Last week’s column covered a quick history of end of life practices in the United States, and introduced a relatively new option for body donation that many people may not have been aware of – body farms. In contrast, home funerals are an end of life choice which has been around for a very long time, however, the growth of the funeral home industry has pushed them into the background.
Home funerals allow for very personalized planning and maintenance of control by the family. The opportunity to care for the body may provide comfort for family members and friends who are grieving. Home funerals will also most likely reduce costs and be more environmentally friendly when compared to commercial funeral services.
According to the National Home Funeral Alliance (NHFA) (https://www.homefuneralalliance.org/), 41 states, including Pennsylvania, allow families to take care of their deceased loved ones without hiring a funeral director. The remaining 9 states (NY, NJ, NE, IL, FL, LA, MI, IN, CT, IA) require the services of a funeral director for certain tasks such as paperwork and transportation. Physical care of the body of the deceased individual is still permitted in these states.
Pennsylvania does have some regulations regarding handling the arrangements of a deceased person. One of the primary regulations covers who has the authority to make decisions. Ideally, prior to death, the individual communicated his/her wishes to loved ones. A written or videotaped statement to back-up conversations is helpful.
If no declaration of wishes was made, by law an individual’s spouse has sole authority to make decisions about final arrangements for the deceased. When there is no spouse, the next of kin receives this duty. In situations where the spouse or next of kin are estranged or incompetent, or the next of kin with equal standing (such as children or siblings) disagree with each other, involvement of the court system may become necessary.
When family members or loved ones choose not to hire a funeral director, paperwork for the deceased must be handled appropriately. Medical certification of the death is required, and PA statutes indicate which professionals are authorized to provide this certification based on the location and circumstances of the death. This documentation is part of a death certificate.
When the death has occurred within our Commonwealth, the death certificate must be filed with a local registrar or the State Registrar of Vital Statistics within 4 days of the death or the finding of an identifiable dead body. After submission, the local or state registrar will issue a permit which allows for disposal of the body. When a death occurs out of state, a permit must be obtained from the state where the death occurred before a body can be transported into or through our Commonwealth, or disposed of by burial or other means within our Commonwealth.
Even though this paperwork may be manageable, a deterrent to home funerals may be the thought of handling a dead body. In most circumstances, it is not dangerous to touch a dead body. The organisms which cause the majority of infectious diseases do not survive long in a dead body, and the spread of an infectious disease is much more likely to happen from contact with a live person.
The question of embalming may also arise in relation to home funerals. There is no federal law which requires that a human body be embalmed. State laws may exist if transportation of a dead body across state lines will occur. If a funeral director is involved, funeral industry standards dictate that embalming must occur within 24 hours or the body must be placed in a sealed casket. Pennsylvania has no preservation time requirements for home funerals, although it is recommended to keep a body cool to slow down the process of decomposition. Additional guidance about caring for a body at home can be found at https://www.homefuneralalliance.org/body-care-cooling-techniques.html .
The benefits of home funerals are numerous. Home funerals allow families to spend additional time with their deceased loved ones in a familiar environment. Advocates believe that when physical care is provided by families, they have a more meaningful experience, which in turn promotes healing. Visitors to the home have more of an opportunity to say their goodbyes in private, and times for visitation can be more flexible. Religious practices may also be easier to accommodate with a home funeral.
But in an era where death is a taboo subject, home funerals may be difficult to comprehend. Sometimes the circumstances surrounding a death may not be conducive for a family to provide care for the body. Certain friends and family members who are accustomed to different practices may feel uncomfortable and try to discourage a home funeral or choose not to attend. If a death was unexpected, grief and the multitude of details and decisions surrounding death may cloud thoughts about funeral options.
Home funerals are not an “all or nothing” proposition. Care of a body at home can be combined with the support and services of a funeral home. The wishes of an individual and the family’s comfort level with death, paperwork, and planning will influence the type of arrangements which are most appropriate.
Karen Kaslow RN, BSN