End of Life Planning Part Three
What’s going to happen to your body once you’re dead? You’ve got options, my friend. Things to think about include organ donation and burial versus cremation.
Organ Donation
We all know about organ donation, but how much do we really know? What can be donated and in what circumstances, how might donation impact our funeral plans? Let’s dive into this so you can decide if organ donation is right for you. For clarification- I will only be discussing deceased donation but some of the resources I’ve provided at the bottom of this post include information on living donation as well.
What can be donated? Organs that can be donated include kidneys, liver, lungs, heart, pancreas, and intestines. In order for organs to be able to be used for donation, the individual must die under circumstances that allow blood and oxygen to continue flowing until the time that the organs are collected; this usually involves a fatal brain injury. If all efforts to save the patient fail and brain death is confirmed, then the donation process can begin. Several types of tissue can also be donated including heart valves, skin, bone, and tendons. Donation of tissue must begin within 24 hours of death, but the tissue can be processed and stored for longer periods of time if needed. Other things that can be donated include corneas. Cornea donation doesn’t require a match (all donors are universal); age, eye color, and eyesight also don’t factor in. These also can be recovered several hours after death and transplantation can be done 3-5 days later. There are some communicable diseases which can prevent someone from donating (think HIV, hepatitis). To learn more about cornea donation visit https://restoresight.org/. As of 2014, hands and faces are also able to be donated. This type of donation is known as vascularized composite allograft (VCA) organ transplants. If and when you sign up to be an organ, tissue, and eye donor it does not include VCA donation automatically unless you specifically list it.
If, instead of donating part of your body, you want to donate all of it- that’s an option. Like organ donation, willed body donation requires planning. The process will vary based on the program you donate to, but most programs will require pre-registration. The programs may send you a card to keep in your wallet which has contact information to be called in the event of your death. If you aren’t sure where you want to donate your body to, you can google “whole body donation” to find programs and more information on them to determine which is the best fit for you.
If organ donation (any or all of it) is something you want, you should discuss it with your loved ones, MPOA, and can even include it in your advance directive. This is the best way to ensure your wishes are carried out. It’s also important to note that organ, eye, and/or tissue donation does not necessarily prevent you from having the funeral arrangements you want, even if they include viewing (VCA donation is the most likely to impact these arrangements).
Funeral and Viewing
If you opt for a funeral, it isn’t as black and white as you might think. Do you want any or all of the ceremony and viewing to be at home? According to the Home Funeral Alliance, it’s legal in every state to keep or bring a body home for bathing, dressing, viewing, and ceremony. However, within that, there may be state-specific requirements (for example, in Arizona the body must be either embalmed or refrigerated after 24 hours). Speaking of embalming, do you want that? Embalming is the process of injecting fluids into the body to slow the decomposition process. This is an invasive procedure and comes at an added cost. There are specific circumstances where it may be required by law (these are rare) however, there may be funeral homes that will not do a viewing without embalming the body. If you don’t want to embalm you can see if there are funeral homes that will do viewings without it, do a home viewing, or do an immediate burial.
Burial and Cremation
If you opt for a burial, the main thing you’ll need to decide is what you’re buried in (in addition to embalming). There are traditional caskets that funeral homes offer, but you also have the option for other caskets; according to the FTC Funeral Rule “The funeral provider cannot refuse to handle a casket or urn you bought online, at a local casket store, or somewhere else — or charge you a fee to do it. The funeral home cannot require you to be there when the casket or urn is delivered to them.” You also potentially can use a burial shroud instead of a casket, which is a great option, especially for green funerals. There are many options available and I recommend looking at Undertaking LA for an idea of the various options (these may not be available everywhere, but it can give you an idea of options).
If you opt for cremation, you may have options depending on where you live. There is traditional heat cremation but in some states, water cremation (technically called alkaline hydrolysis) may be available. With heat cremation, the cremator is heated to 1400-2100 F to properly disintegrate the body; this takes 90 minutes to 2 hours on average. Once this process is done, the dry bone fragments must be pulverized to give what we know as cremains. With water cremation, water and lye are added to the pressure vessel and heated to around 320 F. After 4-6 hours (or longer, if this is done at low pressure) the body is broken down. Again, bone must be pulverized to get cremains. This is basically a sped-up version of what naturally happens to bodies after burial. If you have both options available to you, why pick one of the other? First, there may be a cost difference between the two types of cremation. If that isn’t a factor you may take into consideration environmental impacts. Compared to heat cremation, water cremation uses less energy, produces less carbon dioxide pollutants, and has no mercury emissions.
If you or a loved one is planning on cremation but you aren’t certain what to do with the cremains, stay tuned for a post with lots of options.