Most people do not understand the death process until they are faced with the death of a loved one or they decide to plan their own estate. Decisions for death care have personal and financial impact and should be made with as much information as possible. This article summarizes the primary steps and decisions in the death care process.
The death care process is determined by both state statutes and instructions from the deceased (or next-of-kin). It starts with the issuance of the death certificate. This document is issued by the physician, medical examiner (or coroner) within a certain amount of time specified by state law. In some states, it may also be issued by a hospice nurse. In most states, it must be obtained prior to cremation. The death certificate needs to be filed with the local registrar within an amount of time specified by state law. Either next-of-kin or a funeral home (or mortuary) can obtain and file a death certificate.
Transporting and Disposition Permit
To transport the body of the deceased you are, in most states, required to have a permit. This document can typically only be obtained once the death certificate is issued. It is typically issued by the local registrar. It must often be filed with the state registrar. Some states also require that it be signed and submitted a second time after disposition. Either next-of-kin or a funeral home can obtain and file this permit.
Most states require that bodies be embalmed or cremated prior to transportation out of state.
The circumstance of death will determine where a body can be transported. If a death was expected, the body can be transported directly to the funeral home or to the crematory (except when a pacemaker or other implant exists). Anyone with a permit may transport the deceased but typically this is done by a funeral home. Some crematories may offer transportation. If a death was unexpected, the body will be transported to the coroner's office first. Transportation will be provided by the coroner's office. Note that coroners expect a body to go to a funeral home and may not adequately prepare the body for the family's viewing. As a result, the coroner should be advised of alternate plans in advance. A coroner may also be willing to remove a pacemaker or other implant.
Many states are now requiring a waiver to view a body that is not prepared by a funeral home. This is to protect them from liability due to shock at the state of the body. This is often the case for victims of accidents or violent death. Although "bodies" frequently appear on TV, this does not prepare people to see the body of a loved one that has had an accident.
Preservation and Preparation
Many states require a body to be preserved via embalming or refrigeration. No state requires embalming. Embalming is only done by funeral homes. Funeral homes and crematories have refrigeration. If cremation is planned, a physician or undertaker must remove any pacemaker prior to delivery to a crematorium. Preparing the deceased for any viewing is also typically done by funeral homes but sometimes done by next-of-kin.
Viewing and Service
Viewings are typically done at funeral homes although some religious institutions may allow it. If a viewing is done, the deceased must be preserved and prepared for viewing. Caskets can be rented from a funeral home for viewing or services if cremation is planned. Services may occur in either location, with or without a viewing. Even without a viewing, the deceased may be present in a closed casket. The deceased will need to be preserved at a funeral home prior to the viewing or service.
In many states, a physician or medical examiner must issue a cremation permit. In all states, authorization is required from next-of-kin. If a state has a standard cremation authorization form, individuals may pre-authorize their own cremation. Some crematories also require that next-of-kin attest to the identity of the body.
When the deceased bypasses the funeral home, it is referred to as "direct-cremation". This is possible when no viewing is planned and any pacemaker or implant has been removed. Any jewelry must be removed prior to cremation. Often, crematoriums or funeral homes will recommend where glasses can be donated to non-profit organizations.
Crematoriums offer cardboard containers for cremation. Funeral homes or next-of-kin can also deliver a casket to the crematorium. After cremation, ashes can be placed in a temporary container or a supplied urn. Any container can be used as an urn but many cemeteries or columbariums will require a sealed container. If no container is provided you will, most likely, be given a cardboard box with the contents sealed within a plastic bag. There may be an identification tag that is associated with the body to insure that you are receiving the ashes of your loved one attached to the container.
Deaths occurring on tribal lands or during pregnancy are subject to specific state statues.
A state's registrar can explain what, where and when documents need to be filed. State statues can also be found online: [http://www.state]..us. Ex. http://www.state.tx.us. When death occurs outside of normal business hours, many states allow judges or sheriffs to intercede and allow death care to proceed.
Summary of Death Care Process involving Cremation
If death was unexpected, contact the local coroner to retrieve the deceased. Otherwise, anticipate the following possible options.
If there will be a viewing or a service with the deceased present or if a pacemaker needs to be removed (i.e. a physician wasn't present), contact a funeral home to retrieve the deceased.
If not, arrange for transport to a crematorium through a mortuary or next-of-kin. Be sure to have a death certificate and transportation / disposition permit prior to transportation. Ensure that all cremation permits are complete. Be prepared to identify the deceased, provide a container to bear the ashes, and make arrangements to retrieve and place the ashes.
If a funeral home is handling the death, it can obtain and file both the death certificate and the transportation / disposition permit. Even if a funeral home is involved, next-of-kin can handle the arrangements. Remember that your loved one can be placed in your care and your decisions are able to be accommodated.
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