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Writer's pictureLinsey Cheshire

The Art of Dying with Dignity



Very few people enjoy thinking about the day they will die. As a culture we typically don't like to face the inevitable fact that we all will one day meet our maker; however, the death positivity movement https://www.orderofthegooddeath.com/death-positive-movement/, brought to light by Caitlin Doughty highlights the importance of contemplating and accepting death as a part of life. The Death Positivity Movement has brought conversations about death and dying into a more mainstream venue and I feel that it's something that every person, regardless of age and health should consider.


During my career in senior living and elder care, I have noticed that despite someone's age, people always seem to be shocked when someone they know passes away. As a culture we have been brought up to not talk about death and dying. It's something that happens behind closed doors, to other people, which makes it almost feel shameful. So when it happens in our family or to our friend, we are not prepared for the emotional fallout or the logistical nightmare of planning for post mortem services.


Losing a child, or young person can always come as a shock to everyone. It serves to remind us that our lives are not promised and we don't really know when our time will come. When someone dies when they are older and have lived a full life, there is still sadness and a feeling of loss for family and friends, but it's usually slightly more expected or at least understood. If it seemingly comes out of the blue, regardless of age, we still feel that shock of sudden loss.


Perhaps that shock also serves as a reminder that we too will die one day.


The other detriment to this cultural misstep is that we often don't know our loved ones wishes because we never formally discussed them when they were alive, or they never expressed them at all. This leaves the family scrambling, possibly misguided, through the funeral industry, to figure out how to prepare the body, mourn, make preparations for a service (or chose to not have one), and then live with the thought that they really didn't know what their loved one wanted.


At the end of the day, the post mortem services and preparations are really for the living, not the deceased, but in order to properly honor their memory, it's nice to have something that they would have wanted. These days there are many more environmentally sustainable ways to prepare a body than just embalming, traditional burial and cremation, which still seem to be the most standard.


I'm not here to depress you. I'm here to educate you and open your eyes to the death positivity movement and give you some food for thought about writing your death plan and final wishes, gathering resources for your final days, and having the most peaceful and well thought out passing possible.


The Death Plan:


I know it sounds morbid and depressing, it can be very cathartic to take time to write your own death plan. Start off with the basics. Do you have a living will or advance directives? At what point would you want to exclude extreme measures to keep you alive? While it's always suggested that you have a lawyer draw up your paperwork, so that your next of kin can figure out your wishes if you are unable to express them, you can also download a POLST form for your state, fill it out with your doctor or your loved ones and keep it handy if anything happens. It's pretty straight forward and you can determine what level of medical intervention should be involved to keep you alive, or if you are at the point in your life where you would rather let nature take its course, you can opt for a DNR.


The last will and testament is also important and should be reviewed every five years or so. I can't tell you how many people I've spoken to who have wills drawn up when their children are born and don't touch them for 20 years or more. Wills are not only for the wealthy. Even if you don't feel like you have a lot, your family will know what to do with your assets and belongings and there will be a legally binding document that will ensure that your wishes are executed. This should be an ever evolving and changing document throughout adult life.


Funeral Pre-Planning:


The pre-planned funeral is possibly the best gift a parent can give to their children, and unfortunately, not many actually go through with it. A pre-planned and paid for funeral can save the family much undue stress and heartache. Anyone who has had to throw together a funeral for their parent or other loved one knows how involved and expensive it can be. To think about all these things on the worst day of your life can be challenging to say the least.


If someone knows they are getting close to death due to an illness or just advanced age, they should consider pre-planning. I would say anyone over the age of 80 should at least have a concise and well thought out plan of what they would like for preparation of their remains and any services that would follow. This takes the guess work out of the funeral planning, even if it's not paid for yet.


I have seen ads for death planning journals, so I know they are available. Even just mapping out your wishes on paper will help your family honor your memory in a way you would have wanted. The journal can prompt you to think of all the things you might not think of, because again, who wants to think about their own death and the aftermath.


Hospice Benefit:


Don't forget about hospice and palliative care options if you are diagnosed with a terminal illness or have other declining health factors. Many people think hospice is for the very last days or even hours, but it's actually appropriate and can be prescribed with a life expectancy of less than six months, which is a relatively long period of time that you could be utilizing comfort measures and services. Instead of viewing hospice as giving up on life, think of it as a way to live more comfortably for your remaining time. It's also a great resource for your family after you pass. Hospice will support your family for 13 months after your death. Also, hospice is covered by insurance and will provide medical equipment that is usually required at end-of-life.


Death Doula:


A death doula is a trained individual who has the tools to teach us how to better understand death and dying. Death doulas tend to not be medically trained and don't diagnose or administer direct care or medications, but they can supplement the services of hospice and can be hired to counsel and comfort the dying and their families. Death doulas are also helpful with assisting in writing a death plan and gathering resources to help its execution. Death doulas tend to be private pay, but they are worth every penny to assist the dying and their families fill in the blanks where the hospice may not have the resources. Keep in mind that most hospice companies will only provide a couple hours a week of direct care, counseling, chaplain services and nursing. If you feel that you need more talk therapy or support through the process, a death doula can help fill the gaps in hospice service.


Burial, Cremation and other options:


The funeral industry is a business and in any business, they are always looking at their bottom line. While there are funeral businesses that are truly altruistic and honor the wishes and budgets of their clients, some funeral homes will try to sell you expensive packages with embalming and fancy caskets. This might be your choice, but if it's not, know that there are other options out there. Some funeral practices are also dependent on religious and cultural beliefs and if you ascribe to anything, or chose not to, be sure your family knows before your death, or it's written in your death plan.


The average funeral runs $7000-$12000 in the Philadelphia area and from a little internet research, cremation is less expensive than burial, but caskets and embalming are usually the money makers for the funeral home. Keep in mind that embalming fluid is highly toxic, only keeps the body from decomposing for a short period of time (usually long enough for a viewing) and it will eventually seep into the ground (and the water table) if the body is buried, regardless of a fancy sarcophagus that might be provided to house the casket.


Enough people are getting away from embalming and opting for more natural and sustainable options through the Green Burial Council https://www.greenburialcouncil.org/

GBC commits to caring for the dead with minimal environmental impact. The website provides cemeteries and funeral homes that will honor a sustainable natural burial option. These burials are often performed without a casket and just a thin linen shroud, directly into the ground, as many of our ancestors buried their dead. Obviously decomposition will happen more quickly with this option, and some people are skeeved out about that, but at the end of the day, you won't be there to witness it anyway.


Cremation is still the least expensive option but it's not entirely environmentally sound. The energy used to cremate a body is extensive, as well as the carbon emissions that are a direct impact on the environment. The rate of cremation has skyrocketed over the last 50 years and while it's easy, less expensive and doesn't require a burial plot, there is an ever evolving industry that might be a more environmentally sound answer to cremation, though it's not legal in every state yet. The fairly new idea of human composting (in a facility) is the wave of the future for those in densely populated areas and mimics the green burial without having to purchase the cemetery plot. Human composting is currently available in Washington, Colorado, Oregon, Vermont, California, New York, Nevada, Arizona, Maryland, Delaware, Minnesota and Maine.


Regardless of your choices, knowing and thinking about what your plan might be for your final rest will help you process the inevitable and will help your loved ones when the time comes. This isn't something that anyone wants to dwell on, but having regular conversations is important for ease of transition and better understanding our mortality. We will all die one day. Hopefully with some planning and forethought, the process will be as easy as possible for those that love us and want to honor our memory.













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