Redesigning the End

“There’s a psychological block going on here because the death word is hanging around our head. And that deranges us and shuts our rationality off and opens up our emotions. So we think we’re thinking, but we’re not, we’re just feeling.” Joshua Slocum Executive Director, Funeral Consumers Alliance I’m excited for you to meet Joshua Slocum, the Executive Director of the Funeral Consumers Alliance (FCA), a nonprofit dedicated to education and advocacy surrounding funeral consumer rights. The Funeral Consumers Alliance exists to help people make good decisions about funerals and the tools on their website are there for you when you need them. This episode highlights some of my conversation with Josh. Below is a transcript of the conversation with even more great information about how to buy a funeral. Thanks as always to Pat Cupples and Hotels & Highways for the use of your original music. Photo: from the movie “The Big Lebowski” Free Course: "How to Host a Virtual Funeral" FULL TRANSCRIPT (Recorded on 2/22/22) Joshua Slocum, Funeral Consumers Alliance Brian Hayden, Redesigning the End Joshua: I’m Josh Slocum, I’m executive director of Funeral Consumers Alliance. We’re a nonprofit – think of us like we were the consumer reports of funerals. So we try to help people understand what their options are, what their legal rights. And how to plan a funeral. And I use that term expansively means anything that can be done with the dead body. So it could mean cremation only. It could mean body donation. When I use the term funeral, help people plan and arrangement a funeral that meets their emotional needs, but also meet their budget. Because money is one of the biggest factors that causes people dissatisfaction and funerals. And I got into the work because I used to be a newspaper reporter. And I did some research on the funeral industry a couple of decades ago for a feature story. And, and what I uncovered was so disturbing to me in terms of how consumers were mistreated and how much collusion there was between state regulators and industry lobbying bodies that. you know, I got in contact with this organization, funeral consumers Alliance, and that turned into a job. So that’s how I got here. Brian: Great. Why does the Funeral Consumers Alliance exists? What’s the role that your organization plays and, and who do you serve? Joshua: We serve the general public. Anyone who wants information, needs information on how to plan a funeral affordably. That’s what we’re here for. We try to act as a voice for consumers in public policy discussions might be legislation might be regulations that affect the well-being of grieving people in the funeral, transaction, buying cemetery, property buying funeral. Because consumers need a voice in that arena as well. And there are already industry trade associations that speak for funeral directors. So we try to speak for consumers. So an example of big picture stuff that we do, our organization was heavily involved, many decades ago in helping get passed. What’s called the funeral rule, which is a set of regulations that federal trade commission that give consumers specific rights when arranging a funeral. And today we are pressuring the Federal Trade Commission to strengthen the rule, to bring it into the 21st century. So for example, the funeral rule requires funeral homes to hand people, paper priceless so that they can see what they’re buying. First. We want the FTC to require those price lists to be published online, to meet shoppers, where they shop and the way they shop in 2022. Brian: So how should I shop for a funeral? Joshua: Well, let me take it two ways. Let me, let me give you two scenarios here. I’m going to give you the, the, my recommended best case scenario. For how, how to make it as smooth as possible. And then I’ll walk through the acute scenario where you’ve done no planning at all, or what do you do in that situation? So, what I’m about to describe is the best case scenario. Most people do not do this, they should, but they don’t. We have a hard time with arranging funerals because, on a very basic level, many Americans don’t believe they’re going to die, or if they believe it, they want to live in denial about it. and people find that a little funny. Well, we know everyone’s going to die. Yeah. I know you say that, you know that, but your actions betrayed that you don’t. I understand that psychology of people planning, funerals, and I know what lies we tell ourselves, and we tell ourselves a lot of lies. the first lie that you need to get over is the death is an optional lifestyle choice that might not be right for your family. the undertaker is going to knock on your door. The best way to do this is to have a family conversation and by family, I mean that expansively, whoever your circle is, whether it is by kin by blood or by choice. talk about what is important and meaningful to you as a group, when someone dies in terms of ritual, in terms of body disposition, whether it’s cremation, burial, anatomical donation, something different. Talk about that. At the beginning, I suggest set a reasonable budget. What here, here’s the entire trick to what I do. Everything I can tell you, you already know how to do. I’m not going to give you any new information that you don’t already know. You just don’t think you know it. So for example, people call up and say, well, I can’t afford the $8,000 that Johnson funeral home said this was going to cost, but I don’t know what. No one says, I don’t know what to do when they can’t afford the car at heritage Toyota, they don’t say, I don’t know what to do. They say I’m going to call the next car dealer and see if he has a model that fits my needs. That is within my budget. That’s, this is it’s really basic. You just got to hook up the things that you already know. There’s a psychological block going on here because the death word is hanging around our head. And that derange is us at shuts our rationality off and opens up our emotions. So we think we’re thinking, but we’re not, we’re just feeling right. Set a reasonable budget, just like you would set a budget for the amount that you can spend on a house, just like you would set a budget for the top amount. You are willing to spend on a car or on a new set of kitchen appliances or whatever, set that budget, make that budget realistic to what you can afford. Then you know what your options are going to be. If you don’t set that budget, the undertaker will set it for you and you may find yourself. Feeling guilty, feeling guilted into signing a contract that is beyond your means. we don’t want to see that happen. when you have that family conversation, I used to tell people, tell your kids what you want. I don’t say that. because I no longer believe in dictates from beyond the grave. I find it far more helpful to ask your survivors what will be meaningful and practically doable for them, because remember they will be alive, and if you want them to do things, you need to take their needs into account too. Because as much as it’s your funeral, guess what has nothing to do with you because you’re dead. You don’t know what’s going on. Other people are doing all these. And they’re experiencing grief while you are not because you’re dead. So what will be meaningful to them? Will they want to religious ceremony? Will they not want one? Will they want to viewing of the body? Will they not? How are the family’s finances set up, have that conversation when you can come to a consensus? Start your shopping around and start by knowing what your options are. We have a lot of free [email protected]. Under the consumer tab, it’s organized by things, categories like caskets, cremation, burials, cemetery purchases, legal rights, learn your legal rights, real basic ones. Just to remember, number one, you have the right as the customer to buy only what you want at the funeral home. There’s no such thing as a required all-inclusive package. You can buy a package, but you don’t have to, you can say yes or no to every individual item. Yes or no to embalming. Yes or no to viewing of the body. Yes or no, to a, a grave site, middle ceremony all the way through number two, all funeral homes by law. I must give you price quotes by phone. that’s a second best option. I’m going to use it in the emergency scenario, but I’m going to move away from it here because it’s not your first. Your first and best option first, see if there’s a funeral consumers Alliance, local group near you look on our website. If there is look at their website, because almost all of them have done a cost comparison survey of funeral homes in your area. So you can see who’s charging how much for simple cremation, how much is a full service traditional funeral. That can give you a real good headstart, but many of you will not be in an area where there is such a price survey. So that means you’re going to be doing this on your own. And again, it’s not magic. You’ve done it for every other major purchase. You simply start canvasing prices and services at other funeral homes, I suggest picking at least four or five within a 30 mile radius of where your. give them a call, send them an email. right now the manure only the minority of funeral homes will actually post their complete prices online. So check their site first, but don’t expect that you’re going to be able to do your, all your shot. That’s why we’re pressuring the federal government to make them do it. If you don’t find that, give him a call or send him an email, tell them that your family is, is doing funeral planning and you would like a copy of their complete price and service list. Everything they offer. Could they please send that to you? Any decent funeral home will do that. those who refuse to do that have, have done you a favor, cross them right off your list. You don’t want to do business from somebody who doesn’t want to show you what their prices are. Once you have those, compare them to. You know, look at what a direct cremation costs at Johnson’s versus McGillicuddy versus whoever else it is, or you’re your full service traditional funeral. you will find in most cases there’s a significant price difference between funeral homes, all in your city. Most people choose a funeral home in a way that will not. It will not, it’s not, it’s not in their best interest. Most people say we use this funeral home because my family has always used this funeral home. So what, what does that mean? What it means it, and it may be a very fine funeral home. They may have given you the kind of service you wanted every time. Absolutely fine. But since you’ve never compared costs, you have no idea. If you’ve been paying a good rate in your town, if you’ve been paying the highest possible rate, you don’t know where you are. So shop around that may open your eyes, Brian: Going back to the conversation piece,do you have guidelines, guidelines for like what to talk about or like, I bet a lot of people don’t even know what is possible or what the options are. Where do I go for the F for understanding like sort of the parameters of that conversation. Joshua: Well, I would say again, check our consumer section of the website. all the free articles on there are, nested under alphabetically listed categories, caskets, cremation, financing, body donation, green burial – a lot of that, a lot of those ideas can come from from resources like that. Generally speaking. I mean, there, there are a lot of options, but in the real world, right? Not the media trends story world where everybody’s getting a green burial and being turned into a tree. No, they’re not. Some people are. But where the rubber hits the road, the, the main choices that people end up making are cemetery, burial green, or not cremation. Or anatomical donation to science. There are, there are some states where there are new options, like a process called alkaline hydrolysis, which is dissolving the body in a, in a base solution that breaks the tissue down. Some people call it flameless, cremation, six and one half dozen of the other, you know? And here’s the thing about all of these options you end up just as. No matter where you go. Right? So, I think people may be more concerned about, well, you’ve got to, you know, you have to pick what the physical disposition of the body is going to be, but then you can have a conversation about what, if any ceremonial gathering you want to have, that can be religious in nature. Joshua: It can be secular. It can be. It can be a catered meal. It can be a potluck meal at home, or at church, you can have a Memorial service that is not held at a funeral home. but that is held at a park or at a restaurant banquet room or at your social hall or the VFW. There’s all sorts of places. You can have a Memorial service you’ll want to decide. Is this something that we as a family, want to organize and carry out ourselves? Or do we want to hire a funeral home? To do this planning and carry this out for us. Those are the kinds of things you would have in that conversation. Brian: I thought it was really interesting what you said about the, the people that are, that aren’t dead are the ones who it should be, what they want. I think that that’s, that really resonates for me as I’ve been kind of like getting into this work more recently and I’ve been really excited about green burials. It’s like, great that I’m interested in that, but like, that’s a big ask for somebody else. Joshua: I think we forget that, you know, it’s not that most people are cruel or that they don’t love their family. It is, there are some people like that. and I’ve been on the phone with them. It’s that this is an emotionally difficult conversation and we tend to shut down and go in sort of, we tried these well trodden, stereotypical routes emotionally, too, to stay away from the reality of the topic. So I think that people forget they’re so wrapped up. Here’s here’s the secret, right? A lot of times when we’re doing funeral planning, we’re trying to get a bad thing. and we want to soften it. And so we want to get it done as quickly as possible. We don’t want to talk about details. We want to say general things. Like I just want a nice church service. That doesn’t mean anything. That means absolutely nothing. I have no idea what a nice church service means. You have to say what that means to your family. but I’ve seen so many people. Who most people don’t have the specific conversation and the level of guilt that survivors can carry. Because the last thing dad said was, I don’t care what you guys do. I just want to make sure I’m buried by your mother. Now. That sounds fine. But what happens to the family when mom is buried in Lewiston, Maine, where the family used to live, but no one’s lived there for 30 years and dad dies in Portland or. Does that mean that, that now the family needs to pay the cost of transporting that embalmed body in a casket, in an airplane, across the country to a cemetery that nobody visits because no one lives on that coast anymore. Right? These things are real practical things that come up. That’s why detail is important. And I suggest I, well, I can’t make people do anything, but when I refreshed my funeral plan, In writing and in conversation with my family, when I had an unexpected heart attack in my thirties, that’s when I really changed my mind about this stuff. And I realized, you know, I can tell them all these things that I want, but I’m not even going to be here. You know, what about the. So what I decided to say and what I wrote down to back it up with was you guys know what my values are. You know what my interests are, you know, that I don’t want you to be ripped off unnecessarily in a funeral transaction, but I don’t want to control what you do. I’m not religious. I don’t have any spiritual beliefs, but some of you do you need to have a religious funeral with me, have a religious funeral. You know, I don’t like embalming. I think it’s kind of. But if that is the practical choice that you need to make to satisfy the needs of the people who are there, go ahead and do it because I’m not there anymore. I care about you getting what you need without going bankrupt. That’s all I actually care about. So please feel free to meet your own emotional needs. Brian: So, all right. I have the conversation we shop online. Or, you know, we just, we do shopping at home. We’re getting ahead of it. We’re doing things that, you know, the optimal way, what’s the benefit of pre-buying versus just kind of like having the plan in place, you know, w where do you fall on that? I am largely against it. I don’t think there is much of an advantage to buying your funeral services at a time. Why this is more complicated than we can do in an, in an introductory podcast. But, we, we could revisit prepaying later if you wanted to, prepaying doesn’t take care of everything. what happens if you no longer live near the funeral home that you prepaid? Joshua: What if you move to another state? What if you are on the other side of the country, but you pre-bought a bunch of graves, will it really be the savings that you hoped it was if you have to transport caskets in a 7 47, right? also I find that, well, people are, they often do this because they get taken in by this we’ll lock in today’s prices. Funeral prices are going up. Well, milk prices go up. Gasoline prices go up. Home prices go up, but we don’t run out and say, let me, pre-buy a car in case I need one, you lose certain things in exchange for that price guarantee. So I’ll give you a, I’ll give you a concrete example. Say that what the funeral you want is $5,000. If you were to die today, that funeral would cost you $5,000 and you say, that’s the funeral I want, but I’m at dead today. So I’m going to prepay for it. So I don’t have to ever spend more than $5,000. So. But the, the terms of the contract say that the funeral home is obligated to give you that funeral you prepaid for, even if their prices have gone higher than what you paid. But there’s a flip side to that. And the flip side is if the funeral prices have not risen very much, but the money that’s been building up the interest in your trust account, if that’s more than the funeral costs at the time of death, the funeral home gets all that over. So you actually ended up paying more because you denied yourself all that interest money that would have accrued in your bank account or your financial instrument. So there is a plus and a minus to it. we generally say. It may be a good idea to prepay if you need to do that, because you’re going on Medicaid for nursing care, and you need to spend your own money first on approved items before you qualify. Funerals are one of those things. But for people who want to consider this more deeply, check out the prepayment topic on our website, and there’s a longer list of things to consider before you do that. Brian: Okay. So we talked about the best case. Now let’s talk about the worst case. Joshua: Okay, worst case scenario, nobody talked about anything. Death happened really unexpectedly, somebody dead in the hospital. What do you do? First things first, don’t call a funeral home at two in the morning. Have the body taken out of the hospital by definition, the death itself means the emergency is over. There is no emergency here anymore. It’s amazing to me. but people treat death as the initiation of the emergency phase, right. They associate lights and siren. For what? For what? The worst thing that could ever have happened to that person just happened. They’re dead. Yeah. It’s sad. It’s shocking. But no, nothing worse can happen. The worst things you did it, you were already past it. So don’t just call a funeral home right away. To get the body out of the hospital. Nothing’s going to happen to the body. You won’t get any more debt. If the hospital has, space in there more to store the body, ask them, this can give you a couple of days to make a wiser decision. next set somebody to the. Of calling funeral homes on the phone or five of them, and get a price quote on a couple of things like simple direct cremation, a couple other things like full sir. I mean, it depends on what you want. Right. It’s hard to do this on the phone because there’s a lot of components to this and you won’t know all the questions to ask. It’s much easier to see it in writing, but you can start doing it that way. And for example, if you call a funeral, If you call five funeral homes and say, what’s your cost for a simple, direct cremation, you’ll usually get a price range of somewhere from 900 to $2,500, but sometimes much higher than 2,500. So now you see that there’s a huge difference. It’s more than twice the difference between these two funeral homes for exactly the same nose. No froze cremation. Somebody who’s got a reasonable price on that is probably going to have more reasonable prices on the more full service options as well. That may help you narrow it down. And again, ask that funeral and tell them, you know, listen, we’ve got to make some decisions. I’m not going to make this decision over the phone with you right now, but we’re going to have to make it soon. Will you please email me, text me whatever it is you do. Send me a copy of your price and service list, please. And then you can start making those comparisons. Brian: Hey, one of the questions I’ve been thinking about is, you know, if, if you want help from a professional with this process, And are open to paying that person, but you wanted to decouple them from, a funeral home. What does that, what does that look like? What is that person called? What are they allowed to do? Joshua: I’m of two minds on this. Okay. Because what you’re describing is a concept that some people call a funeral concierge. Right. I don’t like this. Why don’t I like it? You mean to tell me that we need to introduce another third party paid professional into this relationship in order for us to accomplish something? This to me, this, okay, don’t go off on this tangent, Josh, this. This is symptomatic to me of much larger problems in American culture that are not funeral industry specific. We have been trained to be such passive consumers that we can’t find our way out of a paper bag without calling up a professional paper bag, escaped consulting company, to tell us how to walk out of a paper bag. Okay. We are a country that uses the term wedding planner on ironically. Yeah, I know. I know it’s funny because it’s normal now. No, it isn’t. It only got normal 15 years ago when people decided they wanted to make more money off your wedding. You D you don’t need a college degree to do this, and you certainly don’t need a third party professional. That’s that’s my one. That’s my I’m against I’ll go on the other side. People do need guidance. That’s why we exist, right? We wouldn’t be here if people didn’t need. Information, my worry with the consultant side of it is I, my goal and our goal in FCA. I don’t want to plan your funeral for you. That’s not my job. Even if I were capable of doing it, I would refuse to do it. I want to teach you how to help yourself. That’s what I’m interested in. if you want somebody to hold your hand and do it for you, that’s not me. you can do this and you will feel better when you do make these choices. If it is worth it to you to pay a couple hundred bucks to somebody that, that you think is trustworthy and it, you think will have your best interests at heart, I’m not going to try and stop you from doing that. I would suggest though, have some confidence in yourself and do some of your own research. I obviously I sound biased. Cause I keep saying, come look at our website or talk to your local funeral consumers Alliance. But the reality is we don’t have anything to sell you. I’m not gonna make money. If you call me, or consultant other nonprofit organization, consumer checkbook is a great resource for this as well. now, they do some of the best work outs. Our organization is specifically dedicated only to the funeral and death question. Consumer checkbook is much broader, but they’ve done really careful detailed research into this and their, their advice is also trustworthy. Brian: COVID sort of forced everybody to think about virtual celebrations. So, I’m wondering, you know, and, and to some extent, you know, I think as COVID ebbs, you know, like we’ll see some of that recede into the background, but maybe there’s some components that we view as positive and might be more lasting. Are you seeing funeral homes offer these services? How are you seeing them priced? Is there like a best practice or do you have any thoughts about where that’s headed and how it might fit into kind of like the conversation people have and the way they should. Joshua: Yeah. Okay. So, streamed services for virtual services? Yes. There was a big uptake in that, when people were not willing or able to travel, and gather at funeral homes, I believe I just read an industry article that said. At the beginning of the pandemic, perhaps about 25% of funeral homes had offered streaming services. And now it’s closer to 50%. I think those are ballparks. That doesn’t surprise me. What do I think is going to happen? Can’t predict. But I think one of the things that people really felt that they lost during these past two. Was the most important part of the funeral, which is being in the same room with people who are hugging you and passing the mashed potatoes and sharing stories and handing you a tissue and having physical fellowship and companionship with people. They want to go back to that. Virtual is a next best thing, and it’s, it’s wonderful if you can’t be there and you want to be there in some way with people, but it’s not, it’s, it’s not good enough. It’s not a replacement for, for real, what. I think there always be a place for it. And I think that people, especially like people who can’t travel, you know, marry the very elderly in your family who can’t come back for a funeral, really appreciate being able to, to hear and see what’s going on there maybe to talk to people. So I think, you know, I could see, you know, I, I could see using that for a death in my family. If there were a. You know, if there were relatives in far-flung corners, you know, I might consider saying, Hey, could we stream this too so that they could be part of it? I think it’ll be a useful adjunct, for those who value a gathering in-person I don’t think it will replace it. Brian: How are you seeing those services priced? Joshua: I’ll be honest with you. I haven’t paid much attention, because it’s, it’s not going to be the largest part of. The funeral costs. I mean, I’ve seen prices from some funeral homes will include a courtesy stream at no extra charge. Some of them will charge a couple hundred bucks for it. others may charge more than a couple hundred bucks if it requires them actually getting a bunch of cameras or phones out on tripods with microphones at a grave site. If you’ve got to do video production set up, it’s going to cost a little bit more. I haven’t paid attention to the pricing on that because as a consumer advocate, it does not strike me as one of those things that is likely to be a generator of abusive complaints of, of, pricing and such. Joshua: So, and it’s so new. That I don’t yet have a sense of what I would like. I can tell you what I think a fair profit margin price for direct cremation is, but I can’t tell you what I think it is for a streaming funeral. Cause remember that’s, that’s the smallest part of it that in the real physical world, they’re still preparing a body. They’re still transporting a body. There’s still a burial or cremation. Those are the things that really cost the money. Brian: What are the biggest complaints that you, that you get? Joshua: Confusion over pricing is one of the biggest ones. People feeling that they have been overcharged. Sometimes they have been overcharged. sometimes, they haven’t been overcharged, everything was disclosed. They’re just unhappy with the price. you know, and again, this isn’t a criticism of consumers, but sometimes inspires remorse and sometimes the people they’re really upset with themselves for not having shopped around. Right. A lot, a large number of complaints about prepaid funerals because of a misunderstanding among the survivors about what mom and dad or grandma actually bought versus what’s on the paper contract. and honestly of the complaints we get about prepaid funerals, my estimate is. Perhaps a quarter of those complaints are legitimate complaints that indicate that the funeral home did break the contract or, or did do something wrong. But 75% of them are from misunderstanding. They’re not that somebody was a bad actor. It’s a miscommunication. Brian: I feel like this is great. Anything else? Joshua: We could, we can talk about this forever and ever you get into all sorts of abstracts details and if you ever want to play that, we can do that on other topics, but I think that’s a good, that’s a good general introduction to how to think about this. “Just because we’re bereaved doesn’t make us saps!” John Goodman as Walter Sobchak From the Movie "The Big Lebowski"

PACE: Program for All-Inclusive Care for the Elderly “This [PACE] is what kind of program I want to work in. This is what is needed.” Sonja Felton Executive Director, Huron Valley PACE This is an episode about a program that helps caregivers. I recently learned about a program that more people should know about. It’s called PACE: Program for All Inclusicve Care for the Elderly. PACE (Program of All-Inclusive Care for the Elderly) is a unique health plan and care provider, committed to keeping aging adults with challenging healthcare conditions in their home, by caring for their medical, physical and social needs. Caregivers describe PACE as a massive relief – 97% who use it recommend it to others.  People I interviewed about PACE love PACE. It reminds me of the way people talk about hospice. They love it and are so grateful to have found the program. In both cases I think what they love is the coordination of care. The fact that everyone communicates and it isn’t the caregivers job to be the lonely hub of communication for everything. The typical PACE participant is similar to the average nursing home resident. The typical participant is an 80-year-old woman with eight medical conditions and limitations in three activities of daily living. Nearly half (49 percent) of PACE participants have been diagnosed with dementia. Despite a high level of care needs, more than 90 percent of PACE participants are able to continue to live in their community. https://www.npaonline.org/policy-advocacy/value-pace Free Course: "Estate Planning for Aging Parents" Cindy Pierce: Author, Storyteller, Inn-Keeper, Caregiver “Everyone talks a big game about aging in place. I love the idea, but why it worked for previous generations is because usually the mom was not working and at home taking care of kids. And then the kids could take care of themselves, so she took care of the aging parent. We’re both working. Our kids are off doing all sorts of things – like, we’re not around at home.” Cindy Pierce Cindy Pierce is the funniest person I know. In this podcast episode about caregiving and PACE, Cindy tells a really funny story about her time caring for her mom. I love Cindy because she uses humor to talk about the hardest topics.  Cindy Pierce is a social sexuality educator, storyteller and author of Sexploitation: Helping Kids Develop Healthy Sexuality in a Porn-Driven World and Sex, College and Social Media: A Commonsense Guide to Navigating the Hookup Culture. Combining comic storytelling and years of research, she engages audiences with her message about making healthy choices and navigating cultural pressures. Cindy encourages educators to engage in conversations with students about the influences of social media, Internet porn and hookup culture. Young people are struggling more than ever to feel at ease, worthy and relevant as they attempt to find balance with all realms of their busy lives. Cindy and her husband, Bruce Lingelbach have three young adults and run Pierce’s Inn in Etna, N.H. Credits and Thank You Thank you to Sonja Felton from Huron Valley PACE, Robert Greenwood from The National PACE Association, and Stephanie Winslow from the PACE Association of Michigan. Thank you to Pat Cupples and Hotels and Highways for your original music. Thank you to Cindy Pierce for sharing stories about the time she spent as a caregiver. Photo: Ricardo Gomez Angel on Unsplash

“To live in hearts we leave behind is not to die.” Thomas Campbell 19th century Scottish poet How Do You Want to be Remembered? This past week was the 20th anniversary of the September 11th terrorist attacks. And when we talk about September 11th, the thing we always say is how important it is to remember. How we should never forget. I certainly haven’t forgotten. I’ve shared a lot of memories with my kids – who weren’t alive at the time – to help them understand what happened.  And this week I’ve been wondering – WHY is it so important to remember? What exactly is the purpose of remembering? How much remembering is the right amount? And is there a right way to remember? The word legacy first appeared in English in the late 14th century and referred mostly to an ‘ambassador’ who would distribute property as laid out in a will. Over time the meaning shifted to refer to the ‘property left in a will’.  The meaning of legacy evolved again over the next few centuries to include the memories of a person. Thomas Campbell the 19th century Scottish Poet, said: “To live in hearts we leave behind is not to die.” The idea that we can live on through the memories of our loved ones is actually relatively new. It’s a beautiful idea at the heart of Mexican holiday, Dia de los Muertos and you can see it in many other cultures too. The Pressure of Remembering But if I’m really honest – remembering – and being remembered – feels like a lot of pressure. It’s pressure that I’m mostly putting on myself – to do memorable things – but also on my family…to document and remember me appropriately. There aren’t any clear procedural guidelines. One part is just having conversations so the information passes from one brain to the next. To preserve it orally. But is talking about it enough? You can write it down. There are services to do that if you aren’t inclined to become an author. Pictures are great. Though pictures that lack context can depreciate into garbage for future generations who don’t know the stories that go with them. Audio storytelling has a lot of potential and video might be the best way to fully capture the person as they were. But what’s the difference between content and legacy? What are we optimizing for? How much remembering is enough remembering? Rebecca Solnit On Legacy Rebecca Solnit is an award-winning author. She’s written non-fiction books that required years of research and writing and editing. But the most popular thing she ever published is an essay called “Men Explain Things To Me” and it only took her a couple of hours to write. She wrote it effortlessly because it was based on a lifetime of experience and it spoke truth about how women are casually marginalized. Women recognized the truth immediately and it was a big influence on the #MeToo movement. In her memoir she talks about legacy and why being remembered isn’t what actually matters. I want you to hear the whole passage because it totally changed how I think about my own legacy. That’s what this episode is about. It’s a celebration of Solnit’s ability to characterize legacy as something restorative and sustainable. Episode Credits Laura – my wife – read the passage from Rebecca Solnit’s memoir. Pat Cupples provided original music for this episode. Additional music is from the band Hotels & Highways. Photo credit: Jim Herrington via The New Republic Speaking of soil...Check out the "Green Burial Masterclass"

“With our corporate event planning background, we had some solutions that we could implement, and so we quickly put all of our energy into creating Farewell Partners. That’s where we are now. And it’s so fulfilling. And I feel like it’s really filled a void for people when they need it most.” Maria Covell Founder & CEO, Farewell Partners Some of the most heartbreaking stories in 2020 were about families that couldn’t gather together to grieve the death of a loved one. Virtual funerals became a mainstream thing for the first time. I wanted to do this episode because I was hearing stories about virtual funerals that were surprisingly awesome. For every sad story I heard, there was an equally inspiring story of real human connection happening in these virtual settings. I’m not saying virtual funerals are better than in person funerals, but maybe virtual funerals are getting some things right that we didn’t really know we were missing before. Farewell Partners is a great example of a company that has stepped up to facilitate these online events and they serve a huge need. GatheringUs and New Narrative are two other companies offering this service – they actually teach a course called How to Host a Virtual Funeral on our website, but every time I talk to them about this it seems like a no brainer to hire a facilitator. As COVID-related restrictions lift and we go back to doing in-person funerals, I hope we will continue to use digital tools to create meaningful connections and memories. Some amazing things can happen in these virtual events. Let’s carry those lessons forward into a hybrid funeral future. About the Company: Farewell Partners Farewell Partners, a subsidiary of Capital City Events, offers virtual solutions for families and friends to gather their community to honor and mourn the loss of loved ones. With COVID-19, travel bans, and health warnings, people are not able to come together in the traditional ways. Farewell Partners provides family and friends the opportunity to celebrate a loved one by gathering virtually. Everyone, near and far, is able to come together in real-time to share stories and photos, comfort one another, and pay their respects—much like a memorial or wake. Our services include Virtual Tributes, Live Streaming, Family Support Portal, and Celebration of Life Events. Episode Credits Pat Cupples provided original music for this episode. Additional music is from the band Hotels & Highways. Photo credit: Farewell Partners Join us to learn more: "Introduction to Home Funerals"

“Sometimes in our healthcare experiences we just feel like numbers in an office, you know, running through, not getting enough time to say what we wanted to say or get our questions answered. And that’s a symptom of healthcare not being human.” Lane Therrell FNP-BC, MSN, RN, HTCP Clinical Education Director, mynurse.ai Do you have a primary care doctor that you love? If you do, I’m jealous. Sometimes I daydream about finding a great primary care doctor. He takes my insurance. It’s easy and casual to have an appointment so I go in for little stuff. Over the years he really gets to know me and after every visit I walk out feeling really dialed in on my health. He makes sure I’m getting all the tests I need and generally nudges me toward a healthier lifestyle. In reality, I don’t even really know who my primary care doctor is. They keep leaving the health system, so I basically have the equivalent of a court-appointed public defender that I’ve been assigned and that’s the name that I put on forms. There’s no real relationship there. My situation is pretty common. The Association of American Medical Colleges put out a report in 2020 that says we’ll have a shortfall of 55,000 primare care doctors in the U.S. by 2033. This episode is about a company that is trying to close the shortfall of primary care doctors with software. And I think what their approach makes a lot of sense. About the Company: mynurse.ai As Clinical Team Lead at Salusive Health, a telehealth startup, Lane Therrell combines her education and experience as a nurse practitioner with her skills as an educator and coach, to manage a team of wellness coaches who support the chronic care needs of Medicare patients between office visits. mynurse.ai is digital health program helping seniors with chronic conditions live their best lives. Episode Credits Pat Cupples provided original music for this episode. Additional music is from the band Hotels & Highways. Photo credit: mynurse.ai blog Join us to learn more: "Medicare 2021: What Changed?"

“The average time to hire any sort of frontline healthcare worker – nationally – is 49 days. And that’s by far the largest time to hire in any sort of macro industry in the United States.” Charles Turner CEO, Kare (App) Today we’re going to talk about Senior Housing – where do we live when we can’t really live by ourselves any more? It’s a really big market: Americans spend about $688 billion on senior housing services. But for a lot of people this is a scary thing to navigate. It’s like the lint trap of the aging process – all the stuff you don’t want to talk or think about collect in this one knotted up ball of yarn. In this episode I want to introduce you to a giant problem and one possible solution. Let’s start with the problem: US Nursing Home workers turned over at mean rate of 128% in 2017 and 2018. For context – restaurant workers turn over at 17% per year. Can you even imagine trying to run a business when 128% of your workforce turns over every year? I can’t. So what’s going on here? Well there’s obvious stuff: It’s a hard job. You get paid hourly and schedules change week-to-week You don’t get paid a lot – Caregivers in senior care facilities make $37,540.  If you start researching the senior housing labor statistics it gets depressing fast. I don’t recommend doing this alone. To help us understand what’s really going on and think about some positive solutions I want you to meet Charles Turner the founder and CEO of KARE. About Charles Turner and Kare An innovator in the senior housing space, Charles is currently the CEO of Kare, which is creating solutions to solve the labor shortage in senior care. Charles is also CEO of Invidia for Seniors, a multi platform company focused on improving the senior housing and care industry. Prior to Invidia, Charles was the President of Lifewell Senior Living and PinPoint Senior Living where he led development and operating initiatives for the companies. Invidia invests time, money and resources in technologies and programs that provide improve care and evidence based outcomes for its residents. Charles holds a B.A. in History and Politics from Wake Forest University and an M.B.A. in Finance from The University of Texas in Austin. Kare is a platform that empowers post acute caregivers to earn extra income and manage their own flexible schedules, while senior care communities decrease their operating costs by reducing high overtime wages and eliminating costly staffing agencies. Episode Credits Pat Cupples and Moby provided original music for this episode.  Photo credit: StackSource Join us to learn more: "Medicare 2021: What Changed?"

“Advance care planning is not enough. It’s critically important that we develop highly reliable systems.” Dr. Stephanie Anderson Respecting Choices® Advance care planning – clarifying your wishes in advance about the kind of care you want to receive – improves outcomes for patients, families and healthcare providers. The data is so conclusive that legislation was passed in the 1990’s to increase the number of Americans having an advance directive. The legislation failed, but it’s a great start. In this conversation with Emily Lauri and Dr. Stephaie Anderson, we explore the problem and possible solutions. Meet Dr. Stephanie Anderson Dr. Stephanie Anderson is the executive director of Respecting Choices, a division of C-TAC Innovations. She is responsible for designing and leading strategy and operations including the delivery of this internationally recognized program. She has over 25 years of experience in palliative care, hospice, home care, case management, and emergency medicine. Dr. Anderson earned her doctor of nursing practice degree from the University of Iowa specializing in health systems administration. Dr. Anderson has served in a variety of leadership roles. In these roles, her palliative care program was awarded Joint Commission Certification and the system received the Circle of Life award from the American Hospital Association. She co-chaired the Iowa Physician Orders for Scope of Treatment (IPOST) movement, resulting in new legislation and statewide implementation. Dr. Anderson joined Respecting Choices in 2013 as a senior faculty consultant and evolved into the director of consultation and education services prior to her current role. Dr. Anderson currently chairs the National POLST central region leaders group, co-chairs the POLST program assistance committee and a member of the program standards committee. She is vice president of Advance Care Planning – international. Dr. Anderson believes person-centered decision making based on an individual’s goals and values truly transforms care and should be the top priority to delivering exceptional whole-person healthcare. Person-Centered Decision Making Respecting Choices’ goal is to design a system of person-centered care that is guided by the best scientific evidence and is aligned with an individual’s goals and values. This system requires a shared decision-making process that involves respectful interaction among providers, individuals, and families, and keeps the focus of planning on what matters most to each and every person for any healthcare decision. Episode Credits Pat Cupples provided original music for this episode. Additional music is from the band Hotels & Highways. Photo credit: Gundersen Health System Join us to learn more: "Medicare 2021: What Changed?"

” People are looking hungrily for anything that can give them a sense of efficacy in a world that doesn’t seem to care what they think.” Walt Patrick Herland Forest Natural Burial Cemetery Green Burial basically means no embalming, no concrete vault, no coffin. It’s how people did things for millennia, but today it represents just a tiny fraction of the overall market. Why? Meet Walt Patrick Walt is one of the founders of Herland Natural Burial Cemetery in Wahkaicus, WA. He’s also the first licensed natural organic reduction operator in the country. He’s going to introduce you to green burial and make the case for why he’s dedicated much of his life to making it available and affordable to anybody who likes it. Green Burial Green burial is less expensive and better for the environment than embalming or cremation. And it kind of flips the relationship you have with the body on it’s head. This episode is not meant as a critique of funeral directors or decisions made by grieving family members or make anyone feel like they’ve done anything wrong. I don’t have an axe to grind, nobody is sponsoring the show – there’s no hidden agenda here. Maybe it’s for you and maybe it’s not – but you should definitely spend a few minutes leaning what it it is. Pat Cupples provided original music for this episode. Additional music is from the band Hotels & Highways. Free Webinar: "Opportunities in Green Burial"

“The fact that our time on this earth is limited is actually the ultimate incentive to act.” Jeanne Proust Meet Jeanne Proust. She’s a philosopher and educator – in this thirteen minute piece she explains what philosophy says about death. These timeless ideas help us make sense of life, but don’t address the powerful emotions of grief and loss. This episode offers a more precise language for talking about death in future episodes. About Jeanne Proust After studying in Bordeaux, Berlin, and Paris, Jeanne has been teaching Philosophy, Art History and French Literature for the last ten years in the US. During her PhD (Paris 1 Panthéon-Sorbonne), her research has focused on the pathologies of the willpower, both in philosophical and psychological perspectives, but her interests are wide: among many fields, she does research in Ethics, Philosophy of Technologies and Aesthetics. While teaching in New York, Jeanne advocates for a widening of philosophical education beyond the Academia frontiers by participating in different events open to the general public; she taught philosophy at Rikers Island as a volunteer and at the NYPL night of Philosophy. Jeanne also holds a degree in Visual Arts; she collaborates with artists on her photography, drawing and painting works. Jeanne is going to lay out the philosophical underpinnings of death. You’re going to learn things every human should know. But then she’s going to share her human side, and talk about they way her training kinda failed her during a personal tragedy.   Recalibrating the Timeline and Tone of Life’s Biggest Conversations Getting the tone right in a conversation about death can be really tricky. If you don’t acknowledge the grief and fear of others then you’re viewed as cold. But if you are too tentative the conversation is boring and inauthentic. You don’t get anywhere. This show is going to work or not work based on the tone of the conversation. So this is the episode where we start to lay out precise language and mental models for better conversations. Thinking about how we might talk to children about death turns out to be a pretty useful approach. So – I hope you can sit back and enjoy this Cliff Notes version of the philosophy of life and death. This episode was produced by Pat Cupples. Not only did he do the reporting and editing, he also provided original music. Additional music is from the band Hotels & Highways. Pictured: Roman marble bust of Epicurus Join us on January 28th: "How to Host a Virtual Funeral" (Free on Zoom)

Sharon McRill is the founder and owner of the Betty Brigade. Her book, “Downsizing the Silver Tsunami” is the compilation of 16 years of working with thousands of clients and helping them resolve the moving problems and logistical and vendor questions that come up every day. They have put together a comprehensive reference tool that you can refer to over and over to help you navigate the difficult pathways of moving and downsizing. In this episode you’re going to learn what happens to all of your stuff when you move into senior housing. It’s an introduction to what Sharon calls, the “Food Chain of Stuff”. This episode was produced by me. Pat Cupples provided original music with additional music from the band Hotels & Highways. The fact that you’re listening means you see the opportunity. To redesign the intersection of eldercare, senior housing, estate planning, and deathcare.  We’re hosting two free events on Zoom coming up, the first is “Opportunities in Green Burial” and the second is “How to Host a Virtual Funeral” all the details and the registration page is on the webiste. Photo by v2osk on Unsplash Join Us: "How to Host a Virtual Funeral"