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What We Need to Know About End of Life Rituals Part II: Planning Ahead

Posted by Carla Cheatham on

March 29, 2017

What We Need to Know About End of Life Rituals Part II: Planning Ahead?

End of life rituals are important, but they are also a mystery to many. In this series, I’ll share the art and science of funerals, memorials, etc. to help lay persons planning for their own, or their loved ones, and professionals seeking to guide them.

There are two things I do not suffer from: brevity and long-range organization. I’m one of those who naturally enjoy working with the adrenaline of a deadline. For years, I scoffed at planning ahead, so it’s a grown-up skill I’ve gotten to learn along the way in my career. Honestly, I still have much to learn!

The importance of having one’s wishes known well ahead of a medical crisis cannot be overstated. Watching families caught off guard, uncertain what mom or dad, a sibling or spouse, would want for their end of life care is sad and frustrating. These wishes and decisions include what one wants to happen with their body after death.

Sometimes, it’s clear, as persons are very open with verbalizing their wishes. Thankfully, many take the important step of actually writing them down and/or pre-arranging with a funeral home or other agency. When folks’ desires are well-known, the relief their loved ones feel is abundantly clear. When arrangements have already been made, it’s that much better.

When a person dies, no matter how well-prepared we think we are, the emotional, mental, and physical stress catches just about everyone off guard. Trying to make decisions when our brains and hearts are trying to wrap themselves around the sudden absence of one we love and our pre-frontal cortex is shut down in distress is way too hard.

Far too often I see persons denied the necessary space to grieve because they are too busy navigating logistics. Again, when we’re hurting, we’re not thinking clearly. Making decisions on behalf of someone else, trying to please everyone and hack off no one, and plan a ritual that will help you, too, can be too much!

There is no reason to not make these plans ahead of time. So what exactly needs to be considered? I’ll write in more detail about each of these topics in the coming weeks, but here’s an initial checklist to get you started:

Burial, cremation, tissue or whole body donation? Persons range from having strongly held cultural, religious, ethical, and/or familial views about this topic to holding no opinion whatsoever. The options are many and often include considerations about financial resources, as well. Do you prefer to be buried in a cemetery or even buried at sea? Do you want a simple casket or a brass-handled coffin with a lined vault? What about being cremated and placed into a biodegradable urn that holds seeds and will grow into a tree? Want to donate organs or other tissues to those who need them or your whole body to scientific study and research? What can be a challenging list of questions during distress can be a really neat exploration of possibilities on your own or with those you love.

Pre-funeral, funeral, memorial, wake, etc.? The rituals we use to help us mark times of transition are as individual as the personalities of the ones who have died. There is far more freedom available regarding what type of service, if any, is held than most realize. Increasingly, we’re learning to not wait until the time of death to tell someone what they mean to us and, instead, folks are holding their own pre-funeral so they can enjoy the party. Some want a full funeral with all the bells and whistles while others want a simple private affair or nothing at all. There are a number of dynamics and needs to consider carefully here to meet the needs of all involved. Again, this conversation can be challenging, but a huge gift as you clarify for yourself and those you love what you want and how that can be balanced with what your loved ones need.

Service location? Again, we have more options than most realize when it comes to where a service will be held and/or where we will be interred. Home funerals and green burials are on the rise, while others want to be in their family plot in their hometown cemetery. Some want their cremains scattered in places they love, interred in the family plot at the cemetery, or kept on the mantle so they can stay connected to their family. I’ve done memorial services in Mexican restaurants, community gardens, and families’ back yards, simple graveside services with quiet military honors, and full-blown ceremonies with pipe organs and funeral sprays in huge funeral chapels. What works for your family’s unique circumstances, wants, and needs? The possibilities are endless.

Elements to include in the service? There is no one way to conduct a funeral or memorial service. Whatever your beliefs, or lack thereof, you have the right to say whether you want sacred texts read or songs sung, whether you want the Beatles or Elvis or a string quartet or the poetry of Keats or Mary Oliver. Should persons have a chance to say a few words or do you want to keep it short and sweet? Will anyone perform a eulogy? Do you want your (or your loved one’s) religion spoken of? You get to decide, and there are ways to honor what you want and what the various members of your family need. I’ll write more about how to do so later in this series. For now, please do not let anyone force upon you things that do not work for you or those you care about at your service.

Which officiant to choose? If you are part of a faith community, you may already have someone whom it feels appropriate to invite to lead your service. If not, funeral homes usually have a list of clergy or other officiants to recommend. Some are clear that your beliefs are to be honored in the service, while some may struggle to avoid the language and elements most familiar to them in their faith. Many clergy have experience in following exactly what you want and need without adding in his or her own particular spin. Secular officiants are also available to lead such ceremonies in many areas. Find what works for you, what feels best and, again, do not let anyone convince you that you have no options. This is for you and your loved ones. Find the person who will listen and learn and follow your lead all the way. I’ll say more about exactly how to find this person as our series continues.

I hope you’re finding information that is helpful to you in your practice or to share with those whom you work. I look forward to other thoughts or suggestions from you about things I may have missed, since this series of topics has tendrils of information and options I may have neglected to cover.

Together, we can make end of life rituals far less overwhelming and scary, and devise them in a way that brings maximum healing for the grief that comes when someone we love is no longer with us in physical form.

For what it’s worth.

Peace,

Carla

Rev. Carla Cheatham, MA, MDiv, PhD, TRT has served hospices as a chaplain and bereavement coordinator. She’s the Section Leader for the Spiritual Caregivers Section of the National Hospice and Palliative Care Organization and an adjunct professor at the Seminary of the Southwest. Through her Carla Cheatham Consulting Group, Carla provides training and consulting for professional caregivers nationwide. She is the author of Hospice Whispers: Stories of Life and its companion volume, Sharing Our Stories: A Hospice Whispers Grief Support Workbook. Her next book, On Showing Up with Suffering: Others’ and Our Own, is set to publish in 2017.

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What We Need to Know About End of Life Rituals Part I: The Why?

Posted by Carla Cheatham on

March 22, 2017

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What We Need to Know About End of Life Rituals Part I: The Why?

There are plenty of things you would NOT want me to do—your taxes, for instance, or even the minimal chemistry involved in helping your child with her 4^th grade science project—but one thing I will confess to being very good at is performing funerals. I literally have a list of persons who have claimed me in their wills, naming me to their loved ones as the only person allowed to bury them when the time comes.

It’s a bit of an odd claim to fame but, since it comes from those who’ve been to services I’ve conducted and have been so deeply touched by the experience that they want it shared with their friends and family, I accept it as tremendous honor. That they would trust those they love, when they are hurting the most, to the words and actions I use when conducting a ritual is humbling, and I do not take it lightly.

I teach others to lead rituals as part of the trainings I perform, and I’ll share some of those tips in the posts in this series. I’ll also be sharing suggestions for lay persons considering their own or their loved ones’ services, such as guidance for selecting an officiant and a space, choosing the content and tone of the service, navigating family dynamics (that don’t just magically go away during a crisis but often amplify), and much more.

In the lines that follow here, however, I want to make the case for the importance of ritual.

We use ritual all the time. “Hello” and “goodbye” are some of the ways we mark the transitions of beginnings and endings to conversations and other interactions. We celebrate birthdays and anniversaries to honor persons and relationships. We mark other rites of passage like graduations, marriages, births, retirements, etc. as a way of remembering and giving thanks for what was and preparing to look ahead to what is yet to come.

Being the youngest of my family, I only knew my grandparents in their later years, not long before their deaths, so I only knew one facet of them. I learned so much about my grandmother at her funeral from the stories of those who knew her at different stages of her life, and who knew her as something other than my grandmother. Some 25 years later, I still remember them, and they are dear to me.

She was an educator, earning her Master of Education in Northeast Texas in the late 1920’s, no small feat for a female. Grandmother started the first kindergarten in the small town where I was raised and taught elementary children for some 4 decades. I heard stories from those who knew her as friend, devoted member of civic organizations, beloved childhood teacher, massive fundraiser for cancer research, member of a faith community who mentored and encouraged young clergy, and so much more. It soothed me then, and does so now, to know these things about her.

Rituals do even more. They give our Westernized stiff upper lip a socially acceptable excuse to cry publicly without shame…well, actually there’s still plenty of shame around tears of grief, but we are less likely to get funny looks for doing the ugly cry at a funeral than we would at the groundbreaking for a shopping center.

We still fall into the trap of trying to rush each other’s grief by making people feel better or encouraging them to lean on their faith or find meaning in other ways with clichés and theologizing and platitudes. I’ve written a 7-part series through Hospice Times about our discomfort with grief that leads us to speak such well-intended but misguided words to ourselves and each other, so I won’t belabor the point here.

Suffice it to say that we need the time and space of rituals to give us room to grieve collectively and receive support without being shamed, squelched, or hurried up in any way. Grief experts have been rightly critical of the shift to celebrations of life at the time of death since we must not skip over ours, or others’, grief.

By contrast, most people state they do not want everyone crying over their coffin when they die and don’t want a somber event in their honor—they want a party! I believe the two are not mutually exclusive, and will speak to the way to balance these two needs in a later post as well.

We need to gather, give and receive support, share stories, give ourselves and each other permission to share our emotions, look back on what was and re-story a new relationship with the one who is no longer there. How we go about doing that is both an art and a science.

In the weeks that come, I’ll do my best to share what I know and explain what I do in a way that will support lay persons and professionals alike, starting with next week’s post about planning ahead. I hope it’s helpful.

For what it’s worth.

Peace,

Carla

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When the Tree Just Wont Come Down: Creatively Holding Onto Memories

Posted by Carla Cheatham on

February 15, 2017

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When the Tree Just Won’t Come Down: Creatively Holding Onto Memories

They got her home just in time for Christmas. It was her favorite holiday.

She loved nothing more than to see the decorations and lights glisten on the tree, with memories shaped like 5-year old’s handprints and sports figurines. Each one had a story, of the 42 years she had with him until 3 years before, and of their 4 kids and 8 grandkids.

My friend was exhausted from long weeks at the hospital until the doctors said it was time to go home with hospice care, but she was determined to get the tree up for her mom. She was too tired to say “no” when we showed up to help.

As her mom slept off the ambulance ride home in the next room, with a baby monitor on her bedside table, my friend directed us in putting together the tree, covering it with twinkling lights, and making sure the favorite ornaments were front and center.

The durable medical equipment company arrived and set up the oxygen unit and other equipment in the living room, with the hospital bed sitting in the middle of all the activity, directly facing the tree. After the nice young men left, we worked together to get her mom into the electric bed where she could be adjusted to both her comfort and that of those caring for her.

She was too weak to do more than smile at the dazzling display in front of her, but her eyes caressed each story hanging from metal hooks and yarn loops and glistened with love and pride for those whom she loved.

One last time, she enjoyed the sounds of her family’s laughter and delighted squeals ringing out over the crumpling paper and once-a-year songs and holiday specials. She absorbed all of this with her eyes now closed, lifting her nose to catch wafts of freshly popped corn, dressing, spiral-sliced ham, and pumpkin pies brought and shared around her by family and friends.

Three days later, more nice young me came in and carried her mom gently from her bed, as the family quietly wept and walked her out to the dark van.

The medical equipment and unused supplies were packed and moved. The bed went last. But the tree still stood.

“Not yet…”, my friend said.

“Not yet.”

“I just can’t.”

“I’m not ready.”

We understood.

Her beloved had an idea, and invited our help. From a box in the attic, construction paper hearts cut carefully by small pairs of stubbed scissors and two generations of tiny hands over the course of 40 years came down. Macaroni necklaces on red yarn, and other valentines, found their way to dangle amongst the twinkling lights of the tree.

We carefully wrapped Christmas on February 13^th, putting the boxes not too far away just in case this was too much, too soon.

When she came home, she stopped where her mother’s final bed had been, facing the tree. Too full of emotion to speak, her eyes caressed each story hanging from metal hooks and yarn loops and glistened with love and pride for the memories of the mom whom she loved.

“It’s perfect”, she said.

For a full year, family and friends in various groupings would come take part in this ritual of re-decorating the tree for holidays, anniversaries, and birthdays. With each one, there was more laughter, fewer tears.

The bitter never left, but there were fewer cracks left for it to dwell amongst the loving memories that kept her alive in and among them, glistening so vibrantly inside that the outside ornaments finally weren’t needed anymore.

The tree eventually went down after one more Valentine’s Day. They were ready. It was time. And it was all perfect.

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