END OF LIFE DECISIONS

helping older relatives or friends make more informed choices about end of life decisions

Even though we don't like to think about it, we will eventually have to face the death of a loved one. How do we prepare? Open a conversation with your relative to determine if end of life arrangements have been made (i.e., Advance Directives, funeral arrangements, religious services, etc.). If so, ask if they will share with you what type arrangements have been made and where the documents are located, or if not, what their wishes are. There are certain decisions that will have to be made about burial arrangements, such as:

• Does your family member want to have a burial or cremation, or have they chosen to donate their body to medical education?
Are there religious beliefs that will effect this decision?
• Has a mortuary or funeral home been chosen? If yes, has your relative completed a form stating their wishes that is on file at the mortuary or funeral home?
• What characteristics are important, i.e., location, services offered, pleasant surroundings, etc?
• If your relative is planning a burial, will it be local or somewhere else? Has your relative or another family member purchased a cemetery plot or does one need to be chosen?
  Other details that need to be considered include:
  

• Date and location of services, viewing, receptions, choice of officiator(s), type of casket, flowers, music, etc.
• Writing and placement of obituaries or funeral notices, including information such as: full legal name, birth date, place of birth, names of family members; newspapers both locally and in other towns for posting funeral or obituary notices
• The number of death certificates that will be required to inform appropriate agencies and groups

(i.e., Social Security, insurance policies, trusts, bank accounts, etc.) To become more informed on the various burial choices, and details such as locating cemetery plots, casket options or cremation specifics, you can call or visit your local mortuaries or contact the Arizona Funeral Directors Association. Many have brochures and pamphlets that provide information about the options available. Most mortuaries will provide a tour and answer questions about expenses, as well as payment options and advanced planning services. There are also funeral associations that can help lower the cost of funerals through memberships and some religious congregations will assist members. Mortuaries are always ready to assist you in advance or after a recent loss.

What do funerals and cremations cost? Since costs vary, you may want to compare prices and get detailed information about all involved costs. Be aware that there are often tremendous differences in prices. Funeral directors are required to give you a price sheet with detailed funeral costs, and to give prices over the phone if you ask. Be sure to ask about any extra fees that may not be included in the prices. For instance, obituary notices are not required. As a matter of public record, the death will be recorded and the name, age and occupation of the deceased printed in the newspaper. However, if you choose to have an obituary the funeral home will assist the family in preparing and submitting the notices. The cost of notices vary based on the length (charge by word) and the number of days it is posted in the newspapers selected locally and/or in other cities. There are also variations in the costs of caskets. Usually, only the most expensive caskets are displayed in the funeral home. If interested, ask the funeral director if less expensive alternatives are available. In fact, it is possible to purchase low cost caskets through casket outlets that are not associated with a specific funeral home. Also, some mortuaries and funeral homes will rent their more expensive caskets to be used only during memorial services or viewing. This option allows the family of the deceased to purchase a less expensive casket for final internment. Carefully review the terms offered as part of “package deals”. Sometimes additional services are included that may not be required.

According to the Funeral Consumers Alliance of Southern Arizona, the average cost of a “traditional” funeral in the U.S. is now over $6,000. A more extravagant funeral could cost over $10,000. Depending on the arrangements and preferences, the costs for a direct burial can be less than $500, but this does not include the cemetery plot, obituary notices, copies of death certificate and other details. A direct cremation may be available for less than $500 but usually the cost does not exceed $1,000. The price for a simple cremation package, called a “Direct Cremation”, should be listed on the pricing sheet.

Who pays for funeral expenses? Funeral costs can be borne by the estate of the person who died, or may be paid by advanced planning contracts or life insurance plans. Sometimes family members choose to bear the expense. Social Security does provide a lump sum funeral allowance for burial in the amount of $250 for eligible recipients paid either to the surviving spouse or a child less than 18 years of age. The Veterans Administration (VA) also provides a funeral/burial benefit for persons who have served in the military and their spouses. If your relative is in the process of applying or may need to apply to ALTCS there are a number of rules that pertain to burial plans. Please contact Pima Council on Aging or any Arizona Funeral Association for more information.

In some limited circumstances arrangements can be made for people who die without any resources or ability to pay. The funeral director can provide the necessary information about indigent burials. In Pima County, the Office of the Public Fiduciary handles indigent burials (Ph: (520) 740-5454).

What should we know about cremation as an option to burial? Cremation as an option is growing. The number of cremations grew from less than 5% of all U.S. deaths in 1970 to more than 25% in 2000. In part this increase is due to greater awareness of cremation as an alternative; its relatively low cost compared with burial; and the growing number of older people who have retired far away from their hometowns and family burial sites. However, more comprehensive cremation laws are needed to address issues such as licensing, inspections, recordkeeping, disposition and identification of remains, and penalties for violations. Things to consider:

What if your loved one wants to donate their body to science or medical education? Your loved one has to pre-register or enroll with a program in their area. There are a few circumstances under which the medical program may not be able to accept their body; therefore burial arrangements would need to be made. Some exclusions include: the removal of an organ or part of the body, decomposition of the body, severe trauma, suicide, or the presence of contagious diseases.

What if we need to transport the body out of state for burial? Your local mortuary will assist you in preparing the body and arranging for transportation to the receiving location. The mortuary will acquire the death certificates, arrange the appropriate permits and air transportation on your behalf.

• With the help of your relative, keep a record of the basic medical conditions, medications, physician names, emergency contacts and telephone numbers of family and friends your loved one wishes to be called in the event of their death.
• Together with your relative prepare a note card with information on any prearrangements made for funeral plans, mortuary preferences, burial plots, life insurance plans, etc. Also check with local mortuaries or funeral associations for a copy of helpful planning guides.
• If your loved one has a terminal illness, become informed about the option of hospice care.
• Contact a local support group for grief and loss to help you and all family members during this most stressful and emotionally difficult time.