Funeral Directors Research Articles

Bereavement and Bereavement Care in Health and Social Care: Provision and Practice in Scotland

The interview study described here aimed to explore current views of and practice in bereavement care and identify priorities for service development in Scotland. Fifty-nine participants who worked with the bereaved in some way, or whose interest was in bereavement or bereavement care, were interviewed. They represented National Health Service organizations, chaplaincy departments, educational institutions, academic departments, voluntary groups, and other related bodies, such as funeral directors. Transcripts were read repeatedly and initial emerging themes were identified, coded and shared between research team members to reach a consensus for key themes. Priority areas for development were related to raising public awareness, coordination of services, guidance, and professional education.

Post-Mortem Considerations of Yttrium-90 (90Y) Microsphere Therapy Procedures

Yttrium-90 (Y) microspheres, either in the form of resin beads or glass, are currently used to treat unresectable hepatocellular cancer. It has been discovered that long-lived contaminants, principally Eu and Eu, can be found in the waste generated by this procedure. Recently, at our medical facility, an elevated count rate was discovered on a deceased patient scheduled to have an autopsy and who had undergone Y microsphere therapy nearly 5 months previously. Regulatory issues arose when the family of the patient requested that the body of the deceased be cremated. In this particular instance the exposure rate from the body was below regulatory concern; however, the potential contamination and exposure from these long-lived contaminants cannot be ignored for individuals working in the autopsy room, funeral home embalming area, and crematorium. Information provided to potential patients in pamphlet form from the manufacturer failed to identify the existence of long-lived contaminants and possible difficulties associated with cremation. To ensure potential Y microsphere patients and family members are aware of the possible existence of long-lived contaminants, a patient consent and notification form has been developed. The proper disposal of residual material associated with these procedures, i.e., long-lived radioactive contaminants in explanted organs, pose additional difficulties. Further education of medical staff and funeral home directors with crematoriums is necessary. Close cooperation with the regulatory authority was instrumental in resolving this situation.

Funeral directors can bring much to bereavement care

As a former nurse and bereavement counsellor who is now a funeral director, I read the article on grieving with interest (features June 4). Protocols such as that developed by Maureen Brown are innovative and pragmatic.

71 Dignity and Safety: An Intervention Making a Positive Difference to the Way Undertakers Handle our Deceased Patients

At manual-handling training, nurses regularly expressed distress at the way undertakers transferred bodies, finding their handling lacked dignity and contravened manual-handling regulations. To improve the way undertakers remove deceased patients from hospice premises. To assess current practice, in 2002 we audited removal of bodies over a 1-month period. Local funeral directors were told …

Guidelines for Handling Radioactively Contaminated Decedents

The Centers for Disease Control and Prevention recently issued guidelines for medical examiners, coroners, and morticians in dealing with decedents after detonation of an improvised nuclear device (IND) or radiological dispersal device (RDD) (). Partners in this effort included the New York City Office of Chief Medical Examiner and the National Funeral Directors' Association. This paper describes the handling techniques required for loose surface contamination, radioactive shrapnel, and internal contamination caused by inhaling or ingesting radioactive materials from an IND or RDD, and provides suggested guidelines for medical examiners, coroners, and morticians to deal with these situations.

Markets: Preserving Funeral Markets with Ready-to-Embalm Laws

Thirty-nine states currently have ready-to-embalm laws, which typically require that all firms selling any type of funeral service (even those specializing in cremations) have embalming preparation rooms and all funeral directors be trained as embalmers. Ready-to-embalm laws are designed to preserve the status-quo in funeral markets, thereby protecting currently licensed funeral directors from the ravages of competition. These laws attempt to preserve funeral markets as they existed in the mid-twentieth century, markets that centered on traditional funerals sold by small, full-service funeral homes. The economic chemicals needed to preserve the status quo are harsh, leading to higher funeral prices and often poorer-quality services. The empirical evidence suggests that these laws reduce the cremation rate, the market share of Internet casket retailers, the penetration of national chains, and the number of funeral directors who are immigrants. They also appear to substantially increase the retail price of direct cremations and the cost of traditional funerals. Commissions in several states have recently recommended repealing ready-to-embalm laws, arguing that they are anticompetitive. The evidence presented in this paper should make their recommendations harder to ignore.

Let the Dead Teach the Living: The Rise of Body Bequeathal in 20th-Century America

America's medical schools have long used human cadavers to teach anatomy, but acquiring adequate numbers of bodies for dissection has always been a challenge. Physicians and medical students of the 18th and 19th centuries often resorted to robbing graves, and this history has been extensively examined. Less studied, however, is the history of body acquisition in the 20th century, and this article evaluates the factors that coalesced to transition American society from body theft to body donation. First, it describes the legislation that released the unclaimed bodies of those dying in public institutions to medical schools for dissection, thereby effectively ending grave robbery. Then it discusses midcentury journalistic exposés of excesses in the funeral industry-works that were instrumental in bringing alternatives, including the previously unpopular option of body donation, to public consciousness. Finally, it examines the rise of body transplantation, the Uniform Anatomical Gifts Act of 1968, and the subsequent state of willed-body programs at the turn of the 21st century. Body-donation programs have gradually stabilized since and currently provide most of the bodies used for dissection in American medical schools. Relying as they do on public trust, however, these programs remain potentially precarious and threatened by public scandals. Whether American medical schools will receive enough bodies to properly educate students in the future remains to be seen.

Magic, Secrets, and Grim Reality: Death Work and Boundary Management in the Role of the Funeral Director

This article examines the performances that funeral directors undertake in protecting the public from the disorder of death and in creating the “magic” of a funeral. Goffman's (1959) concepts of back-stage/front-stage performances are used to illustrate the tension that arises as funeral workers switch between these two elements of their professional role. Based on fieldwork study in a number of funeral establishments, we present examples of the stress that they may experience in their management of the boundary between life and death.

MO‐E‐BRB‐06: Communicating Radiation Safety Procedures After Patient Death: Beyond Decay in Storage

Purpose: To discuss radiation safety issues that may arise in the event of death of patients who have received radiopharmaceutical therapy or a radioactive implant and to educate clinical medical physicists in specific procedures performed by pathology personnel, morgue personnel, funeral directors and crematory workers that present radiation safety risks to those workers. Also to provide guidance on lessons learned by the author in communicating appropriate radiation safety procedures to funeral professionals and working with state agencies that regulate funeral homes and crematories. Method and Materials: The author researched pathology, embalming, and cremation procedures and facilities and spent considerable time on‐site in such facilities to gain an understanding of the specific risks presented to personnel and safety precautions that are currently used (or not used). Results: The author prepared instructions to be provided to personnel in the event of the death of radiopharmaceutical therapy or radioactive implant patient to comply with state and federal radiation control regulations and ensure personnel safety. The author also provided education to local funeral directors and spoke on this subject at a state funeral directors conference. Conclusions: It is not a matter of “if” but rather “when” a clinical medical physicist at a facility performing radiopharmaceutical therapy or radioactive implant procedures will receive a call regarding radiation safety procedures for a deceased patient. It is preferable to be prepared with specific instructions and establish a relationship with your pathology laboratory, morgue, and local funeral professionals in advance than to flounder when the event occurs.

En quoi différentes approches de l’activité collective des relations de services interrogent la pluralité des modèles de l’activité en ergonomie ?

The aim of this paper is to show that the various characteristics of service relationships in public utilities and demands about them require careful thought concerning what we call “activity”. Following task analysis (nurses, office clerks, policemen, funeral directors, crèche, nurses, educators…) don’t do the same work: their aim, the types of interactions between “customers” and workers, work conditions and organization, possibilities of service relations. So, the problem is to precise what aspects of workers’ activities, we have to take into account so that activity analysis can be oriented to a more adequate understanding of the job and relevant ergonomic interventions. In order to take action about health and efficiency, they can often require passing beyond a behavioral analysis which describes effective task or its observable components, according to work conditions. We need to have a better understanding of the internal activity component that is a better understanding of physiological, affective and cognitive mechanisms that direct and regulate this behaviour according to the operators’ motives, goals and possibilities in interaction with the environmental conditions. To render an account of reality, this kind of pragmatic systemic analysis of activity has to be supported by different “activity theories” according to the research purpose and conditions.

Lord What's-His-Name

Lord What's-His-Name Opposite the bare facts of the life and list of the family in the little pamphlet the funeral home printed up was "Sunset and evening star and one clear call for me...." The line of the fold made it a kind of contest, on the left, art's undying tidal rhythms and rhymes and on the right—spouse, children, the perishing flesh. But someone, the funeral director?, had taken license, I guess funeral directors are the ultimate editors, and lopped out the darker middle two stanzas the quicker to get to the Pilot with the capítol "P" and reassure the death-dogged believers in their belief. In this land-locked little town, some had never seen the sea, and I, who knew just one edge—bath-warm Myrtle Beach— fretted about that long, grey stretch of ocean to be crossed. It was so vast and undrinkable, so out of imagination's reach. 80 ...

Post-mortem personalization: pastoral power and the New Zealand funeral director

This paper critically examines the personalization of Pakeha (European) post-mortem practices in New Zealand. While much of the discourse surrounding funerary and disposal processes maintains that contemporary practices demonstrate a denial of death and funeral director esurience, funeral directors themselves argue that the Anglophone approach to death has been superseded by personalized funerary practices. Although funeral director rhetoric emphasizes the democratization of funeral practices and the primacy of individuality, an examination of the discourse reveals that this personalization also demonstrates the normalizing technologies integral to Foucault's concept of “pastoral power.” This paper argues that funeral directors play a significant role in articulating the boundaries of appropriate funeral behavior by accentuating the importance of “authenticity,”“dignity,” and “healthy grief.” These concepts underline the expertise of funeral directors, define the acceptable parameters of post-mortem practices, and reify the integral involvement of funeral directors in the construction process. This paper illustrates that funeral directors play a salient role in articulating bio-power within New Zealand society, and that this endeavor is integrally linked to the occupation's continuing pursuit of professional identity.

DEAD SERIOUS? FUNERAL DIRECTING IN NEW ZEALAND

This article examines the history of funeral directing in New Zealand and highlights a number of significant shifts in occupational orientation. The first identifiable transition involved the shift from undertaker to funeral director in the early twentieth century. Attempts to professionalise the occupation during this period parallel similar developments in the United States, and illustrate the increasing bureaucratisation and rationalisation of human disposal. A more recent shift has occurred in the past three decades. New Zealand funeral directors focused their attention primarily on grief management and emphasised the psychological value of funerary ritual. Funeral directors also played a significant role in personalising funerals and offering ‘life-centred’ funeral options. Despite the important influence of international industry developments, funeral directors in New Zealand have purveyed and promoted personalised post-mortem practices and attempted to distance New Zealand funerals from perceived ‘impersonal’ British practices, as well as the ‘excesses’ of North American obsequies.

Abject d’Art

Central to the embalmer’s and mortician’s art is an interesting paradox- the signification of death without physical corruption of the body. Howarth’s analysis of the “humanization techniques” in sustaining the fiction of living, points not only to “theatrical strategies” involved, but to the necessary concealment of the artist (the embalmer, the undertaker) in the process.

Professionalization without dead bodies: the case of Swedish funeral directors

The aim of this article is to discuss Swedish funeral directors from a professionalization perspective with a focus on the last decades. The article is primarily based on a research study made in 1998 – 2002 where multiple data were used: interviews, field observations, text analysis, and a questionnaire. Later findings have been added to update. The results show that the funeral directors have acquired a professionalization by broadening their work tasks in different fields. Initially they took care of dead bodies and organized the logistics. In the last decades, new task areas have opened within the law, bereavement, and ceremonial rites. Of specific significance is that Swedish funeral directors seem reluctant to develop work tasks connected with the dead body; rather it is as public experts on death and bereavement that they want to be recognized. A step forward in this direction came with the public need for funeral directors in the aftermath of the tsunami.

MISCLASSIFICATION OF RACE IN CARDIOVASCULAR DISEASE MORTALITY DATA

Graber and colleagues found an ominous deterioration in the quality of race data for American Indian deaths in Maine.1 Specifically, errors because of coding and data entry increased from 0% during 1978–1982 to 33% in 1993–1997; errors in reporting increased from 3% to 22% during the same periods. Part of the problem of race misclassification is being resolved. Coding errors have been reduced as a result of new procedures introduced in April 2003 and have been used by a growing number of states, including Maine, in conjunction with the National Center for Health Statistics (NCHS). The new procedures, in which NCHS codes and edits race/ethnicity data and then quickly returns the data to the states for additional processing, are described on the NCHS Web site (http://www.cdc.gov/nchs/data/dvs/multiple_race_documentation_5-10-04.pdf). Graber et al. did not mention misclassification of race in the denominators of death rates. Errors in the denominators tend to offset, somewhat, errors in the numerators, as shown in an NCHS study of misclassification of race/ethnicity at the national level.2 The authors present 2 types of death rates, those based on “any mention” of cardiovascular disease and those based on “immediate” cause of death. Do the authors mean underlying cause rather than immediate cause? Underlying cause of death is the standard basis for tabulating cause-of-death data as recommended by the World Health Organization.3 While the new NCHS procedures reduce errors introduced during data processing, they do not resolve errors resulting from misreporting of race/ethnicity on death certificates, which Graber et al. show account for almost half the racial/ethnic misclassifications for American Indian deaths in Maine. Errors in reporting can be reduced only by training funeral directors, who obtain information on race/ethnicity from informants or by observation, to be more accurate. Until funeral directors are better trained, NCHS and the states will have solved only half the problem of misclassification of race/ethnicity in mortality data. Graber and colleagues make an important contribution by demonstrating a relationship between state budget resources and data quality. Maine’s race/ethnicity data deteriorated in part because of relaxed quality control standards owing to budget constraints. During the past decade, federal budgets for vital statistics, which support state operations, have failed to keep up with inflation, while—as the authors point out—state budgets, too, have been reduced, with consequences for data quality. The public health community needs to ensure that the state and federal governments provide adequate resources to maintain the data sets used to monitor the health of our citizens.

Mediator Deathwork

ABSTRACT The most discussed and analyzed form of deathwork is the dyadic therapist ↔ client relationship, but this far from exhausts the various types of professional work involving the dead. Mediator deathwork is where the professional gleans or constructs information about the dead, edits and polishes it, and publicly presents the edited version in a public rite; this entails a triadic flow of information: the dead → the mediator → public rite. Examples include pathologists, coroners, American funeral directors, funeral celebrants, obituary writers, spiritualist mediums, and museum curators. Other types include barrier deathwork (in which the professional insulates the living from the dead—the dead | the living— as in British funeral directing), and intercessory deathwork in which priests send prayers the other way, from the living to, or on behalf of, the dead: mourner → priest → the dead. The article focuses on mediator deathwork because, though it is the most widespread form of deathwork, it is the least discussed and analyzed.

Legacy fundraising: a practical guide to the basics

Abstract Remember a Charity, the public awareness campaign run by over 130 charities in the UK, has stated that donations in wills are the largest single source of voluntary income for charities—currently worth £1.3 billion per year (April 2005). So can legacies to charity still be described as just windfall money? Should charities spend precious funds on promoting legacy giving when it is difficult to monitor results? It so, what is the message? Who are the target audiences? What form should legacy promotional literature take? What part could or should solicitors and funeral directors play in legacy campaigns? Patrick Wise looks back on his twenty plus years of experience in the world of charitable legacies, and gives his views on the answers to these questions, and why he thinks all charities should take legacy promotion very seriously. Copyright © 2005 John Wiley & Sons, Ltd.

Positive and negative changes following occupational death exposure

Professionals who work in situations that expose them to death have long been of interest to traumatic stress research. However, the positive changes that these professionals may also experience have not been the subject of empirical scrutiny. This study examined occupational death exposure, death attitudes, subjective appraisals, intrusions, avoidance, social support, and positive and negative affect, and their associations with positive and negative psychological changes in funeral directors. Multivariate hierarchical regression analyses revealed that positive changes were significantly and independently predicted by an approach acceptance death attitude and social support; negative changes were significantly and independently predicted by fear of death, intrusions and avoidance, and occupational death exposure. The discussion focuses on how these findings extend the literature dealing with occupational death exposure, together with a consideration of limitations of the study that inform directions for future research.

What To Do When Someone Dies Paul Harris What To Do When Someone Dies Which? Books 192 pp £10 0 85202 968 3 0852029683

This is a practical book offering sensitively written, straightforward information. Although the author is a funeral director, it considers all options including how to conduct a funeral without using the services of an undertaker.