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Body Preparation Best Practices

Posted By Administration, Wednesday, June 26, 2019
Updated: Monday, June 24, 2019
Body Preparation Best Practices

 

This year at the CANA convention, I’m proud to cover a new topic on how we all serve our cremation families. As a group, we value the presence of the person and often encourage the family to see their loved one for not only identification purposes, but also because we know that the experience can be valuable in grief processing. We discuss this concept from a “front of the house” perspective often, but what does it mean to our prep room staff?

All of us who are in funeral service and caring for the dead are well aware that they come to us in various conditions. We also know that it is our job to observe these various conditions and prepare them in a way that is suitable for whatever disposition they are going to have. The industry term for preparation without embalming is “minimal care” however, that does not mean our efforts should be minimal. If we consider the most thorough method of preparation embalming, we can use it as our benchmark. However, not everyone gets embalmed, but that doesn’t mean that any preparation we do should not meet the highest level of care that embalming provides.

An Ethical Approach

Those of you who are reading this are likely embalmers (or know embalmers), so you are well aware that embalmers feel very strongly about giving the correct treatment to the deceased in their care. However, what does that actually mean, and how does it apply to preparing someone who is not going to be embalmed?

Cleanliness

The first step of any thorough embalming is to bathe the person. Not only do we do this for safety reasons, but also to conduct case analysis (see the next section), and have a better understanding of what we are dealing with.

Embalmers are sometimes told by institutional care staff, death investigators, and even sometimes the family that the condition of the body is worse than it actually is, and a thorough bathing can actually create more of a peace of mind rather than reveal problems.

During this phase, all medical devices should be removed whether the person is going to be viewed by their family or no one other than the person placing them in the cremation container. We do this for safety in the crematory, because some implants can explode or melt, but also because used medical devices are trash and should be disposed of properly. A reasonable embalmer removes all of the medical devices they can from a person before presenting them, and if this is our ethical standard of care, then this should be done regardless. You wouldn’t expect a person to be buried with garbage, in fact the idea is repulsive.

Case Analysis

One of the first things embalmers do when presented with a body is their case analysis. We observe the physical condition of the body in order to decide our strategy for fluid selection, feature setting, and dealing with any possible unknowns that may occur during the embalming such as swelling, purge, etc. But, if we are not embalming, what can we do? In this case, we still observe any pathological or other medical treatment outcomes this person may have. Medical devices should be removed and dealt with, and lesions should be treated appropriately with surface preservation (if allowed), sutured, or wrapped in bandages to prevent leakage.

Bedside Manner

By definition, embalming is always mutilation, which is one of the reasons we have to receive permission from the family before doing it. However, we embalmers bristle at this idea, because we are not in the business of mutilating people, we are preparing them for the most difficult event in a family’s life. We rectify this more negative perception by always minimizing the number of invasive procedures necessary, and we do so in a way that is careful and surgical.

Believe it or not, embalmers must have a bedside manner even though their patients have no idea how – or even that – they are being treated. We know how they are being treated. When we are preparing an individual who is not going to be embalmed, we always have to consider the technique we are using and recognize what is surgical and what is mutilation.

Further, perhaps one of the reasons a family is choosing not to have someone embalmed is because they do not recognize the care we put into it. Exceptional care of the deceased and proper bedside manner in any invasive procedure is not only ethical but respects the family’s wishes as well.

The Practical Approach

So now we have established three points on what to set our benchmark at when caring for an individual, but how do we apply this to a more practical manner? Presupposing compliance with all OSHA regulations and Universal and Standard Precautions, as well as observing the family’s wishes, providing minimal care does not mean compromising the quality of your care for their loved one.

To create a basis for our continued conversation on best practices of care, I have created an outline for you to consider. The outline described below is just that, an outline. This list is not meant to define limitations on best practices, but rather create marks on a spectrum.

Cleanliness

When it comes to embalming, the word “clean” is often used interchangeably with the word “disinfected.” So how does that apply here? Closely observing and cleaning the person often uncovers medical outcomes such as bedsores or fluid pockets that are the result of the ante mortem or post mortem settling of fluids. Furthermore, moving the body from one side to another will reveal possible purge that may have not been otherwise apparent when the person was lying supine. There are different levels of cleanliness that may be available based on what the family wishes and what is possible based on the condition of the body.

  1. Basic disinfection: Basic disinfection procedures should be taken regardless of whether or not a family is planning to view their loved one. This would include the removal of all medical devices and bandages, surface disinfection using a spray, and removal from a soiled container into a clean one.
  2. Mid-Level disinfection: This would include all of the above listed steps in addition to bathing the person, including washing their hair. Once the person has been thoroughly dried, it would also include the replacement of bandages over punctures from medical devices, and suturing of any surgical incisions. It would also include the draining of any fluid pockets that have formed. Orifices should be packed with cotton.
  3. Thorough disinfection: Thorough disinfection includes all of the above steps, but it would also allow for some chemical preservation. While it may not call for vascular injection of embalming fluids, there is the possibility of surface embalming of any lesions, treatment of drained fluid pockets, the chemical cauterization of any surgical incisions, and the chemical treatment of any artifacts of medical device removal. Cotton for packing orifices can be coated in a topical preservative.
Case Analysis

When preparing an individual at any level of service, we must consider the techniques we are using and ensure that they are appropriate based on family directions.

When caring for a loved one whose family has requested minimal care, we have to be sure not to be mired in our own hubris, but rather consider if our course of treatment is going to go well for our case. We must also consider our bedside manner matches the wishes of the family; are the procedures we are using in accordance with their wishes? If a family desires to view their loved one prior to disposition, but requests the least invasive techniques possible, do we understand what that means and are we able to execute that? For example, when closing the mouth in this situation, are you using a dental tie as opposed to a needle injector? Are you opting to use cotton to close the eyes as opposed to an eye cap? This is evaluated during case analysis and applied through bedside manner.

As funeral service purveyors, we are all very cognizant of the importance of the body and how it is honored. Just because a person has chosen not to be embalmed, does not mean we need to negate the philosophy of care that embalming entails. By observing these best practices, we can provide better customer service to our families in the assurance that their loved one will be cared for in a skilled and thoughtful manner.

 


Join embalmers and educators Damon de la Cruz, PhD and Ben Schmidt as they discuss best practices for preparing a decedent for identification, short term viewing, and cremation at CANA's 101st Cremation Innovation Convention. This lecture will include a discussion of safe handling procedures, the removal of medical devices, dressing, and cosmetizing deceased individuals. Ben and Damon will also differentiate between invasive and non-invasive procedures and the grey areas in between, sponsored by Ring Ring Marketing.

CANA's Annual Cremation Innovation Convention heads to Louisville, KY to bring together professionals across the funeral profession – funeral homes, cemeteries, crematories, cremation societies, and combos. Like CANA, Louisville celebrates a storied history even as it embraces its exhilarating future, making for the perfect pairing of location and association. Whether your thing is horse racing, whiskey, baseball, or shopping, you’ll find it in this charming city. Convention activities including social events, programming and exhibit time in the cremation innovation trade show merge seamlessly, keeping you on your toes and focused on the finish line.

Can’t join us? We’ll have recordings available so you don’t miss out on this amazing content.



Ben Schmidt

Ben Schmidt is an instructor at Worsham College of Mortuary Science where he teaches Embalming Theory and Lab, Restorative Art Theory and Lab, Funeral Directing, and Funeral Service History. In addition to his duties there, he is the co-creator of MorTraqr, a web application for tracking embalming and funeral directing tasks. Furthermore, he is co-author of the textbook Creating Natural Form; Restorative Art Theory and Application. Follow the creation of the textbook, the further developments of Mortraqr, and the antics of his two year old son on Instagram @mortraqr.

Tags:  body preparation  embalming  guest post  personalization  processes and procedures  tips and tools 

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Scattering Families: Will that be urn or plastic?

Posted By Administration, Wednesday, September 26, 2018
Updated: Thursday, September 20, 2018
Naming the Problem

 

The Cremation Logs presents the first in an occasional series featuring guest posts from industry experts. Cody Lopasky is the Associate Dean of Academics and Distance Education Coordinator at Commonwealth Institute of Funeral Service and teaches both face-to-face and online courses. Lopasky enjoys writing and academic research; especially in regard to funeral service. He has published numerous articles, written a continuing education course for funeral service practitioners, and was a contributor for a funeral service education textbook. He is also a licensed funeral director/embalmer and a certified crematory operator.


We may see a time when burial becomes the new cremation – something chosen by only a handful of families. This was the norm for cremation only a few short years ago, and the same could be coming for burial. The trend toward cremation is nothing new, but what are cremation families doing? And what are we offering cremation families to achieve their goals?

Cremation families who keep their loved one’s cremated remains on display at home are willing participants in selecting merchandise, but scattering families (or the undecided) present a situation that can be vexing for both you and the family. Without a firm plan in place, how can you effectively guide them to a decision that makes sense? Should they even buy an urn, and if so, what type and when?

Plastic is a Choice, Not a Default

When an urn is not purchased at time of arrangements, most families receive their loved one’s cremated remains in the plastic “temporary container.” This gray or black plastic box can be presented to a family in a velvet bag, but it is still nothing more than a plastic box. Many cremation families are offered a package that includes a “temporary urn.” They may not be shown an example of a temporary urn and may not realize it is a plastic box, but they know they don’t want an urn from the selection room. Offering a temporary urn in a package is a business decision made by the crematory or funeral home; normally due to cost or necessity. On the other hand, some forward-thinking businesses have chosen to provide a spun bronze or cultured marble base option that can be upgraded or personalized. However, the decision to stick with the bare bones (pun semi-intended) should not be made in haste.

Of course, the funeral home wants the scattering family to get an urn because it can help pay the bills for the month and it’s also a more dignified choice, but choosing an urn is often the best choice for the family, too.

  1. Before scattering, many families have a service of some kind to memorialize the deceased. If the cremated remains will be present for the service (e.g. a ceremonial scattering or memorial service), then a dull plastic box may not be the best option.
  2. A family can report that their loved one preferred scattering, but we all know that services and merchandise are for the living. The deceased is no longer here to care. So, when you hear the word “scattering,” do not automatically assume that the family understands what that entails or is choosing a plastic box over an urn. The voice of practicality will say that a simple and disposable plastic box is all that is needed without the knowledge that these can be difficult to open and are not always resealable.
  3. Remember that there should be some thought that goes into choosing the container that will hold what is left of a family’s loved one. This is especially true for scattering since the exact date and time of that event is normally set much later. In fact, internal industry research has shown that roughly 80% of families that say they will scatter have not done so by 5 years after the death occurred. This means that if the plastic box was chosen, then it will be sitting on a shelf for some time.

Urn Options as Solutions

If we assume that a family has not scattered before (yet is planning to scatter their loved one), then they may not fully grasp what is entailed. So you, the funeral director, are just the expert they need. For the scattering families that desire something a little more, there are actually quite a few options that can be presented, for example:

  • Asking a family where the scattering will take place is a great question with which to start. If they plan to do it on the water, then many suppliers and vendors now offer biodegradable urns that will actually float, sink, and/or disintegrate. Using one of these will keep the shore winds from blowing grandpa back onto the deck or into the crowd of family members.
  • If the urn is to be opened for scattering, then ease of entry will be of great importance to the family. That $1,200 piano wood urn may look pretty, but the family may not want to remove 6 screws and scratch up the bottom before they are able to scatter. A good rule of thumb is to show scattering families urns that can be opened easily. Screw-top and chest urns are great examples.
  • Most funeral homes do offer scattering urns, but they can have an inherent flaw that is unnoticed until the scattering occurs: What does the family do with it after they have scattered the cremated remains? This is an opportunity to present the features and benefits of different styles of urns for scattering.
    • A family may not realize it at the time, but the oblong, sliding-top box that they purchased has no purpose to serve after scattering.
    • The benefits of chest urns include attractiveness, utility, and (often) reasonable prices. Many chest urns either come with a plastic container already inside or they will fit the one from your crematory. Using these urns will allow the family to have a presentable container until scattering can take place, and then once it is empty, the chest can be used for a variety of other things, such as mementos of the deceased – old childhood photos, mom’s seashells, vacation matchbooks, dad’s army medals, etc.
    • Psychologically, the empty container can serve as a quasi-replacement for a grave or niche.
      • Obviously the two are quite different, but the positive benefits can be generalized to both. An urn (although empty) that held cremated remains is a tangible and physical reminder of a loved one. It’s an object around which survivors can reminisce and provides that missing link to the cremated remains which are now irretrievable.

An Opportunity for Education

In a world where cremation is taking over, we funeral directors need to change our thought process. The revered casket is now being replaced by the once-inglorious urn. Traditionally, picking out a casket was an integral and prominent part of the arrangement conference. This is now transitioning into the selection of an urn, temporary or permanent, for cremated remains. It is essentially the same concept (a vessel that will hold earthly remains) but on a much smaller scale and with nearly endless options. This is where a funeral director’s experienced advice can really be helpful. Scattering families (and those that are undecided but may scatter) often think that they do not need an urn. The passive funeral director will take this as a cue and move on without any more conversation on the topic. The active funeral director will discuss the options available to a scattering family and educate them so that they can make an informed decision.

Some client families may choose cremation because of the price, but that does not mean they want or need a plastic box – even scattering families. A funeral home’s operational success and sustainability will become reliant on the ability to properly offer and promote cremation merchandise and services. One area within the broad umbrella of cremation in which many funeral homes may fall short is with families who intend to scatter. It is easy to dismiss them as simply another family not getting an urn, and then, they in turn are led to that conclusion by the funeral director’s subtle cues and passive approach, but that is a missed opportunity. This is not simply about the bottom line but rather an opportunity to do what you do best – educate your client families and present appropriate options that meet their needs. If done correctly, this can make both sides of the arrangement conference happy.

Yes, some families will still go with the temporary container, but with proper guidance, the curse of the plastic box can be broken.


Cody LopaskyCody Lopasky has an M.A. in Psychology and History from the University of Houston-Victoria, a B.A. in Psychology from Texas State University-San Marcos, and he is an A.A.S. graduate with honors and distinction from Commonwealth Institute of Funeral Service. As a student at Commonwealth, Lopasky was a member of the National Funeral Service Honor Society. He is a Texas-licensed funeral director and embalmer as well as a certified crematory operator. Starting in high school, and continuing after licensure, Lopasky worked at Schmidt Funeral Home in Katy, TX. He was employed there as a funeral director and embalmer for several years before joining the education side of funeral service in 2016 when he accepted a full-time faculty position at Commonwealth Institute of Funeral Service. Currently, Lopasky is the Associate Dean of Academics and teaches both face-to-face and online courses. Lopasky enjoys writing and academic research; especially in regard to funeral service. He has published numerous articles, written a continuing education course for funeral service practitioners, and was a contributor for a funeral service education textbook.

Tags:  arranging  consumers  guest post  memorialization  tips and tools 

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