Death doulas: the end-of-life guides who are recreating the dying experience
By Isabel Bird
When Rebecca Lyons’ great aunt died, her body remained with the family.
Her aunt’s body was kept cool with the use of dry ice for four days, and the family washed and dressed her for service, held ritual, and prepared themselves for saying goodbye.
“We had candles, we burnt frankincense … it was a gentle process because there was no loss of ownership. It was about coming together and having that time, to laugh and cry, and it wasn’t all doom and gloom,” Ms Lyons said.
“You have looked after this person in life and now you are going to look after this person in death … the whole experience is precious.”
It was a personal death-care experience for Ms Lyons that was also connected to her new role as a death doula.
Doula in Ancient Greek translates to “woman of service” and is traditionally used in the birthing sector, but has been adopted by the death-care movement.
A death doula, end of life doula, deathwalker or death midwife can be hired by a dying person or their family to offer support in a multitude of ways, which can include organising alternatives to conventional funeral home offerings.
Their services ultimately depend on individual need and choice but can range from pre- and post-death planning, assistance with wills or advance care directives, bedside vigils, and the organisation of counselling, respite or other therapies.
Planning options may include dying at home, keeping the body at home for one day or more before burial or cremation, or holding family-led funerals in alternative spaces such as in the home, in the backyard, on a beach or in a forest.
Ms Lyons, a former funeral director, became a qualified death doula four months ago, offering the service as part of her death-care advocacy business You n Taboo.
She said a death doula helped people to make informed decisions, and then worked with families to help carry out those decisions.
“There is so much involved in the death and dying process, yet there is a lack of community knowledge about it,” Ms Lyons said.
“From the point of death a nurse might say ‘which funeral director should we call?’ The question should actually be ‘do you want a funeral director called?’ Right from the start, there is a lack of information given (in the institutional space),” she said.
“When someone dies the family can legally take the body home. Funeral directors are not mandatory, there doesn’t need to be embalming or temporary preservation, coffins are not necessary, and there are choices about the funeral and where it is held, or if they even have one.”
Ms Lyons said planning for death can be beneficial for families because it takes the guess work out of wondering what their loved ones want, and can be beneficial for the dying as they can focus on spending time with family.
Zenith Vorago is the founder of the Natural Death Care Centre in Byron Bay, which has offered deathwalker training for 12 years.
She started working with dying people 25 years ago after dissatisfaction with the conventional way of doing death, which generally involves hiring a funeral home director and relinquishing control of the body.
“We didn’t want to give our people to the medical system, or to funeral directors we didn’t know,” she said.
Ms Vorago explained that the funeral industry in Australia is led by one corporation that had a monopoly over various links in the chain, from funeral homes and crematoriums down to coffin makers.
“There is a lot of money to be made and in my experience people don’t mind paying for a service but they don’t want to get ripped off.”
Ms Vorago also said the health care system would soon not be able to cope with the ageing population, and more people in society would need to care for their own dying.
“What we are doing is skilling people up, so they can participate in that role with some awareness about how to do that well and how to do it with the system (such as) using community nurses,” she said.
“We are empowering people to know what their options are, to consider what is best for them and their people, to make decisions that are right for them, so people die well.”
Social worker Lynne Jarvis has completed Ms Vorago’s deathwalker training, and runs JUMAVE on the North-West Coast.
Her business adopts a holistic, social justice approach to death, offering a range of pre- and post-death services similar to that of a death doula, including funeral celebrancy and the use of cooling blankets for at-home funerals.
Ms Jarvis is also responsible for organising the Coffin Club at Ulverstone, where people can make their own coffins and have open, end-of-life conversations.
She said increased family involvement in the death care process can lead to highly meaningful experiences, and provided the example where an individual held a wake before their expected death.
“It ended up being really beautiful experience for them, it was well planned and simple. As sad and painful as it was, there was still beauty and joy in that process on reflection.”
Ms Jarvis stressed that early planning was important.
“I am focused on training the after-death care (family and friend) network to make sure they know what they need to do,” she said.
“It does take more energy and time … but there is great value and healing, and that healing is really important for the longer term bereavement of those left behind.”
Alternative options, such as taking the body home, will never alleviate grief but it can ease the process.
Ms Lyons said that when someone dies people often feel a loss of control, which is heightened when the body is taken away.
“It brings a massive, massive trauma that adds to the grief … what we are saying to people is that you don’t actually have to do that,” Ms Lyons said.
“For those who suit the conventional processes there are funeral directors out there who do an absolutely almighty job, but, it is a choice.”
She added that alternative options are actually a return to the old way of doing things.
“My grandmother would tell me stories where Mrs so-and-so from three doors down died, and everyone turned up with casseroles, and the body was in the lounge room. People gathered, they mourned and grieved together. The community used to own it. We are reclaiming this lost knowledge,” she said.
“Death has an amazing way of pulling people together, and the process that my family went through, looking after my great aunt – that was truly beautiful.”
[F]or many modern Pagans, there is a somewhat different philosophy on death and dying than what is seen in the non-Pagan community. While our non-Pagans see death as an ending, some Pagans view it as a beginning of the next phase of our existence. Perhaps it is because we view the cycle of birth and life and death and rebirth as something magical and spiritual, a never-ending, ever turning wheel. Rather than being disconnected from death and dying, we tend to acknowledge it as part of a sacred evolution.
In The Pagan Book of Living and Dying, author Starhawk says, “Imagine if we truly understood that decay is the matrix of fertility… we might view our own aging with less fear and distaste, and greet death with sadness, certainly, but without terror.”
As the Pagan population ages – and certainly, we are doing so – it’s becoming more and more likely that at some point each of us will have to bid farewell to a fellow Pagan, Heathen, Druid, or other member of our community. When that happens, what is the appropriate response? What can be done to honor the person’s beliefs and send them on their way in a way that they themselves would have valued, while still managing to maintain sensitivity in dealing with their non-Pagan family members and friends?
Views of the Afterlife
Is death the end, or just another beginning?
Many Pagans believe that there is some sort of afterlife, although that tends to take varying forms, depending on the individual belief system. Some followers of NeoWiccan paths accept the afterlife as the Summerland, which Wiccan author Scott Cunningham described as a place where the soul goes on to live forever. In Wicca: A Guide for the Solitary Practitioner, he says, “This realm is neither in heaven nor the underworld. It simply is — a non-physical reality much less dense than ours. Some Wiccan traditions describe it as a land of eternal summer, with grassy fields and sweet flowing rivers, perhaps the Earth before the advent of humans. Others see it vaguely as a realm without forms, where energy swirls coexist with the greatest energies – the Goddess and God in their celestial identities.”
Members of non-Wiccan groups, particularly those who follow a more Reconstructionist slant, may see the afterlife as Valhalla or Fólkvangr, for those who adhere to a Norse belief system, or Tir na nOg, for individuals who participate in a Celtic path. Hellenic Pagans may see the afterlife as Hades.
For those Pagans who don’t have a defined name or description of the afterlife, there is still typically a notion that the spirit and the soul live on somewhere, even if we don’t know where it is or what to call it.
Tawsha is a Pagan in Indiana who follows an eclectic path. She says, “I don’t know what happens to us when we die, but I like the idea of the Summerland. It seems peaceful, a place where our souls can regenerate before they reincarnate into a new body. But my husband is a Druid, and his beliefs are different and focus more on the Celtic view of the afterlife, which seems a little more ethereal to me. I think it’s really all just different interpretations of the same place.”
Deities of Death and the Afterlife
Anubis guided the souls of the dead through the underworld.
Cultures have, since the beginning of time, honored deities associated with the process of dying, the act itself, and the journey of the spirit or soul into the afterlife. Although many of them are celebrated during the harvest season, around Samhain, when the earth itself is slowly dying, it is not uncommon to see them called upon as someone is approaching their last days, or has recently crossed over.
If you follow an Egyptian, or Kemetic, path, you may choose to honor Anubis, the jackal headed god of death. Anubis’ job is to determine whether the deceased is worthy of entering the underworld, by taking the individual’s measure. To help ease their passing, you may choose to sing or chant to Anubis about the dying or dead person’s accomplishments.
For Pagans who follow an Asatru or Heathen belief system, prayers and chants to Odin or to the goddesses Hel and Freya might be appropriate. Half of the warriors who die in battle go to spend the afterlife with Freya in her hall, Folkvangr, and the others go to Valhalla with Odin. Hel takes charge of those who have died from old age or sickness, and accompanies them to her hall, Éljúðnir.
A Maryland Heathen who asked to be identified as Wolfen says when his brother died, “We had this huge ceremony with a big bonfire, lots of drinking and toasts, and song. My brother had already been cremated, but we added his ashes to the fire, and we sang a song honoring him and his accomplishments, and introducing him to Odin and Valhalla, and then we continued it by calling upon our ancestors, going back about eight generations. It was what he wanted, and probably the closest thing to a Viking funeral that you can get in suburban America.”
Other deities you may wish to call upon as someone is dying, or has crossed over, include the Greek Demeter, Hecate, and Hades, or the Chinese Meng Po. Be sure to read more about: Deities of Death and the Afterlife.
Funerary Rites
In many countries in the modern world, the practice of burying the dead is common. However, it’s a relatively new concept by some standards, and in some places, it’s almost a novelty. In fact, many of today’s contemporary funeral practices might be considered a bit strange by our ancestors.
In other societies, it is not uncommon to see the dead interred in trees, placed on giant funeral pyres, closed up in a ceremonial tomb, or even left out for the elements to consume.
One trend that is increasing in popularity in the Western world is that of “green burial,” in which the body is not embalmed, and is simply buried in the soil with no coffin, or with a biodegradable container. While not all areas permit this, it is something worth looking into for someone who truly wishes to be returned to earth as part of the cycle of life and death.
Memorial and Ritual
How will you be remembered when you’ve crossed over?
Many people – Pagans and otherwise – believe that one of the best ways to keep someone’s memory alive is to do something in their honor, something that keeps them alive in your heart long after theirs has stopped beating. There are a number of things you can do to honor the dead.
Rituals: Hold a memorial ritual in the individual’s honor. This can be as simple as lighting a candle in his or her name, or as complex as inviting the entire community together to hold a vigil and offer blessings for the person’s spirit as they cross over into the afterlife.
Causes: Did the deceased person have a favorite cause or charity that they worked hard to support? A great way to memorialize them is to do something for that cause that meant so much to them. Your friend who adopted all of those shelter kittens would probably love it if you made a donation to the shelter in her name. How about the gentleman who gave so much time to cleaning up local parks? What about planting a tree in his honor?
Jewelry: A popular trend during the Victorian era was to wear jewelry in the deceased’s honor. This might include a brooch holding their ashes, or a bracelet woven from their hair. While this may sound a bit morbid to some folks, bereavement jewelry is making quite a comeback. There are a number of jewelers who offer memorial jewelry, which is typically a small pendant with a hole in the back. Ashes are poured into the pendant, the hole is sealed with a screw, and then the friends and family of the dead can keep them nearby any time they like.
Be sure to read the following articles on death, dying and the afterlife:
Caring for Our Dead: Every society, throughout history, has found some way to attend to the proper care of their dead. Let’s look at some of the different methods in which various cultures have said farewell to their loved ones.
Ray Buckland on Death and Dying: Wiccan author Ray Buckland recently did a presentation on a Pagan view of death and dying. He has graciously allowed us permission to share that presentation here on the Pagan/Wiccan website.
What Happens to Your Magical Items After You Die? Since so many members of the Pagan community work as solitaries, and may never come into contact with other Pagans during their lifetime, one issue that comes up as our population ages is that of what to do with magical tools and other items after death.
A Pagan Blessing for the Dead: This simple memorial ceremony can be performed for a deceased loved one. It invokes the powers of the earth, air, fire and water to send the departed off to their next destination.
Prayer for the Dying: This prayer is one which may be said by or on behalf of a dying person, and addresses the need we have to feel at home in the last moments of life.
Prayer to Hel: In Norse mythology, Hel features as a goddess of the underworld. She was sent by Odin to Helheim/Niflheim to preside over the spirits of the dead, except for those who were killed in battle and went to Valhalla. It was her job to determine the fate of the souls who entered her realm.
Prayer to Anubis: This prayer honors the Egyptian god of the underworld, Anubis. He is honored as the god who takes our measure when we cross from this life into the next.
Prayer to the Gods of Death: At Samhain, the earth is growing cold and dark. It is a time of death, of endings and beginnings. This prayer honors some of the deities associated with death and the underworld.
Traditional funerals where a stranger says a few words about the deceased are on the way out.
[F]orget long-faced funeral celebrants and bodies in their Sunday best – the ‘death positive movement’ is shaking up the way we die.
My grandma was 93 years and nine days when she died in April. She’d had a long and good life but her final years were severely compromised. By the end, she could neither walk nor feed herself, she could barely hear and most of the time she did not know who we were. Her world had shrunk to the size of her room. Then it shrunk some more, to the size of her bed. Was she happy? I don’t know. But I can’t imagine that this was the ending that she had in mind.
Dying used to be a typically brief process. Up until our most recent history, if you survived childhood illness, childbirth, plagues and famine, you generally got sick and then you died – often just days or weeks later. In the absence of today’s scans, tests, and life-prolonging drugs, by the time a person was really feeling poorly, their disease was advanced and they succumbed quickly. People died at home, families cared for the body, death was common.
Thanks to advances in modern science and economic growth, we are living longer than ever. In New Zealand, a female born in 1906 could expect to live till 66. Fast forward 100 years and a baby girl born in 2016 gained another 27 years, with a life expectancy of nearly 93. Now, for the majority of us the end comes after a long medical struggle (cancer and cardiovascular disease are our two biggest causes of death) or the combined debilities of very old age.
With a long life can come a long death, and over time we have unwittingly turned aging and dying into a medical experience. Our final stages have become largely obscured – even to ourselves – as we delegate death to the ‘professionals’. Today, it’s not uncommon for a recently deceased person to be collected from hospital or a rest home, taken to a funeral parlour where they are embalmed, washed, dressed and covered in make-up and kept there until the service, which might be conducted by a funeral celebrant who has never met the person they are speaking about.
The entire process is outsourced, sanitised and distant. As a result, we have become increasingly unfamiliar with death and consequently more frightened of it – particularly in Pākehā culture.
But a quiet revolution is taking place, according to many in the death industry. They’re calling it the ‘death positive movement’, and adherents say it’s about encouraging people to speak openly and frankly about death and dying, pursuing a “good death”, and pushing for more diversity in end of life care options.
Tea, cake and death talk
Mortician Caitlin Doughty is responsible for the phrase ‘death positive’ and founded the LA-based The Order of the Good Death.
American mortician Caitlin Doughty, self-described “funeral industry rabble-rouser” and the person responsible for the phrase “death positive”, has found herself the face of the movement. In 2011 she founded the LA-based The Order of the Good Death, which describes itself as a group of funeral industry professionals, academics, and artists exploring ways to prepare a death phobic culture for their inevitable mortality.
A smell-of-death researcher, an end-of-life activist, a conservation burial pioneer and a grave garment designer are among some of The Order’s members. Doughty also runs Undertaking LA, a progressive funeral service whose emphasis is on placing the dying person and their family back in control of the dying process, including educating families on how to care for the dead at home.
She’s published a couple of books – a bestselling memoir Smoke Gets in Your Eyes: And Other Lessons from the Crematory, and From Here to Eternity: Traveling the World to Find the Good Death – while continuing to host her wildly popular ‘Ask a Mortician‘ YouTube series. Much of her time is now taken up with travelling the world speaking about the history of death culture and rituals, and working to address the death anxiety of modern secular culture.
Closer to home, Graham Southwell runs a monthly Death Café in the Waitakere suburb of Titirangi. Billed as an evening to drink tea, eat cake and talk death, Southwell says the aim is to raise awareness and get people to talk about death and dying. “It is like the last taboo. There is a great lack of understanding, a lack of knowledge, but also a huge fear around it. So when people can hear about good deaths, and some of the experiences people have had, I think it can be really helpful.”
The first Death Café (which is a not-for-profit social franchise, meaning anyone who signs up to the Death Cafe guide and principles, can host one) was held in London in 2011. They’re now popping up all over the world; currently there are 65 Death Cafés listed for New Zealand. Southwell, who has trained as a psychotherapist, has been running the Titirangi Death Café, together with celebrant Kerry-Ann Stanton, for the last three years.
He says their job is to act as facilitators and guide the group’s conversation in whichever direction they wish to go. Topics might include the meaning of life, grief, near death experiences and advanced care directives (a document detailing actions you want to be taken for your health if you are no longer able to make decisions because of illness or incapacity). “The idea is that if we start talking about death and dying it helps people to live more consciously, because it just puts everything in perspective.”
When asked whether he thinks New Zealanders are any good at dealing with death, Southwell, who is from the UK, mentions the tangi, the traditional Māori ceremony to mourn the dead. Usually held over three days, the body lies on a marae while people come to pay their respects. It is an occasion full of ritual and emotion, of oratory, song and storytelling. “They seem to have a very good way of dealing with death, that is rich and about celebrating someone’s life and I like that.”
DIY coffins
There has been plenty of interest in ‘underground furniture’ (coffins) made at local Coffin Clubs.
Every Wednesday morning on Rotorua’s north side of town, a crew of senior citizens gather together to catch up, connect, and construct their own coffins. They’ve been meeting like this since 2010, when former palliative care nurse Katie Williams launched the inaugural Kiwi Coffin Club in her garage, with no tools, no volunteers and no clue how to build a coffin. But after roping in some handy local men who helped with the carpentry, the club took off. Now there are around 200 members at clubs throughout the country.
If coffin construction isn’t your thing, for $350 you can purchase a ready-made one and go to town decorating it. But if you’re thinking of purple sparkles, or pictures of Elvis, or turning your coffin into a racing car with wheels fixed to the side, then I’m sorry to say someone’s beaten you to it. Of course, it’s not just the coffins people come for; it’s also for the safe and supportive space where death and loss can be discussed. The Rotorua club, who describe themselves as “Makers of Fine, Affordable Underground Furniture” also construct baby coffins for their local hospital and memory boxes, which they donate for free.
Death midwives
Death doula, deathwalker, death midwife, end-of-life midwife, soul midwife, companion to the dying. These are all names for the same role; someone who supports the dying and the grieving. And while it’s hardly a new concept – for thousands of years people have done this for one another – there is now an industry springing up to meet the demands of our increasingly secular and death-anxious population.
While death doulas can make a living from their work in the UK and the USA, here in New Zealand, those who are drawn to the role seem to be doing it on a volunteer basis. Strictly a non-medical role, a death doula might help to create a death plan, advocate on a person’s behalf, and provide spiritual, psychological and social support. They may also provide logistical support; helping with services, planning home funerals and guiding mourners in their rights and responsibilities in caring for someone who has died.
Carol Wales, who prefers to describe herself as a companion to the dying, has supported a number of people in their final weeks of life through her work as a volunteer at Auckland’s Amitabha Buddhist Hospice. Her role can be varied. She will visit the person in their home, take them out if they’re feeling up to it and offer massage and aromatherapy. “Some people want to talk about their life and what it means to them. That it does mean something. There might be issues with family members, siblings arguing about money, possessions. It can be very difficult for the person who’s dying to be in their process, because it is a process. Families can be protective, they can be in denial. One of the skills, I believe, is navigating all of that. Being on the periphery when you need to be, and being close to the person when you need to be. It’s like a dance.”
‘Nobody’s got out alive yet’
It’s a beautiful, still Wednesday morning at Dove House hospice in the Auckland suburb of Glendowie. A low-slung modest building, it’s hard to imagine that for some, this is where they come to spend their final days. Designed to support patients with life-threatening illnesses, and their families and caregivers, Dove House is based on a holistic model with a focus on empowering people to understand their own process and look for alternative ways of feeling better. It offers patients and their families counselling, support groups and workshops, as well as body therapies including aromatherapy, massage and reflexology.
Dove House’s doctor and medical counsellor Dr Graeme Kidd says while they do see extremely sick people at the end of their life, they also have a large number of patients who, despite being diagnosed with a terminal illness, may go on to live for a number of years. And while we’ve made huge scientific improvements in understanding diseases like cancer, Kidd, a GP for 40 years, thinks one of the key things missing in the medical model is humanity.
“A patient will finish their treatment and say ‘What do I do now?’ And the doctor will say, ‘Just get on with your life, be grateful you’ve got to a good place.’ And the patient’s thinking, ‘I was getting on with my life when this all happened, but now I’ve got this neon sign saying ‘I have cancer’. A common experience is being frightened of the diagnosis and feeling a victim of the illness, you feel diminished by what you’re living with. So it’s trying to reframe that; ‘You’ve had your treatments and you’re doing really well and how do we now get the rest of the show on the road?’ That there’s still a life to be lived.”
Kidd thinks we are getting better at death. “We’re certainly having some incredible experiences with families where it feels like the death is a positive experience, and people come out of it feeling almost proud of what they experienced. And to me, to experience death sets you up for your own process. Nobody’s got out alive yet and it’s a certainty that we’re all going there.”
Family involvement and personalisation
My grandma was very explicit about how she wanted to be farewelled; a cremation, specific locations to scatter her ashes, a small family-only gathering. No-one was to make a fuss. Her memorial service was two weeks after she passed, so that family coming from overseas could be there. It was a perfect autumn day, she would have approved. The service was held in a restaurant we knew she liked and there, we ate and drank and talked and laughed and remembered. Songs were sung, anybody who wished to say something could, and did. It was not in any way a sombre affair and collectively, as a family, we felt in control of the entire process. The only people that spoke of her knew her, had known her, our whole lives.
Chris Foote from The Natural Funeral Company.
Chris Foote, owner of the Natural Funeral Company, says she is seeing many more of these types of services, like my grandmother’s, where the family opts to run it themselves, instead of using a celebrant. “People don’t like the idea that someone speaks about their person and doesn’t know them.” There’s a shift away from formality and tradition with many of their clients explicitly stating they don’t want religion and prayer to play any part in the service. Instead, “it’s just a whole bunch of people getting together and talking about that person and playing music.”
Increased family involvement is extending beyond the service, too. More families are wanting to assist with the washing, dressing and placing of the body in the casket, which Foote says they encourage. “We used to be community based around our care of the dead, we’ve gone away from that experience, and now we’re simply coming back to it.” She’s also witnessed an increase in families choosing to have the body at home until burial or cremation. In around a third of the deaths they deal with, she and her colleagues will make daily visits to a private residence to care for the body and keep it cool.
The Natural Funeral Company, as the name might suggest, specialises in natural organic body care. They do not embalm, a process involving the use of chemicals to preserve the body and forestall decomposition, instead they use essential oils, homemade restorative creams, minimal make-up and then ice bottles to keep the body cool. Most bodies can last around a week, although there are instances where things need to move reasonably quickly, and the odd occasion where they will recommend embalming. Says Foote: “Part of the reason that I don’t like to embalm is because I think we should see that natural process of the decay of the body. I think it’s quite a beautiful process actually.”
A coffin with nikau design from Return to Sender.
Self-expression in death, as in life, has become one of the hallmarks of our time. Where once our funerals followed the same format, now there is almost nothing that can’t be customised to reflect our personalities. There are legal requirements for paperwork to be completed, deaths to be notified and bodies disposed of, as for the rest it’s your party and you can do what you like.
Fran Mitchell, co-founder of funeral home State of Grace, says the funerals they are involved with are all about best representing the person who has died; from coffins and venues to music and clothing. They are being held in all kinds of places; boat clubs, community halls, RSA’s, vineyards and people’s homes. “Wherever people had an association with, and not only in a church or a chapel where that person may never have gone.” The range of coffins on offer at State of Grace is staggering. From the Departure Lounge range, which includes floral designs and coastal sunsets, through to handwoven willow caskets, cardboard caskets, and simple calico shrouds. For the budget conscious, they can rent a coffin – and given the average New Zealand funeral costs around $10,000 that’s likely most of us.
Among their most popular coffins is a plain casket upon which families can write notes, draw pictures and fix photographs to. “It’s a really nice way to get the children and grandchildren involved. It can be quite therapeutic really.” Their range of urns is equally impressive; ceramic, wooden and hand painted.
As for coffin dress code? There isn’t one. Gone is the Sunday best, now people are putting their loved ones in whatever they think they’d be most comfortable in; pyjamas, no shoes, there aren’t any rules. They have had some people opt to wear nothing at all. Depart in the manner they arrived, you might say.
Mitchell is optimistic about the future of death. “I think things are changing for the better. People are talking about death more and accepting it as a part of life. Celebrating a life well lived instead of mourning a death.”
Body disposal: Mushroom death suits and sky burials
Vultures wait during a celestial burial ceremony in Dari County of Guoluo Prefecture, Qinghai Province, northwest China.
There are four options for body disposal in New Zealand. Cremation (70 per cent opt for this), burial, burial at sea and donating your body to medical science. But many are looking to alternative options. Recently, there’s been a growing demand for natural burials, which sees the body placed in a biodegradable casket or shroud and then into a shallow plot to allow for speedy decomposition (the body cannot be embalmed). The plot is then overplanted with native trees, a living memorial to those buried there. Currently, only a handful of councils in New Zealand offer natural burial sites.
Overseas, the death positive moment is actively endorsing more eco-friendly methods – some of which are still in development.
There’s liquid cremation (which involves dissolving the body, currently only legal in Australia and in eight US states), promession (freeze-drying the body, not yet legalised) and sky burial (a Tibetan funeral practice involving exposure of a dismembered corpse to scavenging vultures – very environmentally friendly). Finally, there’s the Mushroom Death Suit, an outfit embroidered with thread that has been infused with mushroom spores, which grow and digest the body as it decomposes following burial.
Filmmaker Cathy Zheutlin, right, with her mother, Jonnie Zheutlin. Cathy Zheutlin was inspired to make the film ‘Living While Dying,’ when her mother’s partner was diagnosed with terminal cancer.
“It wasn’t loss that triggered this, it was curiosity,” says filmmaker Cathy Zheutlin of her new documentary, “Living While Dying,” a short film whose subtitle reads: “A story of life. A story of death. Finding joy in the journey.” Zheutlin, who stumbled upon the good fortune of having two parents alive in their 90s, became fascinated with the idea of mortality, an inevitability we all face, despite it being hidden from view — and polite conversation, for that matter. Her exploration of the topic extends an invitation to viewers, one that hinges on conversation as the most necessary component surrounding mortality and the end-of-life choices that arise as a result. After having made its debut in Ashland and Portland, Oregon, where the filmmaker and her mother reside, Zheutlin’s film is making the rounds in the northeast; it will be screened Wednesday, June 6, at 7:30 p.m. at Kimball Farms Life Care in Lenox.
The inspiration for Zheutlin’s film came when her mother’s partner, Clair, learned he had terminal cancer. “We had a dying man in the living room,” she recalls in the film’s trailer. “I am a filmmaker so I asked Clair if I could film him; he said ‘yes,’” continues Zheutlin. This impetus, coupled with what she calls a desire to push the envelope of consciousness, led Zheutlin and her husband, Edis Jurcys, a brilliant photographer, to embark on the telling of these stories. Their exploration took them to Australia where they met a death walker, and to Bali where they saw a mass cremation. When the pair learned that dear friend Don was dying back at home, Zheutlin took “a deep dive into reflecting on death and grappling with the meaning of life.” The result is “Living While Dying.”
“This is territory that we cannot avoid,” said Zheutlin, whose work stemmed from a simple observation on her part: “So many people have so much to say [and yet] the conversation is mostly not happening.” The documentary project, a full five years in the making, catapulted her back into the world of professional filmmaking after a 32-year hiatus. She decided to pick up her camera and film four friends with terminal illnesses who chose to live out their days in hospice care at home. What ensues is a bold discussion of the inevitable, and one filmmaker’s attempt to remove the pall from a subject that, if considered from a different perspective, is but the final developmental stage in life — one to be revered and celebrated in much the same way as all those that precede it.
Jonnie Zheutlin’s partner, Clair Killen, near the end of his life.
“You can’t destroy energy, that became really clear to me,” recalls Jonnie Zheutlin of her own experience walking through end of life with her partner of 12 years, Clair. “I don’t actually fear dying,” is the elder Zheutlin’s stance on the subject. Jonnie took an OLLI class in Oregon called “Talking About Dying as If It Could Happen to You,” which she found to be both fascinating and on target — not to mention independent of her daughter’s project. This, coupled with Clair’s death, urged her on to further explore the subject. She recounts the first time Clair showed up, shortly after he died; she was looking out the window and, from the trees, this tape kept coming out. At first Jonnie thinks it’s a kite; she wonders what’s going on and then she has a realization: “The way it moved, it moved the way Clair danced — it was so clear, but I was frantic, I wanted someone to validate it,” she explains. From these experiences, a conversation between the mother-daughter pair has ensued.
“The advantage of having conversations when we are healthy is that, when we are in crisis, it’s not the time to begin thinking about all the various choices. And there are a zillion choices,” says Zheutlin. It’s the pre-thinking to support us along the way that Zheutlin hopes will inspire others to embark on a dialogue that, for many, is not welcome. In the documentary, Jonnie and her daughter model a conversation (Zheutlin is the film’s narrator) while Jonnie sits in a coffin. Zheutlin was conscious of her choice to model the conversation with her mother — who is very comfortable talking about her own EOL choices — in the presence of an image that was not terribly stereotypical. She felt the iconic images of individuals contemplating death while meandering through a cemetery to be too cliché. “That step of taking something scary and foreign and only associated with grief” proved liberating in her portrayal. She goes on to clarify: “I don’t think we should ever disassociate grief and death — it’s just that it’s not the only part [to be emphasized] because it’s natural. We somehow need to integrate it,” Zheutlin explains.
The film arises out of a grassroots movement — with titles running the gamut — that revolves around reclaiming death in much the same way baby boomers reclaimed birth. “They said, ‘let’s have our babies at home, [as] birth is not a medical event.’” Well, death isn’t necessarily a medical event, either. “Death is a natural thing that happens at the end of every single life. It’s 100 percent going to happen,” Zheutlin reminds her audience. But we don’t get to see the images of nonmedicalized death; this is where Zheutlin comes in. “Living While Dying” offers viewers a glimpse of what death looks like when one goes the nonmedical route and chooses hospice at home. “My experience is not prescriptive or comprehensive; everybody’s experience is going to be unique and important and worthy of being uplifted,” Zheutlin said. “I’m not promoting an ideology, I’m promoting a conversation,” she says of her intensely personal approach. One thing is certain: Death is somehow less scary after viewing this film. “It’s not articulated, but it’s felt,” Zheutlin explains. As for Jonnie Zheutlin’s last word on the topic? “I used to have cement in my mouth,” she says, borrowing a term she once heard a child use in her days as a therapist. “I am learning to verbalize; it’s taken me almost 90 years to learn to use my voice,” she jokes, adding “Thank God I’ve lived long enough to do that!”
Zheutlin’s film has been hailed as a brave and honest immersion in a difficult topic. In her director’s statement, she cuts straight to the chase: “Death is a teacher. Many of us are scared of death. We feel unprepared both for our own deaths and the deaths of people (and animals!) we love. Our associations with death are morbid, dark, cold, depressing, and laden with grief and pain. So we do not talk much about death. In modern times, we have medicalized the end of life, and disconnected it from nature. In trying to prolong life by any means necessary, we only succeed in keeping death shrouded in darkness. By keeping our distance from death, cloaking it, hiding our eyes from it, we actually lose touch with a sacred phase of life. Because, as we all know, death is a part of life — for all of us.”
Director-producer Zheutlin has been principal cinematographer on award-winning PBS documentaries including “The Life and Times of Rosie the Riveter,” “The Other Philadelphia Story” and the 1982 Academy Award nominee “See What I Say.” Her 1986 documentary “Just One Step: The Great Peace March” led to a co-production with Soviet TV about the first Soviet-American peace walk. In short, she has spent her career making films that explore consciousness and encourage progressive change. Her documentary “Living While Dying” was an official selection for the THIRD ACTion Film Festival, which celebrates aging and older adults while helping to create an age-positive culture shift. For more information, visit www.livingwhiledying.org.
Sophie Mackenzie on why her family backed her mother’s decision to stop eating and drinking when faced with terminal cancer
By Sophie Mackenzie
[I]t was late evening on a Monday in April, the end of a bright autumn day in Johannesburg, when Mum died. The nurses who were caring for her had made her comfortable for the night, turning her on to her side with a pillow to cuddle, the way she liked to sleep. My sisters Vicky and Jassy and I were with her. We held her hands, told her how much we loved her, and that it was safe and right for her to go. After a few minutes, her breathing stopped. It was a good death – the kind of death I think most people would choose if we could: free from pain and surrounded by love. She wasn’t hooked up to tubes or monitors; she was even wearing her own pretty nightdress rather than a hospital gown. I suppose it’s what you’d call a natural death. But in one way Mum’s death was exceptional, shocking even. She had decided to die, about 10 days before, and for the previous six days had had no food and almost no water. She had chosen to die of thirst.
The story of Mum’s death begins in September 2008, when she sent an email to her daughters, telling us that she had been diagnosed with colon cancer. “Don’t worry about me, darlings,” she wrote – but it was clear that she herself was desperately worried: about loss of dignity, about the cost of her medical care, about whether Dad would be able to learn to make his favourite spaghetti bolognese if she was unable to cook for them both – all the details of death. In the event, after a frightening and rocky few weeks and major surgery, Mum recovered well, and by the beginning of this year we had all started to make plans to celebrate her 80th birthday in August. With Mum and Dad’s five daughters living so far apart, times when we were all together are rare and precious.
Then, at the end of February, came a letter from my eldest sister Emma in place of Mum’s normal Sunday email. “Mum isn’t feeling great,” she wrote, “and she asked me to write so you wouldn’t worry.” But, of course, we instantly did begin to worry, and it was only a few days before the diagnosis we’d dreaded arrived. Mum’s cancer had metastasised and spread to her brain and possibly also to her lungs. Her oncologist immediately set her on a course of radiotherapy and cortisone to shrink the tumours, telling us that it would take up to two weeks before we knew whether the treatment had been effective.
Vicky, who has experience caring for the terminally ill, travelled to Johannesburg to help Mum and Dad, and they had long and honest talks about the decisions Mum faced. She wasn’t quite ready, she said at first, to leave Dad, “this beautiful world”, as she put it, and us. But over the next few days, Mum’s condition began to deteriorate, and she became increasingly uncomfortable and frustrated. Mum was a very private person. She loved order; she hated mess and squalor, and illness is often messy and squalid. She told Vicky again and again that she didn’t want to go through more treatment. She didn’t want Dad to see cancer killing her. She wanted to die quickly and quietly. She didn’t want any fuss.
It was Emma who first told Mum about an article she’d read several years earlier in the Journal of the American Medical Association about voluntary refusal of food and drink as a means of bringing about death in the terminally ill. The author described it as a relatively painless way to die: a gradual slipping away into a coma, followed by death. Typically, a person will take between five and 10 days to die this way and, crucially, they have the option to change their mind and stop the process until almost the end. Mum just latched on to the idea, Emma remembers. She decided that she was going to stop taking the cortisone that was keeping the tumours in check, and stop eating and drinking as well. She wasn’t going to let the disease take over.
Like many people, I simply didn’t know that choosing to stop eating and drinking is, as Jassy put it, “a Thing”. But it is – it’s a thing about which you can find pages and pages of information on the internet, once you have a reason to Google it. It’s a thing that’s been reported quite extensively in medical literature, known variously as VSED (Voluntary Stopping Eating and Drinking), VRFF (Voluntary Refusal of Food and Fluid), PRNH (Patient Refusal of Nutrition and Hydration), or self-dehydration. It’s a thing doctors who have practised for a long time and seen many patients die at home describe as “taking to their bed” or “turning their face to the wall”. It’s a thing that was explored and argued by lawyers acting for the man known publicly as Martin, whose case was recently heard alongside Tony Nicklinson’s. It’s a thing, as I discovered when researching this article, that people seem afraid to talk about.
‘She wanted the kind of death most people would choose, if we could’ (from left): Jassy, Juliet, Sophie, Emma and Vicky with their parents.
There is nothing illegal about refusing food and drink; in fact, feeding a competent person against their will constitutes assault. Nonetheless, Mum was afraid that something would happen to prevent her reaching her goal. She worried about falling and breaking a hip, ending up in hospital and being caught in a spiral of intervention that would prolong her life. She worried that intravenous nutrition and hydration would be given to “keep her comfortable” if she became unconscious. She had signed a living will expressing her preferences, but such advance directives are generally regarded as worthless unless the dying person has a supportive medical team who understand their wishes and are prepared to act upon them.
South Africa’s legal position on assisted dying is fundamentally the same as Britain’s: if you help another person bring about their death, you could risk prosecution. As in the UK, there have been attempts to clarify the law on end-of-life decision-making processes, removing the grey areas that currently exist. Professor Willem Landman, CEO of the Ethics Institute of South Africa, is one of the leading figures campaigning for a change in the law. He explains that in 1998, President Nelson Mandela commissioned a report into the legal and ethical issues surrounding assisted dying, assisted suicide and euthanasia, but after being tabled in parliament in 2000, the report was ignored by the ministry of health. Landman believes this may be because the then minister of health, Dr Manto Tshabalala-Msimang, regarded the issue as something of a middle-class problem. Perhaps it is. When birth and death are less medicalised and a more integral and familiar part of life, perhaps choice in such matters seems an unnecessary luxury. Perhaps mothers do die gently, cared for by their daughters, without worrying about indignity and fuss. But they don’t die quickly, or without pain.
Mum had always talked frankly to us about death. My sister Juliet remembers when she was a little girl and terrified of dying, Mum telling her, “Your body is like a suit of old clothes – by that time you will be tired of it and you won’t want it any more.” Mum hated clutter and hoarding; when a thing had outlived its usefulness, it was to be disposed of without sentiment, whether it was a favourite dress the moths had got to, a book that was falling apart at the spine or her own body. She made it clear to us that she would far rather be dead than be a burden on her husband and daughters. Now, with her hands becoming increasingly unsteady and fits of dizziness coming unexpectedly, she was finding the colostomy bag she’d had since her surgery in 2008 difficult and humiliating to deal with. She felt that her body was wearing out and, more frighteningly, her head felt heavy and fuzzy.
Over the course of a long phone call, Vicky told me that Mum had made a decision. She was going to stop taking the medication that was checking the spread of her cancer, and stop eating and drinking, too. We had about a week to say goodbye, so Juliet and I flew to Johannesburg as soon as we could. It was the sort of family reunion Mum loved, and in many ways it was like all the other happy times we have spent together, filled with love and laughter. We planned meals together, cooked in Mum and Dad’s tiny kitchen, ate and drank together, just as we’ve always done on family holidays, over Christmases and at other celebrations – only this time it was Mum’s life we were celebrating, while she went through the process of dying.
It was the most remarkable week of my life, and it has left me unafraid of death.
I’d been afraid of seeing Mum since this latest illness. I was expecting to find her diminished, somehow less herself. But I was amazed by how well she seemed. Vicky had cropped her hair so that she wouldn’t have to experience it falling out, and Mum, with the pride in her looks that beautiful women never lose, was obviously upset by her appearance. But to me she looked lovely. She shone with happiness at having all her daughters there with her and Dad. She was full of her usual curiosity and humour. She didn’t look like someone who was ready to die, and this frightened me – what if somehow stopping eating and drinking didn’t work, and Mum lingered on in pain? What if the process didn’t take a matter of days but a matter of weeks? Part of me knew how much she would hate to be thwarted in her intent; part of me longed to keep her with us for longer, and hoped that, even now, some sort of miracle might happen. I even suggested to Mum that she should stay at home for a few days, just to see how she felt, but she was adamant: her decision had been made. The next day, she was going to move to the nursing home at the retirement community where she and Dad lived, and she was going to die there.
Although Mum was unable to walk unsupported and her hands were very shaky, she was alert and lucid, chatting to us as she always had. Her appetite was small, but she was still enjoying food: pizza with olives and anchovies, strong cheddar cheese, the fruit cake Juliet had baked and been saving for Mum’s 80th birthday. Juliet’s cake was the last thing Mum ate, on Wednesday 28 March, when her brother visited to say goodbye, and she had a last chat with her sister in the UK. We were all in tears that morning, except for Mum, who stayed calm and cheerful.
I didn’t see Mum leave her home for the last time. Dad, Emma, Juliet and Vicky were with her, and Juliet cried afterwards when she told Jassy and me how Mum had gone around the little house where she and Dad had been so happy, saying goodbye to it and all her precious things, before being driven the few hundred yards to the nursing home. The staff there welcomed her and settled her into bed, and she curled up and went to sleep.
It’s fortunate that Mum was surrounded by people who supported her decision. Her GP believes that people at the end of their lives should have the right to be “conductors of their own orchestra”, and made it plain that she would prescribe whatever pain relief Mum needed to mask the symptoms of her advancing cancer, and whatever sedation she required to alleviate distress. The management of the nursing home hold the same view. Her GP gave them written instructions explaining Mum’s decision and outlining the care she would need. “She is a very brave lady,” the email concluded. And, of course, Mum had five daughters who adored her and a husband who’d worshipped her for almost 60 years, and we were all unequivocally on her side.
The five of us sisters rallied behind Mum and Dad; we were a team. As I write this, it’s difficult to isolate my own feelings and experiences from those of my sisters – who said what, who made decisions, who cried. It’s a gruesome analogy, but the five of us, Dad, Mum’s GP and her carers were like a cheerleading squad urging her on towards the goal she had chosen. This isn’t always the case. I was horrified to read a 2011 report in the New York Times which told the story of Armond and Dorothy Rudolph. The Rudolphs, both in their 90s and with failing health, made the decision to end their lives together by stopping eating and drinking while they were still mentally competent and able to live independently. The management of the assisted-living facility where they had their home responded by attempting to evict them. It was only after intervention by the couple’s family, the local press and medical and legal experts that the attempt was stopped. Armond Rudolph died after 10 days without food and drink, and Dorothy a day later.
We laughed a lot over the next few days. We teased Juliet about developing late-onset colour-blindness when she kept putting bottles of red wine in the fridge, while the white stayed warm on the kitchen counter. Jassy and I speculated macabrely about what would happen if the nurses forgot to take down the “Nil by Mouth” sign over Mum’s bed after she died – we imagined some poor old dear being moved into her cubicle and waving plaintively as the tea trolley rattled unheedingly past. Emma and Juliet still haven’t let me forget the nightmare 10-mile walk I dragged them on around the suburbs of Johannesburg, possibly the world’s least pedestrian-friendly city. One night after dinner, Emma and Juliet went to visit Mum, and the three of them chatted and reminisced until eventually my sisters were asked to leave – their laughter was keeping the other old ladies awake.
In the midst of Mum’s death, our normal lives went on. I was writing a seemingly endless list of product descriptions of cheeses – I’d hoped that Mum would have enjoyed working with me on them; a writer herself, she would have embraced the challenge of describing the differences between stilton and roquefort. But she was too drowsy, although she loved being read to. We planned each day as it came: who would be spending time with Mum, and when; who would cook, and what, and for how many. Of course we talked about Mum and what was happening, sharing our fears about what the next few days would hold, and our happy memories of her. Often, it felt just as if she was there with us, as she always had been when the family was together.
There were hard parts, too. By Friday, although Mum was still spending a lot of time asleep, her waking hours were difficult. She was dreaming, she told us, about drinking ice-cold Coke, and waking feeling desperately thirsty, as one does with a bad hangover. Chips of ice helped to relieve the dryness in her mouth, and she had sugar-free mints to suck as well as frequent glycerine mouth swabs, but the thirst remained. She also developed a pounding headache as her blood sugar level fell. Emma bought her some Coke, thinking that the occasional sip would make her more comfortable and do little or nothing to prolong her life. But Vicky, determined to support Mum completely in her decision, said, “It could set her back days!” and took it away, leaving the nurses crying in her wake. That day, Mum said to us, “I didn’t realise it would be so hard.”
She wasn’t the only one. Being a spectator at the death of someone you love is bitterly hard. We expect medical science to intervene to relieve suffering, and to a great extent it does. But the journey is a lonely one. Even surrounded by the people who loved her most, and professionals who gave her the very best palliative care, Mum fought her battle for death alone. How much more lonely, and how much more frightening, the process must be for people who aren’t supported by their family, or aren’t able to communicate their wishes, I can only imagine.
Mum spent a lot of the next three days asleep, but when she was awake, we chatted to her and to each other, and Jassy read to her from her new novel, which is dedicated to Mum. She also enjoyed having her hands massaged with her favourite body lotion as her skin began to get dryer, and the scent greeted us when we came into the ward to see her. Dad was his usual self: strong, serene and often silent, surrounded by his five chattering daughters, but occasionally cracking us all up with his characteristic dry wit. He spent a lot of time at Mum’s bedside, sitting with her while she slept. Mostly, it was a peaceful and happy time.
On Sunday, Mum began to slip away. In the morning she was still alert, asking for ice to suck and chatting to us almost normally, but by the evening she was no longer able to speak easily. I’d had a bad cold for the previous few days, and when I heard the new rattle in Mum’s breathing, I became convinced that she had caught it and my virus was going to be the thing that finally carried her off. I sat by her bed and cried my heart out – a mixture of guilt, grief and all the stress of the last few days just pouring out of me. I felt embarrassed by my tears in the face of Mum’s courage – absurdly, I didn’t want to worry her. She asked me several times, “Am I going to be all right?” I told her that she was, and that I loved her. There wasn’t anything else to say. That was the last time she spoke.
For most of the six days it took her to die, Mum was in no pain. The morphine patches she had been prescribed relieved any symptoms her advancing cancer might have caused, and the sedatives kept her calm and drowsy. However, it’s not known whether such palliative care actually removes the dying person’s experience of hunger and thirst, even once they have lost consciousness. A paper published in the Journal of Medical Ethics in 2011 concluded that “continuous deep sedation may blunt the wakefulness component of human consciousness without eradicating internal affective awareness of thirst and hunger”. I hope that, for Mum, the dreams of ice-cold Coke and the sensation of thirst stopped once she fell asleep on that Sunday night.
On Monday morning, Mum was moved from the main ward where she had spent the past five nights. The curtains around her bed had remained closed while she was there – Mum would have wanted the privacy, we knew, but still we speculated darkly about whether the staff had kept her hidden in case the other ladies got ideas and decided to emulate her. Her new bed was in a private room. She barely woke when she was lifted, and she was losing the ability to swallow. In the afternoon, the vicar came to say the last rites, with all five of us sisters and Dad there, perching on her bed and chairs around it. Mum seemed to be aware of the words of the service – perhaps owing to the vicar’s maximum-decibel delivery, which we all laughed about afterwards – but she was sliding deeper and deeper into unconsciousness.
That evening passed slowly, as time does when you’re waiting for something important to happen. I carried on with my writing – the cheese product descriptions were complete and I’d moved on to fish, and it was comforting to escape into work. Emma and Juliet were spending the night at home with Emma’s partner and his children. Dad did a crossword puzzle; Vicky made a batch of chicken soup, using Mum’s recipe. Over dinner we talked about the practical things that would soon need to be done, and decided that Vicky would be the one to phone the undertaker, and that she would remove and take care of Mum’s rings and watch. We asked Dad if he felt it was important for him to be there when Mum died, but he felt that he had already said a very temporary goodbye – he was, and remains, confident that they will be together always once he joins her. So Jassy, Vicky and I took the familiar route up to the nursing home to see how Mum was and decide what to do about spending the night with her. It was the last time we’d walk that way; within a few minutes of our arrival, she was dead.
I went back to Jassy’s house that night and wrote about Mum’s death. My overwhelming feelings were relief and pride – my brave, beautiful mother had taken on the hardest challenge of her life, and won. I could go home to my partner, whom I missed desperately, my home in London and my little cat. My sisters and Dad felt the same, I think: tired, but triumphant, too. We’d achieved what we had set out to do, as sisters and as a family.
Even if Dignitas had been a practical option for Mum, I don’t believe she would have chosen it. Apart from anything else, she loathed travelling. (I suspect she would also have regarded the cost as a wanton extravagance.) But what if there had been another way for her to take? An injection administered by a doctor she trusted, or pills brought to her by Dad or one of us? I’m not sure. Perhaps she wouldn’t have wanted anyone else to bear the responsibility of having ended her life. Also, I think part of her relished the challenge, the control and the independence of doing it the hard way.
In the obituary that was read at Mum’s funeral, Vicky remembered a saying that Mum was fond of quoting: “Old age is not for sissies.” Mum was no sissy – as Emma put it later, Mum was a soldier. She embarked on her final journey with steely determination, astonishing courage and immense dignity. I feel honoured to have been a part of the process. I’ve seen that it is possible to choose and achieve a good death, on one’s own terms. I used to be in favour of changing the law on end-of-life choices; now I am evangelical about the importance of autonomy in terminal illness and death. I’m so proud of what Mum did, and of how my father, my sisters and I helped her to achieve it. But that doesn’t alter my passionate belief that people in Mum’s position, or Tony Nicklinson’s, or Martin’s, should have more, better and easier choices.
For years, Dr. David Wong has questioned why religious people, who say their souls go to heaven, would go to such extremes to protect their dead body by embalming, select expensive wooden caskets and then even protect the casket. Perhaps green funerals are the alternative?
By Dr. W. Gifford-Jones
[H]ow would you react if you saw people dumping 800,000 gallons of formaldehyde, a carcinogenic substance, into the earth every year?
Then witness them cutting down four million acres of forests annually? I suspect the environmentalists who fight underground oil pipes would be raising holy hell about formaldehyde and rampant destruction of trees. Yet this is what it takes to bury the U.S. dead every year. So why are environmentalists so silent?
Now, a film called “Echo Death Takeover: Changing the Funeral Industry” has been produced by The Order of Good Death, founded by funeral owner Catlin Doughty who advocates green funerals.
Some readers may wonder why I’m writing about death when I’m trained to keep people alive. But pollution of many types is currently causing serious respiratory and other health problems. Moreover, for years I’ve questioned why religious people, who say their souls go to heaven, would go to such extremes to protect their dead body by embalming, select expensive wooden caskets and then even protect the casket. And although I’m not a religious authority, don’t they always say at funerals, “Ashes to ashes and dust to dust?”
So, what to do about the current burial procedure? Formaldehyde was discovered by a chemist, August Wilhelm von Hofmann, in 1867 and it quickly replaced arsenic as the prime way to embalm bodies. Now we know that formaldehyde is a hazardous substance, highly toxic to humans. It is linked to cancer and irritates the eyes, nose and throat.
Some readers would reply, “But what about cremation? Is this more eco –friendly?” Unfortunately, where there’s fire there’s smoke. Cremation also produces harmful substances such as carbon dioxide, hydrochloric acid, sulphur dioxide, dioxin, mercury from amalgam dental fillings and carcinogens.
If the body is embalmed, smoke also contains vaporized formaldehyde which remains in the atmosphere. That is, until it bonds with water. Then we are rained on with formaldehyde. So be sure to take a good raincoat and hat if attending a rainy funeral. Besides, cremation requires heat that could be used for other purposes.
So, what is a green funeral? It’s a process called alkaline hydrolysis, also called flameless cremation or water cremation. The body is placed in a pressurized steel container filled with 95 per cent water and five per cent potassium. For the next three hours the body undergoes chemical decomposition, reducing it to soft bone fragments. This mixture of amino acids, peptides, sugar and salt can then be used for fertilizer.
Water cremation is not an illogical proposition for the next century. It’s now legal for human disposal in four U.S. states and in 14 for pets.
Are there negatives to water cremation? I imagine some would be disgusted at the dissolving of a loved one in a warm alkaline bath. But, surely, it’s less psychologically shocking than having Grandpa inserted into a fiery inferno.
Another alternative is to wrap the body in a biodegradable shroud made of cotton or unbleached bamboo, place it in a biodegradable casket in a shallow grave and let bacteria break down all these ingredients.
So, what’s going to happen? I hope that good sense will one day finally prevail and the days of spending thousands of dollars on today’s burial rites will finally end.
Shakespeare, in his play “Hamlet,” describes the scenario of life and death so well. He wrote: “Worms are the emperor of all diets. We fatten up all creatures to feed ourselves and we fatten ourselves for the maggots when we are dead. A man may fish with the worm that hath eat of a king and eat of the fish that hath fed of that worm.”
This is not a pleasant thought or the best bedtime reading. But regardless of how expensive the casket is the worms finally win. So, isn’t there a better way to protect the planet and return all the minerals and other elements to the earth?
So, what is my wish on death? My family knows I want a simple bench along the waterfront in Toronto where people can relax and enjoy the view. My ashes beneath can help the trees grow.
After the death of someone close food can seem unimportant. Grieving can make us lose our appetite and the motivation to cook, but food can also play an important healing role in remembering those who have gone.
bowl of borscht
By Anne-Marie Bullock
[R]ob Tizzard lost his mother Rita just after his 30th birthday.
“It was very sudden. She had a problem in her leg and you think nothing of it, and then I got a phone call saying she was in hospital and she had cancer,” he explains.
“It was a huge shock and just five weeks later she was gone. She taught me to appreciate the little things in life, so I have managed to deal with it well.”
In his kitchen, the smell of cinnamon fills the air, as he has been making bread pudding. It is a dish that holds wonderful memories of his mother, and he has been trying to replicate it.
“She used to make it using crusty bread – to use up the stale bread,” he says.
“I’ve left the bread to soak in the milk and the eggs overnight, rather than for just an hour. I just want to get it as close as I can to the way she made it. Hers seemed to cook browner than mine.
“Mum used to make it as a gift for friends a lot. I’m not sure if she liked it that much herself but friends would rave about it and loved her way of doing it and practically beg her to make it.
“Growing up I was interested in cooking and she’d sit me on the kitchen surface as she made cakes and tried new recipes.”
Clinical psychologist Dr Claudia Herbert says cooking can have restorative powers for those grieving, once the initial pain is overcome.
“Food is a connective aspect in our lives and they would have probably shared many experiences that would have involved the preparation, shopping for or sharing of food and taste experiences – this can lead to memories which can be triggered in a positive or negative way,” she explains.
“It may lead to sad or bitter reaction earlier in the bereavement process, but later on a reminder may connect them to the loving memories they shared.
“It can give them a sense of comfort and eating the food may bring them back to the good times they enjoyed.”
Many people have memories of loved ones tied up in food.
For me, Sunday afternoons at Grandma Joan’s were a wonderful time, and she always fed us well, and taught us how to bake and decorate cakes (and how to clean up afterwards).
I lost her several years ago and shepherd’s pie is a comforting food for both my sister and I, which reminds us of her.
Mine never quite tastes as good. I wish I’d listened more carefully to her instructions, but I will keep trying.
I know others still trying to conjure up the magic balance that emulates their grandmother’s goosnargh cakes (a type of shortbread), gravy, or pea and ham soup.
Keen cook and food blogger Bridget Blair has already thought about how to preserve the culinary influence of those close to her.
She has compiled an album of treasured recipes from friends, relatives and neighbours which she shares with her children, and plans to pass down the family.
The battered book is covered in splatters and fingerprints but each recipe has a story attached.
“I do have that smug factor because not everyone has these recipes,” says Lucy Blair, her daughter.
“These have been handed to us by someone quite special and not just some bloke off the telly.”
Geoffrey Wicks has learnt to cook since his wife died and loves a good trifle
But sometimes the early painfulness of losing someone special can remove the pleasure of food, and leave people unmotivated to cook.
Some hospices now run cookery courses to help relatives in the bereavement process, like at the Hospice of St Francis, in Berkhamsted, Hertfordshire.
I went along to meet six people, who had all lost someone, and watched as they cooked a dinner of lasagne, goats cheese and herb bread and trifle – dishes they had asked to learn to make and which they ate together.
Some of them had started with no cooking skills at all, having lost a partner or parent who took on that role.
“I’d been struggling for a year before I came on the course – eating takeaways, not proper food, and putting on weight,” says course attendee William Knight.
“My mum was a very good cook so I’d let her get on with it, but unfortunately that meant I didn’t get the experience.
“I would go in a kitchen and panic – I could burn water. By the end of the first day on the course I had learnt more than I thought I ever would and now have confidence to cook,” he says.
Jo Ash lost her husband a year ago.
“You don’t want to do anything as you’re in a bubble,” she says.
“It was far worse than I thought it would be – I’ve lost family members before but never a partner – it’s like losing half of your own body.
“You just get to a stage where you can’t make anything because it’s showing a form of love and you just can’t do it. This has helped me get cooking again and get interested.”
Geoffery Wicks lost his wife a year ago and has since learned key skills and has mastered several dishes including a personal favourite, trifle.
“I’m of that generation of men who hasn’t a clue and his wife did all the cooking. I found myself unable to do anything except open ready-made packets. I became an expert at that,” he says.
But the course has meant he has been able to embrace cooking and find enjoyment in life once again.
“My dream is to do a roast dinner as I’ve never been able to do that. Last week I made a ‘coq au vin’ – yes there are pictures to prove it and they all enjoyed it.”
