Companions at the End of Life for Those Who Are Alone

He couldn't speak and didn't move. His body had entered the stage his nurses called "actively dying." They assumed he would die that afternoon.

That was why Jane had come.

"I just kind of watch them on their journey," she said gently.

Officially, she was an 11th Hour Companion, a volunteer sent by Phoenix's Hospice of the Valley to sit with patients who would otherwise be alone. But Jane's role was more complex than that. She was an advocate, a guardian, a chaperone into the next life. Another volunteer once described himself as "a patient's last new friend," and Jane nodded her agreement. She soothed family members' fears and stayed when they had to step away. Sometimes, she had to tell nurses that her patient had died.

Companionship and solace for those dying alone

Humans as Compost, Nourishing the Earth

From dust to dust...Washington passes bill to become first state to compost human bodies

It may soon be legal for the dead to push daisies, or any other flower, in backyard gardens across Washington state. The state legislature recently passed a bill that, if signed by the governor, allows human bodies to be composted — and used for mulch.

As the nation ages, U.S. funeral practices are changing. Rates of cremation surpassed 50 percent in 2016, overtaking burials as the most popular choice. The Census Bureau, in a 2017 report, predicted a death boom: 1 million more Americans are projected to die in 2037 than they did in 2015. Human composting, its supporters say, is an eco-friendly option that can meet this growing demand. A Seattle-based company called Recompose plans to offer a service called “natural organic reduction” (it has two patents pending) that uses microbes to transform the departed — skin, bones and all.

“We have this one universal human experience, of death, and technology has not changed what we do in any meaningful way,” said state Sen. Jamie Pedersen (D), who introduced the bill, which passed with bipartisan support on April 19. “There are significant environmental problems” with burying and burning bodies, he said.

Joshua Trey Barnett, an expert on ecological communication at the University of Minnesota at Duluth, listed the flaws in conventional burials: “We embalm bodies with toxic solutions, bury them in expensive caskets made of precious woods and metals and then indefinitely commit them to a plot of land.” Though incineration has a smaller ecological footprint, estimates suggest the average cremated body emits roughly 40 pounds of carbon and requires nearly 30 gallons of fuel to burn.

Living in the Love of the Ones We Lose

“I have learned not to live without her but to live in the love she left behind.” - Anonymous

Podcast on Grief and Loss: Terrible, Thanks for Asking

Welcome to “Terrible, Thanks for Asking,” the podcast about “the complicated nature of difficult experiences,” as McInerny says.

Each week, the podcast digs deep. It allows listeners to think about the pain we live through, how we face it, tackle it, collapse under its weight. It gives permission to grieve, to go on living, to be happy and sad simultaneously. It’s about everything that life can throw at us and the myriad ways in which we must reimagine our lives. As McInerny writes in her newest book, “No Happy Endings: A Memoir,” “death is not the only time we start over.”

And McInerny is an expert in the subject.

“Terrible, Thanks for Asking” and all that has come after was born out of McInerny’s own grief. She launched it in 2016, as a 33-year-old single mom, just two years after losing her first husband, Aaron Purmort, to brain cancer. Weeks before Aaron died, she also suffered a miscarriage and watched her father die.

Aaron’s obituary, which they wrote together, went viral, and people began contacting McInerny. “So many people . . . were reaching out to me, a complete stranger, in the middle of the night to talk about the worst thing that ever happened to them, and it wasn’t because they were all friendless or familyless,” she remembers. “It was just because the people around them were afraid to talk to them or didn’t want to remind them of their tragedy.”

Episodes include guests such as a young man with cerebral palsy; a woman who almost died in a fire that killed her boyfriend; an emergency-room doctor who watched her husband die in the hospital where she works.

Each story is filled with almost-unspeakable pain. And yet, the podcast has been listened to more than 14 million times.

"Families want to put the 'fun' in funerals" -- Washington Post

Death is a given, but not the time-honored rituals. An increasingly secular, nomadic and casual America is shredding the rules about how to commemorate death, and it’s not just among the wealthy and famous. Somber, embalmed-body funerals, with their $9,000 industry average price tag, are, for many families, a relic. Instead, end-of-life ceremonies are being personalized: golf-course cocktail send-offs, backyard potluck memorials, more Sinatra and Clapton, less “Ave Maria,” more Hawaiian shirts, fewer dark suits. Families want to put the “fun” in funerals.

The movement will only accelerate as the nation approaches a historic spike in deaths. Baby boomers, despite strenuous efforts to stall the aging process, are not getting any younger. In 2030, people over 65 will outnumber children, and by 2037, 3.6 million people are projected to die in the United States, according to the Census Bureau, 1 million more than in 2015, which is projected to outpace the growth of the overall population.

Just as nuptials have been transformed — who held destination weddings in the ’90s? — and gender-reveal celebrations have become theatrical productions, the death industry has experienced seismic changes over the past couple of decades. Practices began to shift during the AIDS epidemic of the 1980s, when many funeral homes were unable to meet the needs of so many young men dying, and friends often hosted events that resembled parties.

Now, many families are replacing funerals (where the body is present) with memorial services (where the body is not). Religious burial requirements are less a consideration in a country where only 36 percent of Americans say they regularly attend religious services, nearly a third never or rarely attend, and almost a quarter identify as agnostic or atheist, according to the Pew Research Center.

The funeral as we know it is becoming a relic

Having an Advanced Directive Does Not Guarantee a Peaceful Death

For the past seven months, I’ve carried around my husband’s advance medical directive in my purse. During this time, I’ve shown this lawyer-prepared and notarized document to dozens of doctors, nurses, ambulance crews, surgeons, dialysis center teams, hospital emergency room workers and administrators, intake staff, nurse practitioners, nursing home staff, medical transportation drivers, and others. I’m an expert in summarizing its contents, and my 11-second elevator pitch goes like this: Do not resuscitate. No heroic measures. A gentle and peaceful death, pain-free and with dignity. Please....

Death, we agreed, was a natural consequence of life and not something to be feared. And so we prepared the legal documents that were intended to give him control over the end of his life.

A fat lot of good it did us. On Jan. 4, my husband died, and I threw his advance medical directive into the fireplace. It worked better as a fire starter than it did as it was originally intended.

We simply had no clue that dying and medicine, as it is commonly practiced, exist at cross purposes. And in my husband’s case, the engine of life-prolonging medicine decisively won....Medical good intentions notwithstanding, prolonging death is not the same as extending life. Death isn’t the boogeyman; turning the dying process into a torturous experience is. And yet the medical establishment just can’t seem to help itself when it comes to dying.

Efforts To Prolong My Husband's Life Cost Him An Easy Death

New Jersey Proposal on Assisted Death

New Jersey is poised to allow terminally ill patients to end their lives.

On Monday, in a 21-16 vote, the New Jersey Senate approved the “Medical Aid in Dying of the Terminally Ill Act,” which New Jersey Gov. Phil Murphy had promised to sign into law.

“Allowing terminally ill and dying residents the dignity to make end-of-life decisions according to their own consciences is the right thing to do,” Murphy said.


The bill would require:

A second opinion on the diagnosis to attest that the patient has less than six months to live.
An approval from a psychologist or psychiatrist that the patient has the mental capacity to make the decision.
Qualified terminally ill patients would be required to obtain medication that can be self-administered.
What are people saying?
The legislation was sponsored by Democratic state Sens. Nicholas Scutari, Richard Codey, and Steve Sweeney.
"This is a humane and dignified process that respects the free will of terminally ill patients," Scutari said. "We should permit qualified patients to make the decision to end their own lives in a dignified manner. There is no good reason for them to be forced to prolong their pain and suffering or to prolong the grief of their loved ones if they make that choice."
But Stephen Goldfine, chief medical officer at Samaritan Healthcare and Hospice, believes lawmakers should hone in on providing better palliative care in the Garden State, instead of clearing the path for medically-assisted suicide.
“If we provide really high-level palliative care, which includes good symptom management, good social support, both from a physical perspective and emotional counseling, I do think that we can provide that level of comfort for all patients,” Goldfine said. “For a very high majority of patients, they don’t need to be asking to do medical-assisted aid in dying.”

New Jersey proposal on assisted death