Posts Tagged ‘Death Care’

Cremation Urn Basics

Wednesday, May 13th, 2009

Have you opted for cremation after death? If so, you may enjoy picking out your urn now. Even if death makes you feel squeamish, you can be entertained by the options available – anything you can imagine may be available or possibly created just for you or your loved ones.

With that said, cremation urns are permanent memorials, so choosing a suitable urn is an important decision. There are several options for urn placement, so you might consider the following before you make a choice:

  1. The cremated remains are placed in a cremation urn and are buried in a plot or niche in a cemetery or mausoleum.
  2. The cremated remains are placed in a temporary receptacle or urn that opens for scattering ashes.
  3. A decorative urn is chosen to display the cremated remains at a home or other significant sanctuary.
  4. The cremated remains can be divided and placed in small keepsake urns for family members.

Once you have made a decision about how to dispose of cremated remains, then you can choose the urn. That decision can be based upon hobbies and interests and type of urn material. You can choose among any number of woods, metals and even biodegradable materials. You also can have the urn personalized.

Purchasing an urn today is easy. Many funeral homes and Web sites offer urns for sale, even at discounted prices. When you visit a funeral home for your options, remember that the Federal Trade Commission Funeral Rule requires the funeral director to show a general price list (GPL) of merchandise that the company sells, along with descriptions and prices before showing the urn.

Other laws may apply to your urn purchase and disposition. There are many options, and laws vary from state to state for disposition of cremated remains, or “cremains.” However, an urn is not required by law, and if you cannot make a decision about an urn, the cremated remains can be placed in any container that is firmly sealed (such as a plastic or cardboard container). If you have questions about containers and disposition laws, contact a cremation service provider in your area to learn more.

New Pediatric Standards of Care for Hospices

Thursday, April 23rd, 2009

More than 1,600 hospice and palliative care leaders, managers and industry experts gathered in Washington, DC this week to discuss issues involving healthcare reform.

“Almost 30 percent of Medicare costs are for care provided during patients’ last year of life, with an estimated 30 percent of that figure covering costs in the last month of life,” said J. Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization (NHPCO). “We are raising awareness of the important role hospice and palliative care should play in current debates on healthcare reform.”

While many people think of hospice care primarily for elderly persons at the end of life – 66 percent of hospice patients are over the age of 75, reports NHPCO – care for children and families facing serious illness and death also figured prominently at the National Hospice and Palliative Care Organization’s 24th Management and Leadership Conference. The group released its first set of national standards for pediatric palliative and hospice care at the opening plenary session at the Omni-Shoreham Hotel.

The Standards of Practice for Pediatric Palliative Care and Hospice was developed by NHPCO and members of the Children’s Project for Palliative/Hospice Services. The goal is to help hospice and palliative care providers develop safe, effective, and high-quality programming for children and their families facing serious and life-limiting illness.

On Wednesday, more than 400 hospice advocates went to Capitol Hill and met with legislators to emphasize the need to protect hospice reimbursement and promote access to high-quality end-of-life care for all patients and family caregivers.

“We know that hospice gives Americans the care and support they want at the end of life, and we know that hospice provides cost savings to Medicare for each beneficiary that takes advantage of hospice care. Hospice is part of the solution for healthcare reform in this country,” Schumacher noted.

Facts and figures on pediatric care and more information on the new pediatric standards is available at www.nhpco.org/pediatrics. NHPCO members may download the pediatric standards from the site free of charge. Others may purchase the pediatric standards from NHPCO’s Marketplace at 1-800-646-6460. Consumer information about hospice and palliative care is available at NHPCO’s Caring Connections Web site, www.caringinfo.org.

Your Body for Some Land

Monday, April 20th, 2009

Let children walk with Nature, let them see the beautiful blendings and communions of death and life, their joyous inseparable unity, as taught in woods and meadows, plains and mountains and streams of our blessed star, and they will learn that death is stingless indeed, and as beautiful as life. ~ John Muir

Green funerals are becoming more popular, and not just because they’re environmentally sound. They’re also less expensive in most cases. But now the living can make a decision to become one with nature in death with a plan to increase land for the Texas Parks and Wildlife Department.

Ted Hollingsworth, the agency’s director of land conservation, said. “If tens of thousands of people want to take advantage of this opportunity annually, it could easily double the rate at which we’re adding lands to state parks.”

This news article states that a new embalming fluid will be introduced this month that also is environmentally-friendly, and that cremation services are working to lower the pollution levels. Additionally, shrouds and cardboard caskets are becoming more popular, as people choose cremation as their death care option.

But, in Texas, the Parks service is going one step further by seeking to offer land for ash-scattering in exchange for a small fee. The Texas division plans to become the first government agency in the United States to let families lay cremated remains in protected forests for a fee to help the state buy more land for conservation.

If you truly want to be part of nature’s plan when you die, Texas may have the solution. If you don’t want to end up in Texas, you might have the option in the future to become one with a man-made reef located about three miles off Key Biscayne. Prices will depend on whether ashes are placed in “premium” or “standard” locations 40 feet below the surface. Both plans are the ultimate in “life after life” options.

Uneasy About Embalming

Thursday, April 16th, 2009

Embalming, as an art and a practice, began in ancient Egypt as mummification, and has grown throughout the centuries to become a necessity at times, a blasphemy to some and a horror to others. Embalming, in most modern cultures, is the art and science of temporarily preserving human remains to forestall decomposition and to make them suitable for display at a funeral. According to Wikipedia:

“Contemporary embalming methods advanced markedly during the American Civil War, which once again involved many servicemen dying far from home, and their family wishing them returned for local burial. Dr. Thomas Holmes received a commission from the Army Medical Corps to embalm the corpses of dead Union officers to return to their families. Military authorities also permitted private embalmers to work in military-controlled areas.”

While the Wikipedia entry marks the American Civil War as a time of great advancement in embalming, this practice still had a long way to go. Arsenic often was used as embalming fluid, which was later found to contaminate groundwater. And, it wasn’t until 1867, two years after the end of that war, that the German chemist August Wilhelm von Hofmann discovered formaldehyde, whose preservative properties were soon discovered and which became the foundation for modern methods of embalming.

In fact, embalmers often had a nasty reputation among northerners and southerners during the American Civil War. The following account is from the book, This Republic of Suffering: Death and the American Civil War,” by Drew Gilpin Faust:

The U.S. Army was deluged with anguished protests from families of dead soldiers who believed they had been cheated by embalmers operating near the battlefront. An officer at City Point, Virginia, protested to Inspector James A. Hardie in 1864 that “scarcely a week passes that I do not receive complaints against one or another of these embalmers…[They] are regarded by the medical department of the army generally as an unmitigated nuisance…the whole systems as practiced here is one of pretension, swindling, and extortion.” In 1863, a case was lodged against Hutton & Williams, “EMBALMERS OF THE DEAD” in Washington. Hutton was imprisoned and the company’s records were seized. The suit alleged that the pair regularly recovered and embalmed soldiers without permission and then demanded payment from grieving families, threatening to disinter or refuse to return the bodies of their conditions were not met.

In the fall of 1864 Timothy Dwight of New York pursued a grievance with secretary of war Stanton against Dr. Richard Burr, a prominent Washington embalmer, claiming that Burr was guilty of extortion for preying upon him in his distress after “the loss of a most excellent Boy.” Burr defended his fee of one hundred dollars to the provost marshal, saying his employees has risked their lives recovering the body from near the picket line and then carrying it several hundred yards under fire. He had then disinfected the body “by means of my embalming fluid and charcoal” and enclosed it in a zinc coffin, sealed it, and shipped it – clearly warranting, he insisted, his charges. On January 9, 1865, General Ulysses Grant responded to the chorus of grievances by withdrawing all embalmers’ permits and ordering them beyond the lines. The distances separating the dead and their loved ones nevertheless continued to encourage embalming, in spite of great uneasiness about the practice and widespread hostility toward its practitioners.

If you feel uneasy about embalming, remember this: Regardless of whether embalming is performed, the type of burial or entombment, and the materials used – such as wood or metal caskets and vaults – the body of the deceased eventually decomposes. Modern embalming is done to delay decomposition so that funeral services may take place or for the purpose of shipping the remains to a distant place for disposition. Many states do not require embalming to take place if the body is not traveling a long distance, but the body must be buried within a certain time frame if you decide to bypass this process.

The Beneficiary’s Guide to Life Insurance

Monday, April 13th, 2009

If you become the beneficiary of a life insurance policy, you must file a claim to receive any money. This task could be as simple is contacting an insurance agent and filing some paperwork. But, if this is all you do, you may eventually discover that you have missed out on other benefits to which you are entitled. If you spend time finding hidden policies, you may uncover more money than you expected.

For instance, your spouse or family member may have owned one or more permanent (whole life) or term life insurance policies. The first place to look is in a safety deposit box, where unknown policies might lie with other important papers. Some of these policies often are found within credit card statements. Although most of these policies are not large, you may find enough to pay for that funeral or to pay off several bills. If you’re not sure if your spouse or family member owned a policy and your agent can’t find one, you can contact the American Council of Life Insurance (ACLI). Its members can do a free search for you.

If you feel your loved one carried a group policy through work, you might then look for a certificate of insurance as proof. Look for these certificates in your spouse’s or family member’s personal papers, files, and safety-deposit box, if you can access it. You also can check with your spouse’s or family member’s employer, bank, or credit agency, or study loan paperwork or purchase contracts. Read the following sections for a list of types of group policies your spouse or family member may have owned.

The types of policies you might seek include:

  • Employer-based group life insurance
  • Accidental death and dismemberment policy
  • Travel accident insurance
  • Mortgage life insurance
  • Credit life insurance

When your spouse or a loved one has died, you should notify his or her life insurance company as soon as possible. Usually, you can call the insurance company’s policyholder services department directly, or if the life insurance policy was issued through an agent or an employer, you can ask them to notify the company for you to begin the claims process.

The steps to take to claim the insurance funds include:

  • Filing a claim and signing a proof of death form (be sure to have several copies of a death certificate for this process).
  • You may also need to fill out a Form W-9 (Request for Taxpayer Identification Number and Certification), which enables the insurance company to notify the Internal Revenue Service about any interest paid to you on the policy value.
  • Wait for the company to process the claim, which could take mere days or several weeks.
  • Receive the life insurance proceeds, which often are paid as lump-sum cash payments. If you elect to receive a lump-sum payment, you generally will not owe income tax on the life insurance proceeds that you receive as a beneficiary.
  • Other settlement options are available. It is best to talk with your insurance agent now, before something happens to you, to make arrangements for other options. Talk with your spouse, your kids and your loved ones to make sure they are insured. If they are, then talk with them about making a will. Preparations such as these are not easy for some people to accomplish, but they make life easier for those who are left behind.

Medicare Part A and Hospice Care

Thursday, April 2nd, 2009

Medicare Part A is the portion of Medicare that is available premium-free to all eligible individuals. This part of Medicare benefits provides services associated with hospital, hospice, skilled nursing care and home health care. While you may have read that Medicare Part A covers all costs incurred with hospice, or palliative, care, this is not the case when it comes to custodial care.

Medicare does not cover care that is or becomes primarily custodial, such as assistance with bathing and eating.

Hospice care is death-care for a terminally-ill person, and Medicare Part A provides comprehensive coverage, at home, for symptom management and pain control. In other words, Medicare Part A will not cover custodial care, but it does cover symptom management and pain control. And, several criteria must be met before coverage is allowed as well:

  • The health-care provider must be certified by Medicare to provide hospice care
  • The patient’s doctor and the hospice care director must certify that the patient is terminally ill (i.e., has a life expectancy of six months or less)
  • The patient must elect hospice coverage for the terminal illness instead of standard Medicare benefits, although Medicare will continue to cover care provided that it is not related to the terminal illness
  • Services include nursing care, medical appliances and supplies, prescriptions, home health aide and homemaker services, medical social services, and counseling

If family members need a respite from custodial care, the family – or the patient – is responsible for that cost. The hospice may arrange for the hospice patient to be moved to an inpatient facility for up to five days at a time to provide respite to the hospice care personnel and the family. In this case, the Medicare beneficiary may be charged a nominal daily fee for the inpatient care.

When you interview a hospice service to learn about their program, ask them your questions about Medicare Part A. A professional service is experienced with this benefit and can answer your questions in detail.

Hospice Care, Funerals and Cemeteries on Twitter

Monday, March 30th, 2009

Do you use Twitter? If not, you probably wonder what the Twitter fuss is all about. If you’re using Twitter, you may think that those who don’t use it just don’t “get it.” Whether or not you use Twitter, you might be surprised to learn that this social media tool has penetrated the death care industry. And, unlike the morbid specters you think you might encounter, these folks are – well – they’re alive and ordinary, with hobbies, families and stories to tell.

We let our fingers go walking through Twellow, the Twitter “Yellow Pages” to discover death care industry folks who are using Twitter. While the numbers weren’t astronomical, we don’t doubt that these figures may change as more death care businesses realize this social media tool’s commercial potential. We only chose a few links from Twellow’s search results to provide you with a taste of what you can encounter on Twitter.

The list below is categorized under the search word we used to find these links, and the links are arranged alphabetically under those categories. This method assures our readers that we do not favor one resource over another; however, we did skip over business-to-business accounts to offer Twitter users who focus on non-industry readers.

Hospice

  1. ctsinclair: Hospice & Palliative Medicine Doctor in Kansas City. Co-editor of Pallimed, a hospice and palliative medicine blog.
  2. hvto: This is Robin Watts, founder of first hospice volunteer training online course. Learn more at Hospice Volunteer Training.
  3. MyCareManager: Edward L. De La Loza is a psychotherapist and geriatric care manager. His interests include hospice, aging and eldercare among other things. His Web site is My Family Care Manager.
  4. SanDiegoHospice: San Diego Hospice and The Institute for Palliative Medicine is a “non-profit leader in the relief of pain and suffering.” Learn more at their Web site.
  5. StAnnsHospice: This user’s name is Catherine Williams, and she is the Director of Fundraising and Communications for St Ann’s Hospice in Manchester, UK.

Funeral

  1. buryorburn: Scott Gilligan is the “Funeral Maverick,” fighting big business death. He mainly posts about his blog entries at his Web site.
  2. funeralogues: Here’s an offbeat Twitter find: One woman off-Broadway show that is a darkly comedic look at the inside of funeral homes, funeral rituals and one woman’s personal obsession with death. Visit the official Web site.
  3. funeralplanner: Funeral planning and resource guide. The Web site is called the Funeral Planning Guide.
  4. funeralqueen: This is Muneerah Warner, funeral director of Warner Funeral Home and Publisher of Funerals Today Magazine, a new publication for individuals interested in funerals and an inside look at the funeral industry
  5. Otrib: Free obituary and funeral planning help and grief support forums and chat rooms at their Web site.

Cemetery and Cemeteries

  1. cemeteryminda: Minda Powers-Douglas is a writer who digs cemeteries (”not literally”). She edits Epitaphs Magazine (The Cemetery Club is Epitaph Magazine’s online venue) and teaches workshops.
  2. CemeterySpot: Hal Stevens is an author of books about end-of-life issues and owner of Web sites that provide free online memorials and free buy/sell cemetery plot services. His main site is named, aptly, Cemetry Spot.
  3. JewishGYrabbit: Schelly Dardashti is part of an international team that writes about Jewish cemeteries, news, burial, mourning, symbols and more at the Jewish Graveyard Rabbit.
  4. RivCem: The historic Riverside Cemetery Conservancy goes online to help “preserve the past for the future.”
  5. southerngraves: ‘S. Lincecum’ is an amateur historian, avid reader, genealogist and family historian, lover of cemeteries, and scrapbooker with a Web site to prove cemetery interests.

Go ahead and give Twellow a whirl. However, if you try “green funeral,” “cremations,” “body donation” or “grief management” you won’t find one tweet (an entry made by a person who uses Twitter). But, if you’re patient for a week or so, you may discover that a business or two will fill those niches.

Downsizing the Traditional Funeral

Thursday, March 26th, 2009

People expect the liquor industry, films and other forms of ‘entertainment’ to do well during a recession. These businesses offer individuals a way to escape reality, even if it’s for just an hour or two. But, who knew that the funeral industry would receive attention during this economic turmoil? A brief look through recent news articles brings some interesting perspectives to this death care field.

Some articles listed below point to the fact that funeral homes are feeling the pinch as much as anyone during this recession. So, the focus seems to be about people choosing cremation over traditional burials, as cremation seems to be the less expensive option for funerals. But, as with any commodity, will the law of supply and demand begin to affect cremation costs?

The answer might lie in location (some places are more expensive than others to conduct funeral services) and in funeral options (will you bury the ashes or take them home?). Also, funeral homes need to make a profit, too, so if more people are turning to cremations, expect more options to be available to help that funeral bill escalate. On the other hand, look for some funeral homes to provide sales and incentives to bring business in during this recession.

The following articles all deal with recent economic woes and the funeral industry. The articles are arranged in alphabetical order to show that we do not favor one article over another:

  • A Real Kick in the Ash: This article, out of New York, provides current costs at the Green-Wood Cemetery: “A no-frills cremation will set you back about $400, or less than your economic-stimulus check…Meanwhile, a low-end crypt will typically run a family about $8,500, and a plot of land to bury two people – double-decker style – will set you back about $5,000.”
  • Another Sign Of The Recession — Cremation On The Rise: This article, which covers the funeral industry as a whole, points to gravesites as the culprit behind funeral costs, not caskets. “Sheri Richardson Stahl, who runs Island Funeral Home in Beaufort, S.C., said there are no public graveyards in the Hilton Head area, so plots at the nearest semi-private cemetery start at $2500 and ‘can easily reach $10,000.’”
  • Business is Cooking at Local Crematories. Thank the Recession: “In the St. Louis area the average burial cost ranges between $8,000 to $10,000, while the cremation fee, which includes transporting the body, the urn and a copy of the death certificate, hovers between $1,000 and $1,200.”
  • Funeral business is not immune to recession: Funeral industry profit has dropped from nine percent at the beginning of this decade to four percent, according to Peter Stefan, owner of Graham, Putnam, & Mahoney Funeral Parlors in Massechusetts. “A cremation can cost $2,500, said Stefan, while an average funeral will run $6,000, not counting cemetery rates.” On the other hand, “Bill Duckett, who manages funeral homes in Sudbury and Framingham…declined to connect the economic recession with an increased interest in cremations, which had been on the rise before the economy tanked last fall.”
  • Funeral costs not recession proof: Cremation versus traditional funerals in Spokane, Washington: “An individual cremation, you’re looking at less than $1,000, and with the average full body burial with cemetery property you’re looking at $8,000 to $9,000.”
  • Funeral industry feeling pinch of recession: If you’re looking for a woman who understands the cost of death yet who also believes in celebrating a life lived, look no further than Wiggen & Sons located in Seattle’s Ballard neighborhood. Carol Sauers, who represents that funeral home, “knows not everyone can afford full-service plans. Occasionally, she encourages money-conscious clients to consider a home memorial,” which costs little for the family.
  • Hansen: The business of death turns to discounts: The Merle Hay Funeral Home and the Sunset Funeral Chapel on Fleur Drive in Des Moines, Iowa, is offering 50 percent discounts on all his merchandise during these trying times. “I have a lot of inventory,” owner Blair Overton says. “Taking a little off now helps the customer and it helps me.”
  • Recession-Friendly Rites: This article, also generated out of New York, quotes the Maloney Funeral Homes: “The typical bill for a burial ranges from $8,000 to $12,000…Cremation costs between $4,000 and $8,000. The actual process costs about $400, which is added to the cost of an urn, a service and possibly a niche or burial plot for the ashes.”

Although it seems that funeral homes are feeling the pinch, at Nassau Community College in New York, inquiries about their mortuary science program are up fifteen percent in recent months, and enrollment for last fall’s class was nearly double the year before. According to this article in Newsday:

At the American Academy McAllister Institute of Funeral Education, a private program in Manhattan, enrollment has jumped to 270 students for the spring semester, compared with 200 a year ago. The school attributes the rise to the economic downturn and the addition of an online program.

Maybe these students are forward-thinking entrepreneurs who see a silver lining for traditional funerals in the future?

Religion, Death and Dying

Monday, March 23rd, 2009

The Los Angeles Times recently ran an article that talked about how religious belief drives some patients to fight for life, while others suffer more at the end of life because of their religion. The main character in this article is Holly Prigerson, director of the Center for Psycho-oncology and Palliative Care Research at the Dana-Farber Cancer Institute in Boston and the study’s senior author. The entire article is summed up in the final paragraph from that piece:

In a study published last week in the Archives of Internal Medicine, Prigerson and her colleagues found that patients who discussed their wishes for end-of-life care ahead of time accrued $1,876 in medical expenses in their final week of life compared with $2,917 for patients who didn’t. They were also less likely to be in physical distress, less likely to die in a hospital and more likely to be getting outpatient hospice care. “One-third of the Medicare budget goes to the last year of life, and 80% is for the last month,” Prigerson said. “Most of that is being on a ventilator or from an ICU stay.”

Religious beliefs have come more into focus as a result of this study, which shows that faith in a higher power often can lead to more aggressive treatment than is medically warranted. This problem alone can lead to further medical problems and, without a doubt, more expenses. Such treatments didn’t improve a person’s long-term chances, however.

The solution to this problem? Although the article points to doctors who need to talk with their patients to learn their religious views and motivations, another answer is to plan well in advance for death and dying. Some examples to help you along with this effort include:

  1. If you are in a coma or some other debilitating situation, your family may decide to keep you on life support when your wish is totally opposite. If you plan ahead with incapacity documents, your family has no choice but to follow your wishes.
  2. You may not agree with “buying time” with more aggressive treatment, but your loved ones insist. If you talk with them well ahead of time about your wishes, you can resolve issues while you have plenty of time to heal emotional wounds.
  3. You might insist that “buying time” is your priority, even if you suffer. In this case, it is good to let your doctor in on your plans for suffering so he or she can choose the best staff to help you through this end-of-life trial.

By developing a plan for your death, this work can help you accept death as a part of life. The article states that accepting death “can provide an opportunity to get one’s religious affairs in order and make the most of remaining time with family and friends” rather than dealing with the stress of making decisions during a time when you might be in pain, under medication or – worse – unable to make rational choices.

If you plan now for your death care, you could save money that you or your family might have spent prolonging your life when your prognosis is poor. This money, if you have a will, can benefit someone who has a long life ahead. Additionally, by planning your death care now, you can avoid an unsettling end-of-life battle between you and your loved ones, no matter your religious beliefs.

Three Killer Diseases Designed for Palliative Care

Thursday, March 19th, 2009

Today’s top killer diseases in the United States include heart disease, cancer and stroke. Men and women both are susceptible to these diseases, which cover such ailments as coronary artery disease, heart failure, heart rhythm disorders, all types of cancer and ischemic and hemorrhagic strokes. These diseases, once developed, often are fatal.

But, not everyone who develops heart disease or cancer or who suffers a stroke die immediately. Often, these victims need help, and palliative care, or hospice care, is one route to take for this help. Here are a few reasons for heart disease, cancer and stroke patients to choose hospice services:

Heart Disease: Patients who suffer heart disease often suffer through cycles of treatment. They experience extreme pain, get treated, go home and then experience extreme pain again. Sometimes, a little help on the home front can increase the time between extreme episodes. However, patients would need to meet certain criteria for hospice care, including the prognosis of six months or less left to live.

Cancer: When cancer treatment no longer is viable or a cancer patient cannot tolerate treatment, then hospice care becomes appropriate. Opting for palliative care does not mean that the cancer patient is giving up. Instead, the patient is opting for an alternative to learning how manage symptoms and to improve quality of life while living with this disease.

Stroke: The severity of the effects of a stroke will help determine if a patient needs hospice care. The criteria for hospice care includes a coma, persistent vegetative state, and/or severely reduced level of consciousness and abnormal muscle contractions. Usually, the patient’s prognosis after the first three days following a stroke will determine the need for palliative care.

Remember that Medicare and many private insurance plans won’t cover hospice care and hospital admissions for the same diagnosis at the same time in any disease. With that said, when a patient has exhausted all resources and the end of life seems imminent, hospice services can make the end-of-life transition more comfortable for patients and their loved ones.

Hospice care workers who visit the home to care for heart disease, cancer and stroke victims patients can:

  • Help with pain and symptom management.
  • Help to avoid hospital admissions.
  • Help to gain access to community resources and assist with emotional and spiritual needs.
  • Can help with death care management.

These services can help family members spend more time with the patient as the hospice worker takes on the responsibilities of keeping the patient comfortable and at ease. If you’re interested in using hospice care, you can find many resources here .