Home Funerals/Green Burials: An Alternative to Conventional Funerals

1. Home Funerals/Green Burials: An Alternative to Conventional Funerals Pamela Ortner, RN, MS, CHPN MAOHN September 28, 2012 Michigan Association Occupational Health Nurses Annual Conference Grand Rapids, MI

2. SUCCESSFUL COMPLETION: To receive contact hours, participants must attend the entire program and complete an evaluation. Please return your completed evaluation forms to a MAOHN Associate at the end of the presentation. CONFLICTS OF INTEREST:All activity planners for this educational activity have reported norelevant financial relationships with commercial interests.Presenters for this educational activity have reported no relevantconflict of interest.COMMERCIAL SUPPORT:No Commercial Support was received for this presentation.NON-ENDORSEMENT OF PRODUCTS:The presence of commercial exhibits during the presentation does notimply endorsement by MAOHN or any other parties.

3. Objectives: By the end of the presentation you should be able to: • Self-identify personal values/wishes for after-life care • Describe one difference between conventional & greener funeral/ritual and burial process in the U.S. • List one Michigan-specific legal requirement for burial. • List two themes that emerged from survey of participants in home funerals

4. Who We Are • Nursefor 35 years • Hospice Nurse Educator/Quality • Outcomes Specialist • MS Community/ Occupational Health from U of M • CHPN • UM VPP COHSE; explored alternatives to conventional funerals and burials • Public/environmental health for 24 years PAM

5. What is considered a conventional viewing, funeral and burial? • Chemical embalming/cosmetic restoration • Casket • Outer burial container or vault • Cremation • Urn

6. What would you like to happen? What would you like your room or space to look like in your final days, hours, moments… What type of ritual, celebration, or ceremony would you like to take place after you pass on…?

7. Death is a natural process Until the modern era, our formaldehyde-free bodies were kept in the home for viewing for several days, then laid in the ground, returning to the earth

8. History of Embalming US • Embalming surgeons in Civil War • President Lincoln • Funeral homes and embalmers began to flourish beginning of 20th century

9. Turn of the century embalmer’s kit

11. Reasons to Embalm • It slows body decay by fixing cellular proteins • Restores “life-like” appearance • Provides a “memory picture” • Family/loved ones must view the body in order to process death • “Setting the features” • No evidence that it is necessary to protect human health

12. The process of embalming • Massaging and manipulation of extremities to “break rigor mortis” • “Stay cream” and eyecaps on eyes to shut them or super glue • Closing jaw with thread or wire • Absorbent material or mastic in cheeks and gums • “Seal cream” for the lips • Internal organs are punctured and removed • Area flooded with formaldehyde and phenol • Arteries injected with formaldehyde and phenol • Cavities packed with absorbent material or cotton

13. What’s wrong with a conventional burial? Absolutely nothing! • CHOICE is key! Did you know… • A body does not have to embalmed? • A body does not need to be buried in a casket or a vault? • You do not have to purchase a casket or coffin from the funeral home? • Funeral homes are required by law to show you their price list

14. Did you know? • Home funerals are legal in most states? • Embalming is not required in Michigan (except for a few limited situations)? • That you may keep a loved one’s body at home for several days after death? • Cleansing of the body as well as viewing and ceremony can take place in the home with as little assistance from the funeral home as one desires, as is done in just about every nation in the world -- with the exception of the US, Canada and a half-dozen others? • A casket is not required by law, but most cemeteries require it along with a vault

15. Michigan Specific Requirements • Death certificate: signed by Physician, Medical Examiner and Funeral Director • Estates Code (700.3206): Supervision of body disposition of body: funeral director • Cremation: death certificate filed to obtain cremation authorization by Medical Examiner • Transportation of body: burial transit permit from funeral director/county clerk who certified death certificate

16. Who has the right to make funeral decisions? • Spouse • Children • Parents • Siblings • Nieces/nephews • Grandparents • Aunts/Uncles • Cousins • Personal representative in will • Guardian or appointed representative

17. Why would someone choose to have a home funeral/green burial? • Personal reasons: To care for one’s own loved ones. More intimate alternative. • Lower cost: no embalming, high cost caskets, or concrete vaults. If the family supplies their own shroud or coffin, the cost can be further reduced (Gonzalez & Hereira, 2008) • Environmental Impacts: Annually over 30 million board feet of hardwood and 90,000 tons of steel in caskets, 17,000 tons of steel and copper in vaults, and 1.6 million tons of reinforced concrete in vaults

18. Economic Impacts: Funeral Cost/Rate of Inflation/ Cremation %

19. Economic Impacts • Non-declinable basic services fee ~ $1,817. • Removal/transfer to funeral home ~ 250. • Embalming ~ 628. • Other prep ~ 200. • Use of facilities for viewing ~ 395. • Funeral ceremony ~ 450. • Use of hearse ~ 275. • Use of service car/van 125. • Printing 125. • Metal casket ~ 2,295. • Vault ~ 1,195. $7755.

20. Arsenic

21. Occupational impacts of embalming • Arsenic discontinued in early 1900s • Formaldehyde use first recorded in 1962 • Approximately 3.5 gallons embalming fluid used for each body Long term exposure: • Probable human carcinogen (EPA, 1987) • Known human carcinogen (IARC, National Toxicology Program, 2011) • Possible sites: brain, nasal cavities, lung, pancreas and lymph nodes • Possible neurotoxin

22. Environmental impacts of cemetery burial • Additional binders, glues, stains, varnishes, and fabrics to produce and finish caskets  • Many of these materials have an adverse impact on the environment, leaching dangerous chemicals into watersheds  • Sourcing of exotic hardwoods for caskets depletes rain forests • Carbon footprint for cement, caskets, urns that come from a distance

23. Environmental impacts of cremation • > 1,000,000 crematoriums in U.S. • Uses less resources than burial • Fossil fuel consumption • Lack of pollution prevention devices, especially older facilities • Particulate matter emissions • Vaporized mercury is emitted from dental amalgam fillings; extraction of teeth pre-cremation desirable • Dioxin contamination when body is burned (IARC, known human carcinogen, 1997)

24. “Greener caskets” Final Footprint

25. The Funeral Rule (1984) FTC You have the right: • to choose the funeral goods and services you want (with some exceptions). • to ask for and receive a General Price List that states your right to choose what you want in writing. • receive a disclosure from the funeral provider if state or local law requires you to buy any particular good or service, describing the funeral goods and services you have selected and with a reference to the specific law. • to bring to the funeral home a casket or urn you bought elsewhere (funeral provider cannot refuse to handle or charge you a fee to do that). • ask and receive an alternative container from a funeral provider who offers cremations • to refuse to pay for embalming or cremation that your family didn’t authorize, unless it’s required by state law.

26. What is a “green burial”? Green burial — caring for the dead without the use of toxins and materials that are not biodegradable Green Burial Council: Nonprofit organization First standards and eco-certification program • Burial Grounds • Funeral Homes • Products • Cremation Disposition Programs .

27. Types of “green” burial grounds • Hybrid Burial Grounds • Low-Impact Burial Grounds • Natural Burial Grounds • Conservation Burial Grounds

28. Hybrid Burial Grounds • Conventional cemeteries offering the option of burial without vaults or embalming, and that allow for the use of eco-friendly burial containers.

29. Low impact burial grounds Green Burial Council certification: a) Prohibits use of burial vaults, b) Prohibits burial of bodies embalmed with toxic chemicals, c) Burial containers made from toxic/nonhazardous materials, d) Reduced pesticide use.

30. Natural burial grounds • Low-Impact Burial Ground practices/protocols • Naturalistic appearance, • Use of native plants and materials • Landscaping patterns compatible with regional ecosystems

31. Conservation burial grounds • Natural Burial Ground practices/protocols • Legitimate land conservation • Protect in perpetuity an area of land designated only for conservation • Established conservation organization holds conservation easement or deed restriction guaranteeing long-term stewardship

32. In Michigan • Ridgeview Memorial Gardens - Hybrid Burial Ground0-5151 8th Ave SWGrandville MI 49418 616-249-8439 www.ridgeviewmemorialgardens.com

33. Themes that emerged from survey of participants in home funerals • Washing and preparing the body • Keeping the body at home • Continuing relationship • Caring for deceased as they had in life • Positive community event • Spontaneity of ceremony/ritual (Wilson, 2009)

34. Home-based celebrations bring death out of the shadows and into the light of life. To care for a loved one in this manner can be a choice, a gift to the survivors that may create a more meaningful, lighter ecological, occupational and economic footprint for those who want to honor the final transition in this way.

35. Case Studies Beth Knox Ann and Dwight

36. Alternatives • Eye/organ donation Michigan Eye Bank: www.michiganeyeback.org (800) 247-7250 • Organ & Tissue Donation: Gift of Life: www.giftoflifemichigan.org (734) 922-1357 • Whole Body Donation: MedCure: www.medcure.org (877) 253-0733

37. Resources • Gonzalez, F. and Hereira, M. (2008). Home-Based Viewing (El Velorio) After Death: A Cost-Effective Alternative for Some Families. American Journal of Hospice & Palliative Medicine. 2008 Oct-Nov; 25(5), 419-20. • National Funeral Director’s Association. Accessed April 10, 2012 at: www.nfda.org • Wilson, M.T. (2009). The Home Funeral as the Final Act of Caring: A Qualitative Study. Unpublished master’s degree in nursing dissertation. Madonna University. Livonia, Michigan.