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Practical Guide to the Radiation Misinformation

Posted By Administration, Tuesday, March 12, 2019
Practical Guide to the Radiation Misinformation

 

When CNN’s article regarding the JAMA radiation letter first hit the CANA newsfeed on February 26, 2019, we knew immediately it would be a big deal. And yes, the story has become a many-headed hydra of confusion, concern, and misinformation, accompanied by increasingly scary rumors.

We constantly field concerns from suppliers about cremated remains placed inside keepsakes, from crematory operators and embalmers about their cases, from families about their options, from regulators about all of the above, and from you — in the middle of it all — trying to serve your families, comply with regulations, and protect your staff.

CANA has curated several of the most useful questions in one place to counter some of the fear, anger, and rumors. And it’s all publicly available, so please share this resource far and wide, bookmark it for later reference, come back to check for updates, and, most of all, DON’T PANIC.

Where it started.

The radiation misinformation saga began with a research letter, titled Radiation Contamination Following Cremation of a Deceased Patient Treated With a Radiopharmaceutical and published on February 26, 2019 in the Journal of the American Medical Association (JAMA). In the letter, Dr. Nathan Yu (et. al) discussed a case study of a business in Arizona that cremated a 69-year-old man with pancreatic cancer in 2017. The deceased had been treated with a intravenous radiopharmaceutical for a pancreatic tumor and died five days later. When the medical staff became aware of the cremation, they notified the crematory and the cremation chamber, equipment, and staff were all tested for exposure to radiation. The equipment was found to have traces of contamination, as was a urine sample from one crematory operator (but it was a different isotope from the one used in the patient’s treatment). The contamination levels were below the limits set by the US Nuclear Regulatory Commission. In conclusion, because this is only one studied instance, researchers recommend further testing for more data and better understanding.

CNN was the first major media source we found to bring the letter to the general public awareness. To round out the story, the network solicited the opinion of Dr. Daniel Appelbaum, chief of nuclear medicine and PET Imaging at the University of Chicago Medical Center. He said, "If there are reasonable and fairly straightforward and simple things that we can do to minimize radioactivity, why not do that?” Applebaum also acknowledged the need for better understanding and regulations that keep workers safe. In the case of crematory operators, the doctor recommends "robust enforcement of mask and gloves and handling techniques."

Where it went.

Other media outlets picked up the story and it spread quickly, with information traveling like a game of telephone. My mother’s church group argued against cremation for spreading radiation in the community. One CANA member’s staff are expressing concerns about “the crematory operator who died from radiation” (when none have). Each of which are exaggerated concerns about what we know.

Because while the case study is new, the knowledge about radiopharmaceuticals and brachytherapy is not. And the medical community is quick to reassure that there is Low Risk of Radioactive Contamination from Cremation When Proper Safety Procedures Followed. CANA is aware that these concerns and fears are rooted in a lack of awareness and understanding, so we want to provide information to help.

What we know.

Radiation 101

At CANA’s second Alkaline Hydrolysis Summit, we invited Jeff Brunette, Health Physicist and Manager of Radiation Safety at the Mayo Clinic, to talk about nuclear medicine and its impact on death care. His full presentation is available as a free, on-demand webinar for you, your staff, and anyone to access anytime on CANA’s Online Learning platform, but here are some highlights:

  • Nuclear medicine, as administered by a medical professional, is very different than a nuclear warhead. These treatments are administered at doses for safe and healthful diagnostic imaging and cures, not mass devastation.
  • These treatments have known efficacy windows which range depending on the use. Diagnostic imaging (e.g. PET scans) can take 20 minutes to 67 hours to clear the system. Radiopharmaceuticals can take 3-12 days (this is where the case study falls). Radiation oncology, like brachytherapy, implants treatment into the body to deliver targeted doses over a treatment window and these isotopes can take weeks or months (or longer) to decay to acceptable exposure levels.
  • The variations in the length of radiation are due to different materials (called isotopes) used in treatment and their half-lives (i.e. how long it takes the radiation to degrade to half its original mass).
  • Safe levels are determined by federal regulation. For the US general public, this is anything up to 100mrem in a year (excepting medical treatment — a full-body CT scan provides approximately 1,000mrem), while for people who work with the substances it’s 5,000mrem each year. A fatal dose is more than 500,000mrem. And we are exposed to radiation by taking an airplane, using the microwave, and from nature (both Earth and space).
  • Radiation treatments also vary in strength. Alpha waves are stopped by paper, or blocked by your skin. Beta waves are blocked by soft tissues and thin metal of aluminum. Gamma waves travel much farther. Distance from the radioactive material also changes exposure — the medical community measures the potency at one meter to determine when a patient can go into public spaces. In most of the cases described above, treatment is outpatient (even the implanted seeds) meaning the person can leave that day.Radiation Rays by Engineering Technology
What's the risk?

The US Nuclear Regulatory Commission has set specific levels (mentioned above) to regulate emissions and uses. In the case of cremating a body treated with nuclear medicine, the Commission and medical community agrees that the potential exposure is too low to record. Though cremation volatilizes the radiation treatment, Brunette says even extreme cases are not likely to exceed the limits set for safe exposure due to the combination of medically accepted isotopes, their half-lives, and treatment use. He explains it with an analogy: taking a daily recommended dose of aspirin is fine (around 325 mg) but taking a year’s worth at once (118,625 mg or more than three bottles) is fatal.

Canadian Nuclear Safety Commission has their own rules and regulations and reviewed them extensively last year. CANA recommends their comprehensive Radiation Protection Guidelines for Safe Handling of Decedents as a great resource to learn more about the isotopes in question and safe handling procedures, even for non-Canadians.

Ultimately, Brunette argues that radiation is a limited concern because the levels you will encounter on the job are small, and not very common. Your bigger concerns are the activities that your staff do every day: musculoskeletal injury from lifting, exposure to disease during embalming (HIV; Hepatitis B & C; Tuberculosis; MRSA), and exposure to harsh conditions during cremation operations (heat, noise, dust or chemicals).

How can we operate safely?

CANA recommends asking all families for detailed medical information to properly understand and respond to potential risks. Just as you ask about the presence of pacemakers, ask about nuclear medicine treatments.

Paul Harris of Regulatory Support Services encourages all funeral home, crematory, and cemetery owners to ask the pertinent questions of their families. Cause of death is the first indicator that a case is at risk for radiation therapy, but all families should be asked in the case of death unrelated to their ailment. In many cases, families may be unaware or not understand the procedures the decedent has undergone. In these cases, you may need to ask for a Health Insurance Portability and Accountability Act (HIPAA) release form (in the US, rules in Canadian provinces vary) to contact the medical provider yourself. Asking the radiologist for information on the treatment and about the specific isotope and its half-life is the best way to determine when (or if) it is safe to cremate or embalm the body.

The medical community also recommends installing a simple radiation detector to quickly alert staff to the presence of radioactivity (some states require them in all morgues). Brunette recommends a pancake Geiger-Mueller counter which can be acquired cheaply (particularly if you have them left-over from the old nuclear-powered pacemaker days) and built into your case acceptance procedure.

Mostly, Brunette recommends the following steps to reduce exposure:

  • Awareness: talk to families, ask the radiologist, consider purchasing and/or installing detectors.
  • Protection: Wear appropriate PPE when potential for contact with body fluids, cremated remains, or AH fluids.
  • Disposal: Drain blood and body fluids during embalming directly into the sanitary sewer system and don’t aspirate unless necessary.
  • Proximity: Maximize distance to the body and minimize time in close vicinity to the body.

What we do next.

The medical community should do what Drs. Yu and Applebaum say: research. Learn more about these situations so everyone can make informed choices about safety. In the long-term, this will serve us better than knee-jerk reactions and blanket rules to refuse all cases who have ever been treated.

Our professional community should continue to do what you do best: serve your communities safely and compliantly. Enforce PPE, add this to your list of questions for families, do your due diligence. You should review your existing policies, processes, and procedures to ensure that you are screening for the use of radiopharmaceuticals and staff are taking proper precautions. Inform yourself and staff with basic information about diseases that could indicate potential treatments and which isotopes are used. Know who to contact with questions like your local hospital’s radiology department (or the decedent’s doctor) or regulator.

Mostly, DON’T PANIC. Now that the public is aware of this issue, this is an opportunity to educate our communities and ourselves with good information from reliable sources. CANA will periodically update this post with new knowledge, so bookmark this for later.

 


Sources of information referenced in this article:

 


Barbara Kemmis

Barbara Kemmis is Executive Director of the Cremation Association of North America.

Tags:  education  processes and procedures  safety  tips and tools 

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Hospice, Families, and Funeral Service

Posted By Administration, Wednesday, February 27, 2019
Updated: Monday, February 25, 2019
Hospice, Families, and Funeral Service

 

There are a number of proactive measures we as a profession can take in pursuit of remaining relevant to contemporary consumers. Developed from ideas presented by Kim Medici Shelquist, Senior VP of Planning & Development for Homesteaders Life Company, and Ernie Heffner, President of Heffner Funeral Chapel & Crematory, this post focuses on the relationship between end-of-life care and death care and the family’s experience.

Hospice

The first US hospice was established in 1974 and viewed as an alternative to current heathcare options for those at the end of life. Kim explained that, in many cases, traditional healthcare establishments were not welcoming, so hospice professionals had to fight for respect. The largest growth of hospice care providers in America occurred after Congress passed legislation in 1982 to create a Medicare hospice benefit allowing Medicare/Medicaid to fund hospice care. As of 2014, there were 6,100 hospices nationwide and more entering the market every year.

Facts About Hospice Providers

Most hospice care is not a non-profit endeavor but rather care provided by for-profit organizations and keenly attuned to demographics, networking, market shares and the competition. Ernie described that hospice organizations have changed significantly from the volunteer-based approach some of us may remember from the early days of hospice care and now have first-class marketing graphics and a business plan to match. The close personal relationship of a hospice care provider with surviving family members does not end with the patient’s death but can extend for more than a year after.

Ernie researched and reported many of the following statistics from the website of the National Hospice and Palliative Care Organization.

  • Free standing hospice organizations not affiliated with a hospital are on the rise, 58.3% in 2013 increased to 72.2% in 2015.
  • Not-for-profit hospices are decreasing, 34% non-profit in 2011 down to 31.9% in 2016.
  • Of all US deaths, 44.6% in 2011 occurred under hospice care, 46.2% in 2015. 59% received in-home care.
  • The average length of care decreased from 72.6 days in 2013 to 69.5 days in 2015. The median length of care decreased from 18.5 days in 2013 and to 17.4 days in 2014 and increased to 23 days in 2015.
  • Aftercare: Few if any funeral homes have an aftercare program like hospice. 92% offer community bereavement support. Through ongoing bereavement activities by a “bereavement coordinator,” the hospice organization maintains a relationship with the family long past the time of the patient’s death, in fact monthly for 13 months after the death.
  • Volunteers in Hospice Care: Statute requires that 5% of people hours are provided by volunteers. Many hospice organizations have a person dedicated to recruiting volunteers. In 2014, 430,000 volunteers provided 19 million hours of service.
  • Spiritual Advisor: Hospice organizations are required to have a spiritual advisor on staff. Hospice chaplains are often very well-trained in non-denominational, non-religious approaches to the spiritual side of life and death.

The Role of the Hospice Worker

Hospice care providers are a very special, caring group of people. They are held in high regard by the families they serve. Their opinions and advice are trusted. They are passionate, dedicated, and tenacious. There is little turnover, and even those who do leave often move to another hospice.

No other healthcare professional actively talks to family about the end of a life and planning the way a hospice care provider does. Kim explained that they do whatever is in their power to reunite families and meet patients’ needs, they are flexible and open-minded, and they figure out how to provide the best end-of-life experience possible. Ernie recommends the chapter “The Power of Presence” in Doug Manning’s book, The Funeral, to appreciate the connection and relationship hospice care providers have with families.

Almost half of all deceased people in the US last year were under hospice care before they ever got to a funeral home, crematory, cemetery, or anatomical gift registry. That’s significant, because unless you have a great community engagement program, a family’s first contact about funeral plans is hospice staff. Social workers ask patients and families about their wishes and intentions long before you see them. Statistically, these caregivers have built a very personal relationship with almost half of these families immediately prior to the death of their loved ones. If that doesn’t motivate you to think about what you’re doing in your community and your hospice outreach, I don’t know what will.

The average length of hospice stay is about 70 days. That’s a long time to create a relationship with the family. 59% of hospice patients receive in-home care. Hospice staff go in, day after day, and build that relationship and gather the details of their lives and their family dynamics. It’s a very different situation – we get three days, they get almost three months to hold those really hard conversations about really hard parts of a patient’s life. In that role, they become trusted advisors and the go-to people for all things related to death and dying.

Serving Hospice Families

The average hospice caregiver, no matter how well-intentioned, only knows as much about funeral service as someone who goes to a lot of funerals. Most are invited, and attend, many patient’s services and thus see many local funeral homes. But, there’s no aspect of hospice training that goes into the ins and outs of funeral service.

We use a lot of trade-specific information and technical jargon that is confusing to families and just as confusing to those caregivers. And if these people go to a lot of funerals, it means they go to a lot of bad ones, too. What does that caregiver think after they leave? If the next family asks, “What should we do?” they might not recommend your funeral home because they remember that bad service.

Some funeral directors ask, “Why do they tell them to do the cheapest thing?” Kim reminds us that the social worker has seen their hospital bills, heard about maxed-out credit cards, and sat with the widow afraid of losing the house after losing her husband. That social worker is not concerned about whether the funeral home is interested in offering an upgraded casket. If the social worker sees you trying to sell the family anything, they might remind them that they don’t need it. It’s not right or wrong—it’s just the way it is. We can talk about “that’s not her role” or “the family might have wanted to do something nice and she took their choice away,” but you’re talking about a dynamic where she was protecting them. Hospice social workers and caregivers take their role as advocates very seriously. They value collaboration. That means if you can create a relationship and build trust, you can position yourself as an advocate of the family, and you can collaborate on the process. If they see you acting in the best interest of their families, they will support you.

By the time the hospice family comes to the funeral home, you need to understand what they’ve been through. You are professional and passionate members of funeral service, but terminal illness is different. In a hospice situation, the family often has the opportunity to come together and say goodbye. Sometimes, they’ve done it three or four times. They’ve done the first part of the grieving process. They've had a lot of time to talk about death, to think about death, and often have additional support via hospice resources to prepare and guide them. The family is often present at the time of death, and it’s not unusual for them to have a brief ceremony right then. Kim explains that, the presence of the family, the words of the chaplain, the goodbye to their loved one – after that, they may not need a traditional funeral to process their grief. And it’s important for funeral professionals to understand that.

That’s not to say that there isn’t need or opportunity for service and ceremony, but we must remember that those in hospice have declined for a long time. Their survivors often say “I don’t want people to see my loved one like that.” It’s hard for families to think about a visitation because of the change that illness has brought. They don’t want their friends and families to remember the deceased that way, or worse, not recognize their loved one anymore. But they don’t necessarily understand what you can do about that. They don't always understand how body preparation can make a big difference—whether they agree to full embalming (which can reduce swelling or return moisture) or merely a shave and a haircut (which can make them look like themselves again).

Lastly, you know that these families are spread out, so they’ve spent time and money on travel in addition to the financial costs of long-term care, lost time at work and time with their immediate families. They are exhausted physically, emotionally, and financially. And this stress has likely heightened any kind of disagreements about medical care and funeral planning.

How to get started in developing a hospice outreach program

Developing a meaningful relationship with hospice care providers in the community is not about dropping off cookies at Christmas. It is a commitment to education that can benefit all concerned, providing the families we mutually serve with seamless and meaningful end-of-life transition. Ernie provides three key strategies for starting your hospice relationship:

  1. Research
    Read all you can to learn about the hospice profession. Then research your state’s licensing requirements for Registered Nurses (RNs) specifically the continuing education (CE) requirements and what qualifies for program content.
  2. Build formal PowerPoint presentations
    These need to be compliant with RN CE requirements. Include reporting, record-keeping system and handout material to be used. Then apply to get your program(s) certified by your state’s nurse licensing division.
  3. Recruit a hospice care provider as your outreach person
    This could be a part-time position about 18 to 24 hours per week. Consider recruiting a retiring hospice social worker interested in a part-time position. Have this person be your representative to offer continuing education. This person should also attend monthly networking events relevant to serving seniors.

In Conclusion…

Dr. Alan Wolfelt, internationally acclaimed grief counselor, author and educator, has said “Education starts with understanding the people we serve.” To that point, it is helpful to review the demographic and societal statistics of your community, understand how these facts dramatically impact end-of-life service providers, and embrace the adaptations needed by the profession—including further education and training—in order to remain prospectively relevant to contemporary consumers.

Like Ernie says, life is about relationships and experiences. We are in the business of celebrating the life of the individual by recognizing how they touched the lives of others. Our mission is to orchestrate and direct a meaningful ceremony with compassion, flexibility and options and in way that is as unique as the person who died.

 


Kim Medici Shelquist's remarks excerpted from her presentation at CANA's 2017 Cremation Symposium titled "Seek First to Understand: How will changing demographics and end-of-life care options impact the funeral profession?"

Ernie Heffner's full article is featured in The Cremationist, Vol 55, Issue 1, titled “Staying Relevant in a Changing World” featuring important discussion on the role of Celebrant services, the importance of minimum standards, hospice, and more. The Cremationist is an exclusive benefit of CANA Membership.

 


Ernie Heffner Ernie Heffner is President and Owner of Heffner Funeral Chapels & Crematory, York, PA. After graduation from Pittsburgh Institute of Mortuary Science, he joined his father in a two-location firm serving about 100 families annually, with a cremation rate of about 4%. The firm grew to 22 locations in 2 states with 100 employees. That growth was during the acquisition mania of the 1990’s. Subsequent to strategic contraction, the firm today serves from six Pennsylvania locations, continuing as a “Mom & Pop” firm owned by Ernie & Laura Heffner and operated by Heffner and John Katora, V.P. and Heffner associate of 38 years. Ernie appreciates the truth of proverbs 22:10, which he paraphrases as, “Minimize the challenges in your life and your life will be better.” Focusing on organic growth and the pursuit of relevance to contemporary consumers has led to gratifying results.

 

Kim Medici Shelquist Kim Medici Shelquist joined Homesteaders in 2009 as Director of Marketing Communications after many years as Business Development and Communications Director of Hospice of Central Iowa. At Homesteaders, she added breadth and depth to the marketing department that resulted in the creation of several key B2C public relations and sales programs. Her efforts were also instrumental in helping Homesteaders become a recognized leader in preneed funding. Today, Kim oversees Homesteaders’ strategic planning and project management process as the Senior Vice President of Planning and Development. Her team is charged with identifying, evaluating and developing new opportunities that will help Homesteaders grow long into the future. Kim holds a bachelor’s degree in journalism and a master’s of business administration, and is a Fellow, Life Management Institute.

Tags:  aftercare  arranging  celebrants  consumers  education  marketing  preplanning  services  tips and tools 

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Personalization Is More Than Products

Posted By Administration, Wednesday, February 13, 2019

Trade shows make for a great opportunity to check out innovations in memorialization—scattering urns, the latest keepsake jewelry, contemporary stationery designs, and cemetery monuments. These products offer new ways for you to match the unique personalities of families and their loved ones.

But true personalization is so much more than products. From the moment you answer the phone, you have the chance to differentiate yourself from your competition and enhance that family’s experience. Then, once they walk in the door, you have the opportunity to infuse ceremony in each interaction and make a difficult process meaningful to the family.

Extracted from examples provided when Lindsey Ballard facilitated an interactive discussion on Best Practices in Personalization and Ceremony at CANA’s 2019 Cremation Symposium, we offer the following ideas as inspiration.

Removals

Transfers and removals offer a unique opportunity to gather helpful information about the family through observation of the home and the items of comfort that surround the deceased. Encourage your staff and removal technicians to take notice of décor, family photos, items on display that might reveal a passion or treasured activity, and even the colors that fill the space. Empower your staff to engage with the family—it’s here they can learn some of the stories behind these beloved objects and see what motivated people in life. These initial impressions can help start the conversation about ways to make a service personal and demonstrate that you care.

Symposium attendee Franklin Rainier, of Franklin J. Rainier, Jr. Funeral Home, shared a story about entering the home of a 95-year-old woman and finding it decorated with Pink Floyd memorabilia and album covers. When asked, the woman’s son confirmed that she had been a true fan. Back at the mortuary, Franklin and his staff played Pink Floyd and lit candles to honor her as they prepared her body.

Arrangement Conferences

For some families, such as those who make a direct cremation choice, the arrangement conference may be the only time they will be acknowledging their grief before moving on. Sometimes, a special window opens up during these conversations and it’s important to pay close attention. Attendee Rita Alexander, of the Cremation Society of Illinois, recommended being especially sensitive to the pauses in the conversation and allowing people as much time as they need to grieve in the safe space you’ve provided for them.

Attendees agreed that a primary strategy is to make the arrangement conference into a conversation, to put the pen down and get to know the family before filling out the forms. You can introduce yourself and your company and describe how the process will work, then invite them to converse and share. Ask them about themselves, the deceased, and family and friends—that’s the time to take notes. At Simon Dubé’s funeral home, a Dignity Memorial location, these notes are discussed in staff meetings to brainstorm how arrangers can make sure the family’s experience is special. Not everyone on staff is equally creative, but together they can design the meaningful service that each person deserves.

Attendee Keith Charles suggested keeping the acronym FORM (part of the word information) in mind to guide your questions: F” is for family and their relationship to the deceased. Make sure to acknowledge every single person in the room. O” is for the occupation of the deceased. What type of work did they do and what was its impact? R” is for recreation. Where did they go on vacation as a family and are there photos to use during the ceremony? And lastly, M” for motivation—what put meaning in their life? With this acronym to guide you, you’ll be sure to touch on the major aspects of someone’s life and gather valuable stories to create a meaningful service.

Viewings, Visitations, and Services

Attendees agreed that getting the family’s permission to personalize the service is the first step to providing a unique and memorable experience. Many attendees shared stories of services they’d performed that conveyed real meaning to the family they served. A signature purple door for a Friends fan, a dress carefully chosen and displayed with a tuxedo to re-create a meaningful dance memory, or the seemingly modest touch of preparing the body’s fingernails with a signature teal polish and passing it out to the family to wear, too. Never underestimate the power of the small gesture of service: accents of a favorite color, the gift of a small pin (such as an American flag pin in the case of a service for a U.S. veteran) distributed to each guest, and other touches go a long way to demonstrating you listen and care.

Simon Dubé explained that taking time to requires a lot of work, but staff that are motivated by family service are willing to make the extra effort. Word of mouth is your most powerful advertisement. When you create an unforgettable experience, the conversation keeps going and spreads the word about how your firm goes above and beyond for the families you serve. Simon had many useful tips, including the recommendation that you invite the family to view the set up of the room an hour ahead of the service to make sure that they are comfortable with what you’ve done. This leaves plenty of time to remove a display if the family disagrees, and also provides them an opportunity to grieve and remember with the memorabilia in private.

Facilitator Lindsey Ballard pointed out that every moment can be an opportunity to turn service into ceremony. Handing a flag to a veteran’s family can be more than a simple keepsake if you use it to bring the family together to reflect on the symbol the flag holds. Lindsey does this by inviting close relatives to lay a hand on the flag while she recites a few words about commitment: a veteran to his country and theirs to his memory. In this way, a service for the family is transformed into a ceremonial experience they will remember.

Committal and Scattering

Be sure to inject ceremony at every pivotal moment, even during scattering. With a water scattering, you can pinpoint the GPS coordinates and give them to the guests. Balloon or butterfly releases can accompany an event. Processions will provide a really special memory for those in attendance. Don’t be afraid to ask local groups related to the deceased’s passions or occupation to participate as an honor guard. That could be firefighters, motorcycle groups, or high school athletic teams. At the end of a committal or scattering, as people are standing awkwardly, unsure about what to do next, give them an invitation to do something to finish with ceremony. For instance, they can leave a “handprint” by stepping up to touch the casket or urn before they leave.

Transfer of Urn Into Family’s Care

The urn transfer can provide an opportunity for ceremony, too. If the family is open to it, you can schedule a military honors ceremony for veterans with the military present and a flag-folding presentation. Another idea is to hand-deliver the urn along with the death certificate. You can wear a jersey when the family of a deceased fan comes in to pick up cremated remains.

Aftercare

It’s important to stay in regular contact with families before, during, and after the services. Suggestions for accomplishing this goal include memorial service for donors, annual remembrance events, and mailing special cards to the family on the date of the deceased’s birthday or the anniversary of the death.

This presentation included many images and stories that had several professionals tearing up in the audience. Interested in hearing the recording? The 2019 Symposium Recording is available for purchase. Visit the event page to learn more.

Tags:  arranging  consumers  personalization  services  tips and tools 

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8 Challenges Leaders Face

Posted By Administration, Wednesday, January 30, 2019
Updated: Monday, January 28, 2019
8 Challenges Leaders Face

 

I had the pleasure of presenting for CANA in 2009, and the past ten years have seen changes across the business world. What’s new or different about leadership today? And what are the biggest challenges leaders face in their businesses and communities?

In my work I advise hundreds of leaders each year. From their experiences, questions, hopes and fears, combined with the assessments of those they lead about what their leaders do well and what they do poorly, I’ve compiled eight challenges I hear most often and some suggestions about what to do to find your solution:

  1. Use of outdated time management thinking.

    The research is clear: multitasking is a myth – switching between two tasks can take up to 40% longer to complete both. Life balance doesn’t make sense either. It is about life design: devoting the right number of hours and energy to the most important things. It is time to reexamine outdated beliefs about time management and productivity. The ability to focus intently (“single-tasking”) on what is important should be at the top of your productivity list. And don’t feel guilty if your life isn’t balanced if it is well designed.

  2. Treating those they lead as “followers.”

    When asked what I think is the biggest change in leadership, my answer is followers. Those we lead increasingly resist thinking of themselves as followers, and for good reason. This is a limiting term that poorly represents the relationship we need. Employees want to be (and deserve to be) thought of as contributors, colleagues and team members. The concept of “following” to those we lead is as negatively tinged as referring to those in customer service as “servile.” Unless you’re a religious guru, you are better served leading a team of contributors than a band of followers.

  3. Fear of the great unknown.

    No leader likes uncertainty but today the size and impact of the unknown can be more devastating than in the past. Nassim Nicholas Taleb wrote the definitive book about overconfidence in our ability to predict, anticipate and plan. He describes the improbable black swan: an unpredictable or unforeseen event, typically one with extreme consequences. Many leaders act as if black swans never happen, or can be avoided, but leadership is as much about taking action in the face of the unknown as it is gathering information to eliminate the unknown and mitigate consequences. No leader is clairvoyant, so he or she must accept the real limitations of knowledge about the future and act accordingly.

  4. A false dichotomy of ethics.

    Trying to separate personal ethics from professional ethics is a bad idea. There are just ethics, and trying to apply two different standards isn’t just confusing, it is wrong. Why would you trust someone at work that you know to be a conniving liar in his or her personal life? And why would you allow something that you know is wrong to happen at work? One psychologist calls it the normalization of deviance: making it acceptable to do at work what is wrong to do outside work. Leaders work hard to create what I conversely call the “normalization of integrity.” Without clearly defined values that are lived and observed by others, ethics slip dangerously.

  5. Overemphasis on generational differences.

    Not that long ago leaders often seemed to ignore generational differences. The pendulum has swung to another extreme. There seems to be a belief that everyone is so different we can’t effectively lead! Generations are different, and understanding those differences can provide effective tools for communication and collaborating better. At the same time people regardless of age share much in common: the need to belong to a winning team, meaning in their work, satisfaction in the jobs they do, and much more. Leaders must balance understanding and using differences and unifying their teams with shared interests and beliefs.

  6. Employee engagement.

    It is as important as competing for talent, a common dilemma according to my clients. One of the biggest myths I encounter is the belief that if you just get the best people on your team, your job is done. John Wooden wisely noted that he didn’t want the best players on his team. He wanted the players that made his team best. That points to the importance of engagement and teamwork. Talent is a start, but it is never enough. Divisive star players and disengaged genius are both liabilities. Good leaders find the best people and then focus on keeping them engaged.

  7. Lack of preparation to successfully lead.

    My research shows that only one in four leaders feels prepared when they assume formal leadership positions. Leaders need to learn to lead before they get their marching orders, not after. And that isn’t accomplished just through books and coursework but through real world projects and assignments where leadership skills are developed. If you don’t give your team members a chance to lead before they become formal leaders, they will lack the skills and confidence to lead when they move into management.

  8. Business model innovation.

    While speaking to a global technology company, I learned that their executives were more worried about innovation in business models than the impact of technology. A business model is the way a company makes money, and can be used defensively against competitors, to reinvigorate revenues in declining markets, or as a way of exploring new opportunities. Few business models are exempt from the need to be revisited and revised regularly. Business model innovation is increasing at lightning speed and may well be the single greatest high level business challenge leaders face.

Which of these challenges are you facing? And what are you doing to meet them head on?

Here’s a final thought: no challenge + no change = boredom. You might wish for fewer challenges than you currently face, but ultimately dealing with challenge and change is the essence of leadership.

 


Want to talk leadership? CANA’s 2019 Cremation Symposium highlights business innovation tactics, maintaining your leadership edge, hiring well, and mentoring across generations. Mark won’t be joining us, but we have experts from across our profession to talk these issues and more. Join us next week in Las Vegas!.

Excerpted from The Cremationist, Vol 52, Issue 4: “10 Challenges Leaders Face” by Mark Sanborn.

 


Mark Sanborn Mark Sanborn, CSP, CPAE is president of Sanborn & Associates, Inc., an idea studio for leadership development. He is an award-winning speaker, internationally recognized authority on leadership and the author of the bestselling books The Fred Factor and You Don’t Need a Title to be a Leader. To obtain additional information for improving yourself your business (including free resources), visit www.marksanborn.com.

 

Tags:  hr  leadership  public relations 

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Rethinking Preneed… a modern approach

Posted By Administration, Wednesday, January 16, 2019
Updated: Monday, January 14, 2019
Five Important Tips for Selling Preneed Online

 

Superstar sellers, unreliable incomes, infighting amongst staff, confusing metrics… the list of problems in the world of preneed sales can be exhausting. The world of preneed is full of myths, misnomers, and fake news. These things can foster unrealistic expectations, or worse, can create significant barriers for managers responsible for their preneed programs and for regular folks seeking a meaningful career in funeral sales.

To find the solution, let’s take a look at the following formulas:

AC / #AA = C%
#CG / C% = RA
AC / AAB = CC%
RA / CC% = RLG

No, these are not a new batch of curse words or hashtags, they are tools you can use to maximize your preneed potential. They may look intimidating, but they are easy-to-use formulas that allow you to use real data to drive real sales.

Play Moneyball

But let’s digress for a moment.

Most readers will have seen or heard of the movie Moneyball. The film dramatizes the real-world example of how, in 2002, the Oakland Athletics baseball team radically changed the traditional game of baseball by using statistics and mathematics (called sabermetrics) to scout and analyze players.

What they realized was that traditional methods of scouting relied heavily on biased or incomplete information. This led other teams to overpay players in the hopes of buying success. In contrast, the Athletics adopted sabermetrics to build formulas using quantitative analysis of different player abilities. By building the right formulas, they were able to put the right pieces together to build success. This new method translated to on-field success; the newly-built Athletics tied the longest winning streak in American League history, and clinched the 2002 American League West title.

How does this concept translate to preneed sales? To quote a line from the movie: “Your goal shouldn’t be to buy players (i.e., counselors), your goal should be to buy runs (i.e., appointments).”

Using statistics and mathematics, a successful preneed program can be developed to reliably predict success and take the mystery and magic out of the game of preneed.

Metrics Vs. Intuition

So where do we start? The most basic metrics of a successful preneed program can be distilled into a simple mathematical equation:

Actual Contracts divided by Actual Appointments = Close %
AC / AA = C%

This should be the launching point for the development of a simple formula to accurately predict the number of contracts a program can produce annually. All managers responsible for preneed programs should have a reliable way to accurately measure the closing percentage of each of their counsellors. Further, they should know their closing percentage for every type of lead. For example, the closing percentage for call-in and walk-in business should be over 80% whereas the closing percentage for a more challenging lead, like direct mail, will be significantly lower. When developing your program, this metric can be used to strategically apply human resources to the appropriate lead source.

Teamwork vs. Superstar

When developing a preneed team, many people are overlooked for a variety of perceived reasons: they’re too quiet, they aren’t motivated, funeral directors aren’t good at sales, etc. However, it is unrealistic to expect that one person can bring all of the necessary traits or skills to develop a successful preneed program. In the same way that the use of sabermetrics in Moneyball proved that a baseball team doesn’t need to have a superstar to win, the game of preneed doesn’t need to have a superstar seller to be successful.

Once you have figured out your closing percentage, you can safely estimate the number of appointments you need to book to reach your goals. This formula looks something like this:

Contract Goal divided by your Closing Percentage = Number of Required Appointments
#CG / C% = RA

This means that if you have an 80% closing percentage and your goal is to sell 200 contracts, you need to book 250 appointments to meet your goal.

Working backwards, you then need to know how many calls you need to make in order to book those 250 appointments. This can be tied to your call conversion percentage, which can be calculated by using the following formula:

Actual Calls divided by Actual Appointments Booked = Call Conversion Percentage
AC / AAB = CC%

If you make 100 calls that result in 15 appointments booked, your Call Conversion Percentage is 15%. If we tie this percentage to the previous example, where your number of required appointments was 250, this means that you’ll need to have 1,667 leads to call to meet your goal:

Required Appointments divided by Call Conversion Percentage = Required Lead Generation
RA / CCP = RLG

Each organization will generate leads differently, but the best way to build leads is to diversify your lead sources. Consider incorporating direct mail campaigns, social media, referral programs, group seminars and presentations into your marketing mix. You can even apply Moneyball-style formulas to calculate how many leads you’re generating and where they’re coming from.

Putting It All Together

Using these formulas, or designing your own, can reap huge benefits for your organization. Using a reliable and consistent approach will put an end to the “feast or famine” results that are often seen when working campaign to campaign. Year after year, your contracts and volume will stabilize and your success will become much more predictable.

For more information on how “hacking your process” can improve your preneed business and help the families you serve, check out my session “The Art (and Science!) of Creating a Successful Preneed Program” at this year’s CANA Preneed Summit!

 


Are you looking for more about creating a preneed strategy that makes a difference? The Art of Selling Cremation: A Preneed Summit is back for the second year to with a one-day intensive on today's pressing preneed topics. Join colleagues in Las Vegas on February 5th, 2019 – see the full schedule at www.cremationassociation.org/CANAheroes.


Heather Kiteley Heather Kiteley is the President of Guaranteed Funeral Deposits of Canada (GFD), bringing over 25 years of experience in the field to the largest organization for managing preneed funeral trust funds in Canada. Heather blends her unique background and experience together with a skilled team of professionals at GFD to provide members with a trusted resource to help ensure their preneed programs succeed.

 

Tags:  hr  preplanning  statistics  tips and tools 

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