due to a trauma or the death of a loved one, and in many African customs it is taboo to do so. Though it’s been 13 years since my dad left I still weep as if he just died. He was my hero. I have been praying over it, and God has helped me to accept the reality, and to stop living in denial.

Grace, 26-year-old living in Nairobi

Mourners attend a vigil for bus driver Manmeet Alisher at a Sikh temple in Brisbane, after he was burned alive when an incendiary device was allegedly thrown at him while he was letting passengers on at Moorooka

‘There is nothing to fear about death’

I lost a little boy who was just two months old – he suddenly passed away one night unexpectedly. I did not understand how this could happen to me – not even as a punishment because I felt I had never done anything that would have deserved such a chastisement.

This was when I started to try to find an answer, so I began reading about what happened after death, the meaning of life and death, why we are here on earth and so on. I got the answer after 30 years of research, so I know now why this happened to me. To me, death means to continue to live in a different form in another dimension where I will be able to meet all my dear ones who died before me and most importantly review all my past life on earth. I will then know if and how I have progressed spiritually. This will be done without judgment, just with love. Then, I will examine and decide what still has to be improved and go back to earth for another experience.

In 2012 my mother died at the age of 84. She suffered a lot and wished she could die as soon as possible “waiting for the angels to take her”. One day she had an accident at home while cooking – she was burnt and taken to hospital where she died two months later. At the very minute she died, I felt filled with an unutterable sensation of happiness which I couldn’t explain at first and I understood when I was told the precise time when she died. I was so happy that she had been freed at last. My sisters got depressed and didn’t understand my reaction at first, but I told them how I felt and they agreed that it was the best way to deal with our mother’s death.

I hope there will be more records similar to mine, so that people grow aware that there is nothing to fear about death – no judgment, no hell, no punishment – only love exists.

Jean Louis, 65-year-old retired teacher living in France

‘Those who talk openly and honestly about death tend to have a more peaceful, meaninful time at the end of their life’

Popular media images of death and dying often portray an image of inevitable suffering, as does frequent media coverage highlighting the inadequacies of health and social services in providing good end of life care and support. As a result, many people live in fear of death and the dying process and ultimately do not have the death they would have preferred.

Problematic issues including misconceptions, unspoken anxiety, lack of control, or the loved ones of a dying person perceiving the dying process as a ‘bad death’ can all contribute towards problematic grief. My own observations of dying people and bereaved relatives are that those who have talked openly and honestly about death and dying – and who have planned for what they would like to happen when the time comes – tend to have a more peaceful, meaningful time at the end of their life.

Katie Shepherd, 43-year-old clinical nurse specialist in palliative care, and permaculture designer living in Spain and Yorkshire

‘I dealt with the deaths of those close to me quite badly. It’s why I’m an undertaker’

Death has shaped my entire life, literally. I became an undertaker, something for which you need no professional qualifications almost 17 years ago after seeing Nicholas Albery of The Natural Death Centre talk about a different way of approaching funerals, environmentally, socially and religiously. I had a welter of family deaths as a child, most of whose funerals I didn’t go to. Now we do the opposite, encouraging as much family involvement as possible.

It is entirely understandable that people find it difficult to talk about death. The implications of our own extinction and that of the Earth’s are huge, particularly now we are at a stage when even the planet may die. I dealt with the deaths of those close to me quite badly. It’s why I’m an undertaker – do what I say, not what I do.

Rupert Callender, ceremonial undertaker and sexton, and co owner of The Green Funeral Company

‘I know that he’s still present’

My father’s death two years ago was sudden and unexpected. The family gathered, and we supported one another. Tears, yes, but plenty of loving laughter – he had an offbeat personality in some ways with a great sense of humour, even around death: he’d always said (in jest) that when he goes he wanted to be stuffed and sat in a chair so he could be glowering at people!

Of course there is the awful reality of his loss in all our lives, the desperate sadness that he’s not here in the physical. He genuinely hadn’t an enemy in the world, and family, friends and colleagues past and present, travelled from far and wide to be at his funeral.

I know that he’s still present though, with countless confirmations of that, so we still go on walks together (a shared love of nature) and we ‘chat’ daily. It’s the next best thing to being in the same physical universe.

Angela, 55-year-old artist and writer living in Ireland

‘It is far easier to grieve among family and friends’

My father died while I was working in Saudi Arabia in the 1980s. My brother sent a telegram, but my employers (who had my passport in a safe) did not pass the telegram to me. I found out a few weeks later via a letter from my mother which started from the premise that I knew already. From this experience I learned that it is far easier to grieve and move on if you do it among family and friends.

Old Scarborian, 58-year-old lecturer

Complete Article HERE!

November 4, 2016November 3, 2016

‘Just say death!’ Plays teach healthcare workers about end-of-life care

Dying is taboo among health and care professionals who sometimes prioritise medical initiatives over individuals and families

dont-leave-me-now — Don’t Leave Me Now, a play about early onset dementia, was performed at St Gemma’s hospice in Leeds to an audience of healthcare professionals.

[S]eth Goodburn seemed fit and well until two weeks before he was diagnosed with pancreatic cancer. He died just 33 days after diagnosis, spending much of that short time in hospital. In the emotional whirlwind of coping with the poor prognosis his wife, Lesley, felt their hopes for Seth’s end-of-life care were sidelined by medical professionals trying to do their job.

“The NHS focuses on the medicine and trying to fix people even when that’s not possible,” she says. “A lot of the conversations and decisions that we might have made were overshadowed by dealing with what was the next medical treatment and intervention.”

There is an ongoing conversation in the medical profession about how to care for terminally ill patients, given that the profession’s instinct is to preserve life. The issue is just one of many being address by Brian Daniels, a playwright commissioned by the National Council for Palliative Care (NCPC) to tell stories such as Goodburn’s through plays, and help educate healthcare professionals about patients and families’ experiences of end-of-life care.

Homeward Bound, a play based on a series of letters Lesley Goodburn wrote, in the months after her husband’s death, to medical professionals involved in his care, launched NCPC’s national conference this year to an audience of 300 healthcare workers.

In addition, Daniels’ plays on early onset dementia and palliative care for those with disabilities, have been performed in hospitals, hospices, care homes and to general audiences across the country. Daniels says: “[They] take people out of their professional role for a minute to look at the family and human side of the people they’re dealing with.”

For Goodburn, that human aspect is key. She could not fault the professionalism of those involved in caring for her husband, but says poor communication could leave the couple feeling worse. “There were just so many things where people weren’t cruel or unkind or deliberately unthinking, but just didn’t really think about what it was like to be me and Seth. He went from being well and living a normal life to suddenly being told that he was dying.” She says, for example, a physiotherapist asked Seth to march on the spot as part of an assessment to see if he was able to go home, as he had previously wished, seemingly unaware that his condition had deteriorated and he was dying.

Claire Henry, chief executive of the NCPC, says plays such as Homeward Bound are designed to encourage medical professionals to reflect on the people going through this traumatic process. “We obviously work very closely with people who have experience and they tell us their stories. Some are good, some not so good. Healthcare professionals don’t go to work to do a bad job, but sometimes they don’t think of things that affect people in a broader sense.”

What impact does a play have that a lecture, for instance, cannot? Don’t Leave Me Now, another play by Daniels, about early onset dementia, was performed at St Gemma’s hospice in Leeds to an audience including nurses, housekeeping staff and workers from other local hospices. Dr Mike Stockton, its director of medicine and consultant in palliative medicine, says the play enabled them to see some of families’ and patients’ challenges through a different lens. “It’s sometimes hard to have a full understanding … of what people may be going through and the reasons behind their actions or the emotional challenges, adjustments or the resilience that people need.”

Lynn Cawley agrees. There was barely a dry eye at a performance at Morley Arts Festival in October of Bounce Back Boy, the powerful dramatisation of her adopted son, Josh’s, story. Josh was severely disabled following a serious head injury as a baby, and later adopted by Cawley. Despite pioneering medical treatment throughout Josh’s life, Cawley says he was denied admission as an inpatient to a local hospice because his needs were too complex, and died a difficult death at home. She is fighting to end what she describes as end of life discrimination against those with disabilities.

Cawley thinks a play is an effective way of communicating that message, and for getting people to think about palliative care more broadly. She says: “When it’s someone’s real life story, people put themselves in it [and] they might think of a patient that they know. We hope that it will change policy but also people’s attitudes.”

For Stockton, working in a hospice, the wider issue of how treatment is balanced with patient comfort is a daily consideration. He says the two can often be done together: “It is about having early, thorough, open, honest, transparent conversations with people about what they want.”

For Cawley, as a carer and mother who went through the palliative process, those open conversations about dying are key. “We even find it hard to say the word,” she says. “When we’re watching Casualty on a Saturday night and they’re trying to tell a relative that somebody is dying, but they won’t say the word dying or death, we’re just like – say death!”

Complete Article HERE!

November 4, 2016November 1, 2016

‘I’ve known death’: Hospice chaplain comforts grieving and dying people

By Sam Friedman

It took David Rumph Jr. more than five decades to learn that his calling in life is to help people die.

Rumph is the chaplain at Hospice Services for Fairbanks Memorial Hospital. He’s a former photo lab worker, military policeman and pet supply retail worker who was led to hospice work by both his own experience with the death of family members and his sense of community service.

At any given time Rumph and other hospice staff members help as many as 45 people who are dying from terminal illnesses. Hospice is based on a philosophy of treating patients rather than diseases, helping patients die with dignity and free of pain. What Rumph does to help varies greatly among families. Sometimes he performs bedside religious services. Once a month, he meets with a group of male surviving family meetings at Denny’s. Much of the time he just listens actively, a method he calls “companioning.”

“Patients elect for this service,” he said. “We are invited guests into what I consider to be a sacred time and space. Many times there are hospital beds set up in the living room in front of the big window so that grandpa can look out.”

Rumph, 61, is from Kentucky. He was interested in ministerial work more than 20 years ago but life got in the way. As a young man, Rumph worked in photo laboratories, served in the Army and attended and dropped out of college several times. When he was 35, he decided he wanted to be a Methodist minister. He received a bachelor’s degree in philosophy from Northern Kentucky. His 18-year-old daughter killed herself when he was partway through a Master of Divinity degree.

Rumph’s marriage fell apart and for three years he experienced complicated grief, a disorder he sometimes encounters among family members he helps today.

Rumph credits Alaska with helping him recover from the grief. In 2001, he visited Alaska with his brother, who worked as a dog handler for Susan Butcher. Rumph planned to visit for two weeks but he ended up staying for two months and later moving to Fairbanks. Rumph worked as a clerk at Cold Spot Feeds and as an educator at First United Methodist Church. He went back to school and completed his master’s in divinity in 2005.

In 2004, he began volunteering for Hospice of the Tanana Valley, the organization that later was folded into Fairbanks Memorial Hospital’s hospice services. Working in hospice was a natural fit for Rumph.

“I’ve known death,” he said. “There was nothing scary or taboo about death itself. It felt like a unique and significant way to love my neighbor.”

Fairbanks hospice has transformed since it became part of the hospital program. As a volunteer, Rumph’s duties included driving patients to pharmacies and transporting medical equipment. The program was run out of a small office on Fourth Avenue. Today the Fairbanks Memorial Hospital hospice program has a building on Gillam Way near the hospital. A team of about 20 medical workers, social workers and Rumph care for patients. Rumph was hired to be the program chaplain in January 2014.

When new patients enter hospice, they usually have less than six months to live, but death is unpredictable. Sometimes patients get better and “graduate” from hospice care. The program recently readmitted a patient who’s bedbound again after improving enough under hospice care to walk with a cane.

After a death, Rumph is available for grieving friends and family members for as long as they need him.

Complete Article HERE!

November 3, 2016October 31, 2016

From rigor mortis to shouting at corpses: What I learned about dying from those who work in the funeral industry

There are only two rules when it comes to being dead: get someone to register your death and keep your body covered when moving it around. The rest is totally up to you – from getting your ashes tattooed into your loved one’s arm to punk funeral services

By Kirsty Major

The UK's only tandem hearse is one such alternative idea being adopted to mark the life of a loved one Good Funeral Guide — The UK’s only tandem hearse is one such alternative idea being adopted to mark the life of a loved one Good Funeral Guide

Halloween is one of the few times of the year when you are allowed to be morbid, so why not take the opportunity to think a little about your own funeral? If fear of death is fear of the unknown then we should definitely be more afraid of funerals. For a start, most of us don’t know that there are only two laws to keep in mind when planning a funeral: you have to register the death of a person within five days, and secondly, you can’t travel with an uncovered body on a public highway. Seriously, that’s it – the rest is totally up to you.

Why have some black-suited blokes coming to haul your body away in a Transit van to have your eyelids glued together, only to be subsequently burned to cinders in a glib 20-minute service at a crematorium, when your shroud covered body could be crowdsurfed into your mate’s Volvo or turned into a firework? I spoke to five women making funerals that work for the dead and their families about what makes a ‘good funeral’.

Not all dead people are ‘loved ones’

Let’s start with terminology. Hopefully you’re living your life being the best person you can be, but if you happen to fall short and die being widely regarded as a complete and utter a***hole, then your relatives should be able to say so at your funeral. Some people cause pain and funerals are a good place to finally put those feelings to rest (alongside your body).

“I remember the first time any anger was expressed at one of our funerals, and I hadn’t seen that it was missing. This young man was in his late twenties and he had been a heroin addict for 15 years and his brothers were angry, as they had tried to help him for so long, and they just stood up and shouted and it was so brilliant and it was a relief to hear that,” says Claire Callender from the Green Funeral Company.

Tell your family to relax around your corpse

Before you pop off, try to remind your relatives that just because you have breathed your last breath it does not mean that your body stops being you. As a death doula – someone who provides care to the dying and their families – Anna Lyons describes “families who are happy to sit and hold somebody’s hand while they are in the dying process, and the second their heart stops beating and they stop breathing they shy away and their body becomes untouchable and something disgusting, because we have medicalised everything and we have stripped everyone of the normality of it.”

Ditch the funeral parlour

Louise Winter, a funeral celebrant, says: “Funeral directors have come to see it as their duty to protect the living from the dead.” Perhaps instead, we should be protecting our dead selves from funeral directors. Tora Colwill, from Modern Funerals cautions: “You shouldn’t just pass over your body to be manhandled. The mortuary hub is often in an industrial estate, where they stack up the bodies and one by one wash that, cut that hair, embalm there… if we actually asked questions about how our bodies are being treated, some of the answers we would be unhappy with.”

There has been a move over the past 20 years to return funeral care, planning, and burial logistics back to the home, the traditional place where families dealt with death before the rise of the funeral industrial complex following the Second World War. Claire Turnham, a funeral planner, says: “It is not about doing things differently, this is the way things were always done, this is the norm. This is the traditional.”

Funeral directors are probably going to rip you off

For anyone who has yet to organise a funeral, the receipts would cause you to die of shock if you could afford it. Reflecting on her time working at a funeral directors, Anna Lyons says: “(A) lot of funeral directors push people toward spending more money. You are working with people at their most vulnerable and people have been taken advantage of for too long.”

Embalming is gross and unnecessary

Many funeral directors recommend that a body should be embalmed if it is to be displayed in an open casket during a wake or service. However, according to Cara Mair, co-founder of ARKA Original Funerals, “Embalming fluid is lethal, it is formaldehyde, and it is carcinogenic. The embalming process is so invasive and it is not needed.” Instead, proponents of the natural death movement like Tora Colwill use natural methods, often alongside the family, to prepare the body for an open casket. “When you die, you can use rigor mortis to your advantage. For example, instead of having your gums stitched through to keep the mouth shut, you can simply roll up a towel and place it under the chin keeping the jaw locked as your corpse begins to stiffen.”

You don’t even need to have a coffin

Undertakers offer luxury metal and wood coffins costing several thousands of pounds; instead coffins can be made from biodegradable cardboard that your family can decorate as part of the wake, or bodies can be buried in traditional shrouds which cost just under £100. Also if there is life after death, I would much rather wake up in a cool shroud to haunt people in.

Your funeral service can include anything

Since there are really only two rules you can literally incorporate anything into your funeral service. Claire Callender and her husband Rupert use the ethos of punk and rave when helping families plan funerals: “I just throw out the rules, there is no set way of doing it, just make it up as you go along. And that is the punk, DIY, let’s just set up a record label in your bedroom, let’s just do it … with the rave aspect it is that thing about rave where you just found yourself dancing with a thousand people and you were all connected and you had this communal thing and you had a church without a religion.” Giving your family something to do allows them to process their grief, so don’t outsource it all to a funeral director.

Throw the eulogy out of the window

By having one person who is allowed to give their version of your life you lose out on the rest of it. You are more than a mother or husband – maybe your ex-partner has a salacious story to tell about that one time in Vegas, because what happens in Vegas should not stay in Vegas, it should be told at your funeral to all of your assembled relatives. The advice given by pretty much everyone I spoke to was to get everyone in a room, preferably with your body and let conversations happen.

Crematoriums are the worst

The most important thing is to not have the service in a crematorium, or as Louise Winter, from Poetic Endings calls them, “hospices where flowers go to die”. For Callender they can be one of the most challenges places to work: “The crematoriums hate us because they just want to bring a dog in, light the candle and rearrange the chairs – it is because we are trying to bring ritual to a really spiritually barren place.”

You don’t have to choose between burial and cremation

You can do so much more with your corpse. You can be buried in a pod that later grows into a tree; blasted into the sky in a firework; or inked onto your loved one’s skin forever in the form of a tattoo until they too die and then it’s up to them where you end up.

If you do decide to get buried, you don’t have to go to a church or local authority cemetery – you can be buried in a natural burial ground or on private land. It is recommended that you check in with the landowner, police and local environmental health authority – nobody wants to become drinking water.

Finally, whatever you do at your own funeral, make sure it is honest

We don’t get to say the things we really feel because we are too anxious, or tied up in the tedium of the everyday. Funerals are the one time that people are listening and really want to talk about life, death, love and all of the things inbetween. Like really talk about it – not just pretend they are talking while they’re swiping away their phones. So make some space for that.

Complete Article HERE!

November 2, 2016November 1, 2016

On This “Day Of The Dead”, Here Are 10 Mind-Blowing Questions to Ponder About Your Own Inevitable Demise

Traditionally, the “Day of the Dead” is a time when family and friends gather to remember friends and family members who have died. But it’s also a perfect time to think about your own death – if you dare.

Care to face your own mortality? Here are 10 Mind-Blowing questions to ponder about your own death.

Most people won’t go there because it’s either too scary, too painful, or we just pretend it will never happen to us. But ready or not, there’s a 100% certainty death will eventually get up close and personal with every one of us. Here, from MORTALLS – The Death-Positive Conversation Game, are 10 mind-blowing but worthwhile questions to ponder about your own death… if you are willing to do so:

What scares you the most about dying?
What are some not-so-scary things about dying that don’t really bother you?
When you die, would you rather be awake and aware, or sedated and oblivious? Why?
What would be the best thing about a quick death? The worst thing?
What do you think you will regret the most when you are dying?
What is something you want to be remembered for?
What is something you do not want to be remembered for?
Who will carry out your final wishes when you die? How will they know what those wishes are?
Does the certainty that you are going to die affect the way you live your life right now? If so, how? And if not, why not?
What three words would you use to describe your own attitude about death and dying?

Complete Article HERE!