Living With Dying articles
Home Funerals
By Leah Carey
Oct. 11, 2016
In this exploration of death and dying, I have come across many concepts that are new to me – for instance, the word “psychopomp” is still running circles around my brain.
But perhaps none are so foreign, yet so sensible, as the idea of a home funeral.
It’s a subject that has come up in numerous conversations with end-of-life care providers, but at first I was stuck at the level of language – does having a home funeral mean burying someone at home? If so, what do people who live in apartments do?
It is, apparently, a common misconception. So before getting into the meat of the interview with an avid home funeral advocate, let’s clear up the language.
A funeral is the time of remembrance and ritual that happen between when a person dies and when their body is placed in the ground (interment).
A burial is the placing of a person’s body or ashes in the ground (a common alternative is the scattering of ashes on land or in water.)
In other words, the funeral is everything that happens after the moment of death but before the burial. The “funeral” has nothing to do with the location of burial. Therefore, a “funeral” can happen in the home, while the “burial” might happen in a traditional cemetery.
All of this was explained to me by Lee Webster, the president of the National Home Funeral Alliance. She also happens to be close by, living in Plymouth, New Hampshire.
The organization, she said, is focused on “educating the public to the possibility and the understanding that they can care for their own after death.”
Why a home funeral?
“It doesn’t matter where you live – the family, the next of kin, has legal custody and control of the person who has died,” Webster explained. “Most of us don’t realize that. We think we have to hire a funeral director because they’re an authority. But they’re not. They’re a service.”
While some people might look at it as a means of cost cutting, Webster said, even more are looking for a more meaningful way to connect to the process after having lost a loved one.
“They’re feeling more and more disenfranchised. They don’t spend time with the body, with each other, dealing with the details that happen with taking care of someone,” she said. “People are starting to see it as an opportunity to bring the family together, rather than an inconvenience.”
What a home funeral is
Much as it sounds, a home funeral involves keeping the body of the person who has died in the home, rather than in a funeral parlor.
According to Webster, that can include bathing the body, changing their clothing, laying the person out, and inviting people to visit.
“The biggest thing to understand is that they’re not all the same,” said Webster. “We want to get away from cookie-cutter traditions. What people are looking for is to do this their own way and create meaning by honoring the person who has died and be authentic to who they were.”
Is that legal?
The first questions Webster receives are, “Is it really okay to do that?” and “Is that sanitary?”
She offers an emphatic “yes” to both.
“We have huge misconceptions about the dangers of dead bodies, and great fear about them,” Webster said. “The reality is that dead bodies don’t pose any more risk of being infectious than they did in life, and in fact some are even less infectious because the host has died … We’ve been taught to be afraid of it.”
“If you have someone who has been in hospice and hasn’t been eating and drinking and everything shut down, it’s pretty simple,” she continued. “It’s different if somebody has had a 12-course meal and died in a car accident. Then there will be issues of digestion in the body and decomposition.”
She said that she often recommends the use of dry ice or Techni-Ice, which is inexpensive, and that it’s okay to keep bodies up to three days in a 65-degree room.
In fact, this was standard practice for centuries prior to the rise of the funeral industry. Families would often lay out their loved one in the large windows of their parlor room so the community could pay their respects.
“At three days – 72 hours – the body starts to internally move into a different decomposition process,” Webster explained. “Even without paying attention to the time on the clock or calendar, people tend to observe in a loved one that by about day three, they’re really cognizant of the fact that the person is no longer there.”
There are 10 states that require the participation of a funeral director in some capacity – to file the death certificate or oversee the burial, for example. According to Webster, however, that does not impair the family’s ability to have a home funeral and make all of their own decisions in any state of the union.
Why people do home funerals
Webster told two stories that exemplified two of the many reasons why some people opt for a home funeral.
In one case, a woman who had been caretaking her 100-year-old mother for 25 years. After such a long time of intimate closeness with her mother, she wasn’t ready to say goodbye immediately after her death.
“She wanted to keep her mother home those extra few days. She put on a parka and sat in a cold bedroom and watched black and white movies, which is what they had done,” said Webster. “She sat vigil with her for the weekend. By Monday, she was ready for her mom to go … She clearly understood that she wasn’t finished and she would know when she was ready. And she did.”
At the other end of the spectrum are parents who lose children, whether through illness or accident. “Being able to hold the child for longer than after the death seems really important. It’s that internal connection. You can’t feel the heartbeat and see them breathing any longer. You need the time to see it and feel it and absorb it,” Webster said. “It is essential to that family. To remain parents, not to stop being parents because their child died. They get to continue to care for, if not nurture, that child until they’re really ready.”
Empowering the family
Webster said she came to advocacy for home funerals during her time as a hospice volunteer. “I’ve watched families struggle with what to do when the death occurs, and after the death occurs,” she said. “Often the hospice families are so involved in the care at home … Their goal is to get to the moment of death, but they don’t have any plans after that moment … That’s what brought me into this, is that void – what do we do now?”
She said she wants families to feel empowered and to experience community in the hours and days after their loved one has passed, and this process can often encourage that.
“I want them to understand that they can still sit there and stroke their hair and say what they need to say at three in the morning with nobody else around,” Webster said.
For years Mom and I had conversations about what she’d want done with her body after death. It was always a theoretical conversation, since she was basically a healthy person whose parents had lived into their late 80s and early 90s.
She had mixed feelings about every option. She didn’t want to be buried in a Jewish cemetery, because that was not her primary community. She didn’t want to be buried in a town cemetery because she didn’t feel she belonged there either. She wasn’t sure about organ donation or cremation because she still carried with her what she had learned as a child – Jews don’t desecrate the body in any way.
In these theoretical conversations, she always ended up in the same place: “I don’t know yet. I’ll keep thinking about it.”
Then, suddenly, the conversation wasn’t theoretical anymore. We were no longer talking about “someday,” but about a day that was rapidly approaching.
Out of nowhere, my mom said words that took me completely by surprise: “I want to donate my body to science, if that’s okay with you.”
It was something we’d never talked about before. I’ll admit, I had to get beyond the idea of some unknown medical student digging into the depths of my mother’s body without knowing her as a person. But when I saw how serious she was about the idea, I got on board pretty fast.
I made a bunch of phone calls and learned that the Anatomical Gifts Program at Dartmouth Medical School makes the process easy (the University of Vermont has a similar program, but as a New Hampshire resident my knowledge is about the New Hampshire program.)
Here are the most important things I learned:
* The patient must be capable of signing the paperwork themselves. Family members cannot donate their loved one’s body to Dartmouth without prior consent.
* The hospital or hospice nurse will call the body donation program at the time of death to determine whether the body is suitable for donation. This cannot be determined in advance, so you must have a “plan B” – either a second body donation program or cremation or burial.
In the end, we were unable to donate Mom’s body, so we had to go to our plan B.
Thankfully, when push came to shove, Mom decided she would be okay with cremation and pre-registered with the Cremation Society of New Hampshire.
Today, Mom’s ashes are in a beautiful wood box in my apartment.
That box could never begin to replace the fullness that was my mother. But I talk to my mom every day, and that box is a specific place where I can direct those conversations if I need it. It is a beautiful reminder that she is always with me.
Full article listing
- Prologue - Mother's Day
- Part 1 - Making Peace With Death During Life
- Part 1a - Creating an environment for a peaceful death
- Part 2 - Musical Pharmaceuticals
- Part 2a - More Musical Pharmaceuticals
- Part 3 - When helping people to die is your work
- Part 3a - Death through the eyes of nurses
- Part 4 - It's always too soon until it's too late
- Part 4a - Advanced directives in an ICU
- Part 5 - I just can't keep from singing
- Part 5a - A heart-to-heart connection
- Part 6 - What we need to know when we help our loved ones to die
- Part 6a - More with Dr. Lakin
- Part 7 - Doctor/patient communication
- Part 7a - Holding two possibilities
- Part 8 - The language of death
- Part 8a - Discovering the patient's goals
- Part 9 - A death midwife
- Part 9a - End-of-life guides
- Part 10 - Signposts of dying
- Part 10a - Signposts in action
- Part 11 - Being a good patient advocate
- Part 11a - Behind the hospital curtain
- Part 12 - Home funerals
- Part 12a - Why embalming?
- Part 13 - End-of-life utterances
- Part 14 - Ongoing end-of-life treatment
- Part 15 - Beyond the statistics
- Part 16 - What doctors want at the end of life
- Part 16a - Doctor survey results
- Part 17 - Doctors talk about end of life
- Part 18 - How to be with someone who is dying
- Part 18a - Local hospice founder
- Part 19 - No regrets
- Part 20 - Do no harm during death
- Part 20a - Becoming a palliative care doctor
- Part 21 - Helping a child to die
- Part 22 - Helping a child to die, pt 2
- Part 22a - Marital stress when a child is dying
- Part 23 - Caregiver exhaustion
- Part 24 - A family's journey with disease
- Part 25 - Teaching the next generation
- Part 26 - A year of Living With Dying