Considering the End of LifeConsidering the End of Life
In 100% of cases, life results in death. You can help your loved ones by expressing your preferences and planning in advance for handling arrangements when you die.
Advanced Directives
There are different types of advance directives
that are important in planning for the inevitable:
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When Death is Near If you are preparing for caretaking at home, consider the resources
(human and financial) that are available, and the emotional toll on family
and friends. The possibility of transfer to a hospital if symptoms are too
severe to manage at home is not a failure. Discuss how to handle difficult
times. Use the resource of help from Hospice. Know your options ahead of
time so that you have an alternative to calling 911. Acknowledge the
stress and grief that you feel, and ask for relief from hospice or home
health care services or from your faith community.
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Immediately After
Death You do not need to rush to call a funeral home immediately after an
expected death. Family and close friends may want to visit in the home or
hospital. Note the time of death, then consider what you need. Hospitals
and health care facilities encourage family members to take time with the
body.
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Care for the Body Go back to the top
Service
Providers Go back to the top
Embalming Go back to the top
Burial Containers Go back to the top
Cemeteries Go back to the top
Cremation Go back to the top
-Be an informed consumer. Ask questions.
-Families should discuss options before making arrangements with a
funeral director.
-Avoid making a decision while under emotional stress by organizing
ahead of time.
-Pre-planning does not mean pre-paying. Get advice from a consumers
group.
-The funeral provider must give you pricing information either over the
telephone, by mail, or in person. The list may not contain all of your
options. Ask for what you need.
-Embalming involves toxic chemicals that are released into the sewer
system by service providers without being regulated by law.
-Inexpensive containers made of pressboard, cardboard or canvas can be
used for cremations and for some earth burials. A funeral director does
not have to mention or show you these options: in most cases you will need
to ask. Service providers may not refuse, or charge a fee, to handle a
casket you bought elsewhere.
-Having your wishes in writing is no guarantee that those directions
will be followed. There is no statutory provision for giving priority to
the wishes of the deceased. The family's wishes come first to healthcare
providers as well as to the funeral director. Discuss your wishes with
your family!
You can hold a family
conference with health care providers (doctors, hospital or nursing home
staff, etc.). Request information on the likely course of the illness, and
allow the patient to make known any requests. Discuss what the priorities
are for whatever time is left. Ask frankly how to know when death is near.
Is hospice care desired?
Immediately after
an expected death, call your doctor or hospice staff member. A local
health officer is needed to certify the death; the county coroner is in
charge if there is no family doctor or hospice involved.
Who will care for the body? Those you love and trust may feel ready to do this. Some faith
communities have designated persons who wash and dress the body in a
simple shroud. Funeral homes are willing to allow these people to use
their facilities for that purpose. Religious concerns are given great
weight by service providers. See our article,The Body After
Death, for more information about caring for the body after
death.
In Indiana, a funeral director must be involved in filing the required paperwork, which means
certifying the disposition of the remains. Cremation societies also act in
that capacity. You MUST use a service provider; however, a family who is
clear about its needs is more likely to get them met. For instance, if
limited funds are available, or if simple, low cost arrangements are
desired, inform the funeral director of this in a straightforward manner,
and be willing to go elsewhere if your needs are not met. The Indianapolis
area has many low-cost, simple alternatives. In other areas, ask for
specific rates. See our page on Service
Providers.
There is no public health purpose served by embalming and it is not
required by law. It is only
required by funeral directors in certain cases, for example, a public
viewing ritual outside the home or hospital, or shipping across some state
lines. If you choose no embalming, the funeral director will require
direct cremation or immediate burial, so be prepared. Refrigeration is the
alternative for preserving a body for more than a day.
You can use simple ("minimum") containers for burial or cremation.
Funeral directors are not
allowed to charge an extra fee if you provide your own container.
Cardboard or simple wood boxes are appropriate, and may be decorated by
the family if they wish. Particle board containers are usually available
through funeral homes or via special order websites. Plans for
make-it-yourself containers are also available, on the web and in books.
(For general information, see Funeral Consumers Alliance
National page on containers).
Most cemeteries are set up so that a body will not return to the
earth.
Most cemeteries require a grave
liner (concrete vault) to keep the earth from settling after burial. Some
groups have negotiated to change the requirement to a dome-shaped liner,
so that the bottom is open to the earth. Some private cemeteries
connected
with faith communities or on family property do not require liners. To set
aside part of an individual's property as a burial ground requires a
$100,000 deposit to a perpetual care fund. Contact the county health
department for more information.
Cremation is the cleanest and simplest way we now have to return human remains to the elements, as well
as being the most "earth-friendly" alternative. Cremation "societies" are
funeral directors that deal directly with the family and file all
paperwork, but have lower overhead costs than funeral homes. A waiting
period of at least 48 hours after the death is required before cremation,
though the body is held by the service provider. This rule can only be
waived by the coroner. No "storage" charges may be incurred, nor is
embalming required, for the waiting period. The pulverized bone fragments
that remain are clean and may be stored indefinitely or mailed by parcel
post for interment elsewhere. The remains may be scattered or buried on
any public land or waterway in Indiana. On private property, an attachment
to the deed may be necessary, though this is not enforced. For more
information, see the website of
The Cremation Society of Indiana , call 1-800-373-0223 or email: cremation@iquest.net.
More About Cremation
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