Finding the Right Help for YouNavigating the world of funeral planning and provider services is like learning a new language. There are many professionals and volunteers ready to assist you. Your job is to figure out what you want to have happen, what you can afford, and who you want to invite into your circle of helpers. For many of us, getting a crash course in funeral planning while we are bereaved is probably not going to lead to the most satisfying experience, so the more we can do to learn about who and what is involved ahead of time and make those contacts and plans, the better.
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Working with Medical Authorities
Depending on where or of what cause a person dies, different medical authorities will be in charge. Anticipated deaths in a hospital or care facility will be overseen by the Physician of Record who will be responsible for completing the medical portion of the death certificate stating cause of death. Some anticipated deaths that occur in the home when not on hospice service may be certified by the deceased's Primary Care Provider if he or she was actively providing medical care. Unanticipated deaths will be handled by the Medical Examiner (ME), called in by the police or paramedics who must be notified in this case. It is the ME's job to determine cause of death. Families may approach ME's with religious concerns regarding autopsy or other invasive procedures, but the decision rests with the ME. The body will be released back to the family after the determination is made. Informing Medical Examiners ahead of time when the family intends to conduct a home viewing is appreciated.
Even though a transportation permit is required for transferring the body to burial or cremation, there are hospitals and care facilities that are unfamiliar with Maryland families’ rights under the law. Because businesses can write their own policies, such institutions may have body release protocols in place that insist or imply that use of a funeral services company is required, or that transferring the body back home or to another location prior to disposition is perfectly legal. To address this barrier, see How Hospital Staff and Administrators Can Support Maryland Families in Caring for Their Own Dead and Sample Hospital Policy Language Regarding Removal of the Body.
Even though a transportation permit is required for transferring the body to burial or cremation, there are hospitals and care facilities that are unfamiliar with Maryland families’ rights under the law. Because businesses can write their own policies, such institutions may have body release protocols in place that insist or imply that use of a funeral services company is required, or that transferring the body back home or to another location prior to disposition is perfectly legal. To address this barrier, see How Hospital Staff and Administrators Can Support Maryland Families in Caring for Their Own Dead and Sample Hospital Policy Language Regarding Removal of the Body.
Working with Hospice
Hospice staff primary goals are to support the patient and their family during the dying time, though bereavement services may continue for 13 months after the death. When someone dies on hospice service in the home, the hospice nurse is notified to initiate the death certificate by signing the time of death before giving it to the physician of record to complete the cause of death.
The legal authority to custody and control of the body goes immediately to the next-of-kin, not to a funeral director or hospice nurse or medical staff unless body, organ or tissue donation is involved. Be sure to let hospice know well before the death occurs that you are planning to keep your loved one at home (or bring them to a home or community location from a facility) so they can help make the aftercare smooth for all. They may be unaware that there is no legal time limit in Maryland for how long families may keep their dead at home before final disposition.
Do not assume that the hospice nurse will continue to care for the body after death, though many are more than willing to help. At the point of attesting to the time of death, any further services, such as helping to bathe the body or hair, are offered on a voluntary basis by invitation of the family only.
The legal authority to custody and control of the body goes immediately to the next-of-kin, not to a funeral director or hospice nurse or medical staff unless body, organ or tissue donation is involved. Be sure to let hospice know well before the death occurs that you are planning to keep your loved one at home (or bring them to a home or community location from a facility) so they can help make the aftercare smooth for all. They may be unaware that there is no legal time limit in Maryland for how long families may keep their dead at home before final disposition.
Do not assume that the hospice nurse will continue to care for the body after death, though many are more than willing to help. At the point of attesting to the time of death, any further services, such as helping to bathe the body or hair, are offered on a voluntary basis by invitation of the family only.
Working with Funeral Directors
Standard Funeral Service or Cremation
Funeral directors, morticians, and crematory operators are licensed by the State to run establishments that deal with care of the dead. To prepare for an arrangement meeting with a funeral director, read What to Expect When Funeral Shopping. You can also see what funeral homes in Maryland charge by item on their General Price List on the 2018 Maryland Mortuary Price Survey.
The first item on the General Price List is a non-declinable fees and those bundled in a "direct or immediate" cremation or burial usually cover:
Blended Funerals
Home funeral families may choose to hire professionals to handle things that they find more complicated, such as managing shipping, completing paperwork, or transportation if an appropriate vehicle is not available. Feel free to exercise your rights as a consumer by shopping for what you are really looking for at a reasonable price.
Funeral Consumer Protection
If you have any complaints about your funeral service contract, and they can’t be resolved by talking with the owner or manager of the funeral home, consider contacting the non-profit Funeral Service Foundation for help with information, mediation and/or arbitration. The toll free number is 1-800-662-7666. You may also find support and information through the Funeral Consumer Alliance, a 30-year old nonprofit funeral consumer protection organization with affiliates throughout the country. You can file a formal complaint with the Maryland Board of Morticians and Funeral Directors.
Funeral directors, morticians, and crematory operators are licensed by the State to run establishments that deal with care of the dead. To prepare for an arrangement meeting with a funeral director, read What to Expect When Funeral Shopping. You can also see what funeral homes in Maryland charge by item on their General Price List on the 2018 Maryland Mortuary Price Survey.
The first item on the General Price List is a non-declinable fees and those bundled in a "direct or immediate" cremation or burial usually cover:
- filing death certificates; obtaining copies for the family;
- obtaining transit and burial permits;
- coordinating arrangements with the cemetery and crematory;
- filing for Social Security, veterans, and insurance benefits;
- overhead costs and charges for the arrangement conference;
- preparing notices and obituaries.
Blended Funerals
Home funeral families may choose to hire professionals to handle things that they find more complicated, such as managing shipping, completing paperwork, or transportation if an appropriate vehicle is not available. Feel free to exercise your rights as a consumer by shopping for what you are really looking for at a reasonable price.
Funeral Consumer Protection
If you have any complaints about your funeral service contract, and they can’t be resolved by talking with the owner or manager of the funeral home, consider contacting the non-profit Funeral Service Foundation for help with information, mediation and/or arbitration. The toll free number is 1-800-662-7666. You may also find support and information through the Funeral Consumer Alliance, a 30-year old nonprofit funeral consumer protection organization with affiliates throughout the country. You can file a formal complaint with the Maryland Board of Morticians and Funeral Directors.
Working with Cemetery Staff
Conventional cemeteries are generally accustomed to funeral directors educating their clients about the arrangements they will need to make directly with the cemetery. Purchase of a grave plot is usually handled privately between purchaser and the cemetery sexton, commissioners, or other cemetery representative, as is the setting of a marker. Outer burial vaults, if required, are purchased by the consumer from either the cemetery or a funeral home. Grave markers are typically purchased through the cemetery. When making arrangements directly with a cemetery, consumers generally have to be prepared to understand and/or initiate discussion about:
Green burial cemeteries often encourage direct contact with families making their own arrangements. They also encourage family participation and their staff will gladly assist you in creating a ceremony or supporting your plans. If you are engaging a funeral director to make cemetery appointments and arrangements for you, the process will be essentially the same as for conventional cemeteries. It is up to you in either case to know what you want and express that clearly to either the funeral director or cemetery representative. In turn, cemeteries operate under bylaws that dictate their policies and procedures, and some have specific guidelines for body preparation, container types, and how the mourners are to proceed on the property. A simple phone call or visit ahead of time will help with your planning.
- fees for opening and closing the grave and ongoing maintenance of the grave;
- arrangements for the purchase of an outer burial container (burial vault or liner), if required;
- opportunities to participate in processing with and lowering the body (by hand, if desired), and closing the grave;
- opportunities for other cemetery-based ceremony such as a graveside service, or use of other cemetery facilities. (Note: For burial in a military cemetery, typically veterans’ families are required to choose between either witnessed burial at the gravesite, or a short ceremony in a cemetery shelter. For more information on Military Burial, see How to Arrange Disposition.);
- arrangements for grave markers and other forms of cemetery-based memorialization.
Green burial cemeteries often encourage direct contact with families making their own arrangements. They also encourage family participation and their staff will gladly assist you in creating a ceremony or supporting your plans. If you are engaging a funeral director to make cemetery appointments and arrangements for you, the process will be essentially the same as for conventional cemeteries. It is up to you in either case to know what you want and express that clearly to either the funeral director or cemetery representative. In turn, cemeteries operate under bylaws that dictate their policies and procedures, and some have specific guidelines for body preparation, container types, and how the mourners are to proceed on the property. A simple phone call or visit ahead of time will help with your planning.
Working with Staff to Arrange Cremation
Most families work with funeral homes that have a crematory on site or subcontract with independent crematories, taking care of paperwork and liaising with the crematorium. Maryland families may make direct arrangements with any facility that offers cremation services if the facility is willing to accept the body directly. Whether making arrangements directly for a cremation, or arranging a cremation through a funeral director, consumers generally have to be prepared to understand and/or initiate discussion about some items that may have additional fees:
- who will complete and file the death certificate (a signed version of which constitutes the transportation permit), and obtain all necessary copies (See How to Complete Paperwork.);
- removal of materials such as a pacemaker or prosthetics;
- purchase of a combustible container for the cremation;
- picking up of the cremated ashes;
- opportunity to witness the cremation. (For more information on witnessing cremations, see How to Arrange Disposition.);
- planning of any funeral or memorial services (some crematoriums don’t allow for services);
- permanent resting place for the ashes, if desired.
Working with Home Funeral Guides and After-Death Care Educators
Home funeral guides are well versed in ways to assist families seeking to conduct funeral care in their own homes. Home funeral guides are:
- responsible for knowing the applicable policies and laws, procedures and protocols for the time from death to disposition;
- trained to guide families and others through logistics, ritual opportunities, community resources, local products and services, appropriate and safe body care, ceremony design, home preparation, and much more;
- not allowed to charge for any service a funeral director is required to have a license to do. The next-of-kin is legally in charge of care and may ask others for assistance;
- may be paid or may volunteer their time. Any payments to home funeral guides are for educational and consultative services and not for funeral practitioner services that require a license;
- not certified because there is no certifying body regulating home funeral guides. Many learn their trade by taking trainings and some have learned by doing.
Working with End-of-Life Doulas
End-of-life doulas (EOLDs) seek to make the act of living out final days in familiar, loving surroundings more feasible for the dying and their caregivers, whether or not they engage hospice services. End-of-life doulas:
(To locate an end-of-life doula near you, go to the National End-of-Life Doula Alliance directories.)
- provide non-medical, non-judgmental support to individuals and families through education and guidance, sometimes including practical, emotional, and spiritual care;
- nurture, inform, support, guide, empower and comfort;
- provide assistance with life review, legacy work, and deathbed vigil planning when requested;
- actively seek to complement medical services, including hospice, by being available during peak need hours for extended periods as needed. EOLDs often work closely with hospice personnel to support the hospice plan of care;
- are hired by the family privately;
- are not certified as there is no certifying body regulating end-of-life doulas (see NEDA Certification Description). Many learn their trade by taking trainings and some have learned through service in their communities;
- paid responsibilities typically end when the patient dies unless they are prepared to follow the guidelines for home funeral guides, as after-death care is regulated by the funeral profession;
- may offer ongoing emotional or practical support outside of after-death care arrangements.
(To locate an end-of-life doula near you, go to the National End-of-Life Doula Alliance directories.)
Working with Clergy and Celebrants
Ordained Clergy
Depending on the tenets of your faith, the role of clergy is to support the family planning and officiating a ceremony. Ordained clergy are trained to design and perform services, and arrange date and time for use of facilities if you are planning a service in their house of worship. Most clergy accept honorariums anywhere between $150 and $300, though a frank discussion is appreciated. If arranging the ceremony through a funeral home, they may offer to schedule a retired clergyperson and include the clergy fee as a “cash advance” item on the purchase agreement.
Celebrants
The role of a celebrant is to assist the family in preparing a ceremony that tells the story of the deceased's life. Celebrants are trained in how to design ritual and ceremony that is appropriate for secular, atheist, agnostic, and spiritual but not organized religion, as well as most religious traditions. Increasingly, funeral homes are training staff members to serve as Celebrants; fees for their services are included in their General Price List. Some religious congregations use laypeople as Celebrants, available to congregants at no charge or by gratuity. Other community-based Celebrants are independent ceremony specialists, charging a flat fee or a sliding scale payment plan.
(To learn more, see How to Create Ceremony.)
Depending on the tenets of your faith, the role of clergy is to support the family planning and officiating a ceremony. Ordained clergy are trained to design and perform services, and arrange date and time for use of facilities if you are planning a service in their house of worship. Most clergy accept honorariums anywhere between $150 and $300, though a frank discussion is appreciated. If arranging the ceremony through a funeral home, they may offer to schedule a retired clergyperson and include the clergy fee as a “cash advance” item on the purchase agreement.
Celebrants
The role of a celebrant is to assist the family in preparing a ceremony that tells the story of the deceased's life. Celebrants are trained in how to design ritual and ceremony that is appropriate for secular, atheist, agnostic, and spiritual but not organized religion, as well as most religious traditions. Increasingly, funeral homes are training staff members to serve as Celebrants; fees for their services are included in their General Price List. Some religious congregations use laypeople as Celebrants, available to congregants at no charge or by gratuity. Other community-based Celebrants are independent ceremony specialists, charging a flat fee or a sliding scale payment plan.
(To learn more, see How to Create Ceremony.)
Resources and Online Links
Maryland Funeral Resources and Education is a non-commercial public interest site dedicated to helping Maryland consumers care for their own dead with or without the assistance of a funeral director. All rights reserved © FuneralPartnership.org
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