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My mother, who lives with my husband and me, wants to be cremated with no service after her death. She is in good health for 100 years old with a great appetite. She is able to toilet and dress herself but does wear disposable underwear 24/7. Since she has made her wishes clear with a sound mind, would it be advisable to make arrangements prior to her death with a local crematorium? My husband and I cared for his parents for several years in our home. His mother passed away in her sleep in her own bed. When we found her unresponsive, we called 911; and it was overwhelming with the fire truck, ambulance, and police cars racing to our home with sirens blaring. Is there a way to deal with a death at home with less fanfare and more dignity?

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If you don’t want to have to call 911 and deal with first responders, see if you can get her on hospice. Otherwise, you’ll have to call 911 if she passes at home BUT you can ask for a silent approach. The EMTs & fire department here gladly honor that request and quietly pull up to the house.

Personally, having experienced an unexpected death, an expected death with arrangements prepaid and an expected death without expenses prepaid, i say YES if possible, take care of the funeral home/cremation fees before hand (where I live, the funeral home has a crematorium and they handle the cremation). You will have one less thing to stress over and worry about when the time comes. If you don’t have the money or access to your moms money, you’ll have a financial burden on your hands. My in-laws both went on hospice with a predicted few months to live. My MIL had the mortuary come out & she picked out what she wanted and & even bought her plot. All her kids had to do was go to the mortuary to schedule the services. My FIL did not make his arrangements or instruct his children to do it, he just said he wanted to be cremated so when he died, his children had to pick a mortuary to come get him and then go down there and deal with all the arrangements & the sales pitches and pay for it out of their own pockets because they could not access his bank account.
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Katrinka49 Sep 2019
Thank you. Your advice has been very helpful. I feel a sense of guilt making arrangements in advance, as it appears that I may be expecting my mom to pass away soon. I know what a circus it was when my MIL passed away at home with no prior arrangements, and I am just trying to prevent that scenario with my mom.
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Yes, do it now.    Even when you anticipate the loss, it's still emotionally challenging if not overwhelming, and often difficult to make decisions.   And there are always last minute issues to deal with.
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Absolutely. When my dad passed unexpectedly, the whole funeral home visit and planning was so grim and such a source of stress.
We have pre-paid our Mom's wake and funeral and made all the arrangements and are resting much easier after the fact. There is nothing to feel guilty about. This is something that you would have to do down the line anyway. Do it now and save yourself later, when you were surely be aggrieved.
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Planning and paying ahead of time is very common in my part of Canada. When my step dad was dying last Fall, I knew he had prepaid for his cremation. I called the company ahead of time to ask what the procedure would be.

They pulled his file, as we knew it would be within weeks. He died in hospital, but if he had died at home, they would have come get him with an unmarked van. No need to call 911.

After he died we met with the funeral home to finalize the arrangements. We had a memorial service at his and Mum's church. I attended all the meetings with Mum. He even had a file with his contract with the hymns he wanted sung at the service.

Comparing this to when my mil's brother died. His death was unexpected and it took hours to go through all the forms at the funeral home. And this was just for a cremation, no service.

Far better to plan and pay ahead of time.
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jacobsonbob Sep 2019
"...if he had died at home, they would have come get him with an unmarked van. No need to call 911." It's good to read that at least in Canada, the system operates more sensibly than in the US. After reading that the fire department, EMS and police come for a death reported at home, I wonder, for example, what useful services the fire department would be able to perform other than wasting taxpayer money and being unavailable if someone actually reported a fire elsewhere. I suppose the police come to verify that there is no evidence of murder or other foul play, and perhaps simply to oversee the process. However, what if the caller indicates the person is stiff and cold (such as having been discovered in the morning after a death that might have taken place at midnight)? Would EMS be able to do anything useful? How much bureaucratic intervention is needed? Wouldn't sending a van such as used in Canada, and perhaps the coroner, make more sense? Am I the only one who feels this way?
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You may not feel this way now but you were blessed with the manner in which your MIL passed. There is nothing quite so awful as waiting for the inevitable death of someone. Events happen towards the end that can remain haunting. There really is a death rattle.

That being said I think you certainly could look into a place to handle her remains. Just know that no matter how much you plan death arrives on it's own agenda. I hope you find the peace you need to proceed.
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It sounds like it is not an uncomfortable topic for your mother and so she may even feel comfortable being a part of the pre-planning process. It will be less to contend with at a trying time, and I agree with seeing if hospice can be of any help, if that makes sense in light of her health and circumstances. If expenses are a concern, see if your town has a memorial society. They often have more basic choices to choose from...
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Are you aware of the POLST that you and your parents can make out with their doctor together. They amount to physician's orders and are hung on refrigerator or somewhere prominent for when the elder is alone, so that is EMS is called they will not do what the patient does not want done and will do what the patient does want done. For instance my own says NO to both CPR and intubation. If found gone I want no heroic measures. This can save some trauma as the 911 call would be that the patient has a POLST indicating no heroic measures (or otherwise)
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Yes! It is wise! My sister did it for her dying husband, and years later did it for our dying mother. At first I thought it was ghoulish. I couldn't understand it. But when my mother died, overnight in her home, everything was already taken care of. We had to call hospice to come over and confirm her death, and they took care of calling the funeral home to come and take her for cremation. It took so much strain off us at a very chaotic time. I definitely recommend it.
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kbaratelli, There is no guilt in planning funeral arrangements according to your mom's wishes! Consider it one more item to make mom happy. It's assurance that everything will be taken care of smoothly without the sudden flurry of paperwork, clothing preparation for her, choosing the casket, myriad problems that could arise, and the possibility of overlooking an item your mom might desire, etc., all to be done while in the first 2-3 days of grief, when thinking clearly might be difficult. Ask your mom if she would like to accompany you to the funeral home to make the arrangements. It also less expensive to pre-plan. My MIL was asked twice through the years what she would like, but always said "I don't want to think about it". We pre-planned everything for her, keeping in mind what she would prefer for every item, and her funeral was beautiful. We pre-planned for my dad, who only had one request. So much easier during a stressful time. There was more than enough to take care of at the time without planning either funeral at the last minute.
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The one thing my folks did that really has helped was to pre-plan and pre-pay for their own funerals. People act like this is ghoulish ir something, but it's actually a great GIFT to your LO's. There is no fussing or questioning what they'd want. It's all there in black and white.

Daddy passed at home after being on Hospice for several months. It was a quiet, family event that was actually very sweet and spiritual. We did not call the mortuary for a few hours, wanting to spend a few hours reminiscing, praying and being together as a family.

A day later, we kids went with mother to the cemetery where we gave them dad's clothing, the obituary and chose flowers. We were done and done in under 2 hrs. Mother was able to be calm and at peace.

My FIL died leaving NO instructions whatsoever and it was a hot nightmare from start to finish. I was the only sane one in the bunch and that's saying something.

GUILT overcame the 3 kids and they overspent by thousands and thousands of dollars on things that FIL wouldn't have wanted.

In the end, same result, we had a funeral and all--but my dad's was so peaceful and lovely and FIL's just makes me sad to think about to this day.

I'm pre planned for everything. DH won't do it, assuming he'll go first. Grrrr….
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jacobsonbob Sep 2019
My maternal grandfather was about 11 1/2 years older than my maternal grandmother. However, my grandmother died at age 72 1/2 but my grandfather died about 6 years later just before his 89th birthday. (Maybe you can show this to your husband so he can see that things don't always go "as expected".)
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First of all. Do not call 9-1-1. There is no emergency. Have the DNR paperwork and DMPOA available in case someone calls, misunderstanding there will be NO RESUCITATION PERFORMED. It is best to have a contact number for a funeral director and a business number for the police/coroner to establish natural death in the home, if that happens. We had a hospice nurse visiting twice a day at that point, when death was imminent. The nurse offered to stay at the very end. Our family declined—we wanted privacy. We had our plans all laid out in advance, and had already made arrangements to donate her body to a medical school. We had a number to call. This was consistent with my mother in law’s and family wishes; our hope is that her brain would offer clues about Alzheimers disease, as she had a very healthy body, even at death. She actually died due to the dysfunction of the brain due to the disease, not as a secondary cause, which was unusual. The hospice nurse came by after the death event once we called to notify them. She certified her end.

I would have a plan and know who to call to get the ball rolling, when the time comes. Makes things less confusing in an already stressful moment.
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MaryKathleen Sep 2019
If a person is not on Hospice, I would call 911. Otherwise who pronounces them dead? This is a legal thing and if there is anything remotely suspicious you could find yourself in handcuffs.
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By all means, preplan and prepay as much as possible. It does makes an emotional time much easier.

My MIL had her wishes written in her will (cremation, alter flowers, hymns, charitable donations, etc.). The preplanning also meant no disagreements between siblings about her wishes and no guilt for doing her service "wrong."

The only hiccup we encountered was that, in Georgia, the majority of her children had to sign off on her cremation (2 of her 3 kids). That was only a problem because of the long drive to the funeral home/crematorium involved just to sign a piece of paper.

And, yes, the first statement to be initialed was that the children understand that cremation is not reversible.

One thing that would have also helped us was if we had a picture of her already chosen that she wanted in the program at her funeral.
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If a person is on hospice there is no need for fire truck, ambulance, or police cars coming to the scene since the death is expected and hospice handles calling the funeral home you have picked out.Hospice staff is trained to handle most all of this. They prepared my mom for when the funeral staff came to pick her up. I just had to tell the funeral home about my mom's wishes to be cremated at the time, and what she wanted. It was an easy process because she wanted no funeral or calling hours. Some people make arrangements before they pass away with the funeral home of their choice. When a death is sudden with no hospice involved, there will be police and rescue vehicles etc. at the home.
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It's her last wish, I would gladly grant it. Let her die in the dignity she so chooses. Consider that your last gift. Sad, of course, but it's her last wish!
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Get hospice. Seriously. They can help with health issues and comfort in the last stages and there is no congregation of authorities concerned with foul play when the loved one dies.
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Yes.
Several suggestions that made it easier for me when I was with my MIL and she passed at home.
Talk to her doctor as soon as it seems she is failing and get her on hospice at home. Once that is done, the visiting nurses will be checking on her and giving you meds to use if necessary.
Definitely get in touch with a funeral home. Prepay if possible as if for some reason she did end up in nursing care that is an allowable espense regarding the look back and medicaid (if that's a possibility) but not only for that reason - if you have an arrangement with them and with visiting nurses/her doctor, then when she passes the nurse comes out, declares and does the paperwork and calls the funeral home to come and do what they do. When MIL passed I called the VNA, and she came to do what she had to do to declare, then she called the non emergency number of the police and stated there was an attended death at home of a person on hospice. They had no need to come, no ambulance, etc. There was a bit of a wait for the nurse but it was 2 am. Mom passed around then and the funeral home came to pick her up at about 4:30. It's all about getting the ducks in a row. If you don't already have a funeral home on deck as it were, then there is a long wait, paperwork, money.... just set it up ahead of time...
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Great question, great responses.

Never too late to plan for funeral for yourself or loved ones. I agree with many posters that once in hospice, you do not need to call the police. The hospice staff will take care of certification that your loved one died from natural causes or an illness, not foul play. My dad died at home last year in his bed while in hospice care. No police, ambulance, firetrucks, drama, embarrassment ... (My sister made a huge drama about the funeral service though, but that’s another topic.)

If hospice is not in the care plan, the police needs to be contacted for them to certify there no homicide had occurred. It is the law, so you cannot get around that.

I am glad to hear you MIL is still mostly independent and lucid. I wish my husband is like that.
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My MIL had the forethought years ago to prepay/plan her funeral. Mom had her casket, and anything else she wanted already selected. I had bought her burial clothes several years ago, and had assembled everything ready to go. We did her funeral cards ourselves, and I think they were nicer than what would have been done by the funeral home. Everything was paid for, I don't think we were out much at all. It's just good sense to prepare as much as you can, at least have things written down so family will know what the wishes are.
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Yes, I find it Wise at her Age....
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My husband asked for the same thing so when he passed that's exactly what he got. We did however have an immediate family gathering for dinner together.
My husband was on Hospice. It might be a service to check into for your mother. She might qualify based on age. If so her life transition can be handled much quieter than a full force emergent event.
I did pre arrange his cremation and went as far as writing his obituary. Even though his death was expected I knew that in the moment I wouldn't be thinking straight and I didn't want to forget anything that might seem important.
I think pre arrangement and following the wishes of your loved one is a wise choice.
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Yes; great question. If your mother passes away at home, you can call the funeral home that you've chosen in advance and have them come instead of police and fire. Sounds like you have discussed her wishes which is great. We held a celebration of life service for my brother who passed away unexpectedly and wanted to be cremated.
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I would check with local authorities on protocol. Maybe the crematorium can get LO direct.
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Medicare guidelines for hospice admission are quite strict. From your description of her, she doesn’t seem to qualify at this point. But if she begins to fail, become bedridden, you can have them evaluate her.
When you preplan, you are being a grown up and accepting that death is inevitable for all, and especially someone your mom's age. It is not ghoulish. Our country is so odd about death anymore. The funeral home will be able to tell you how they handle it when she dies. I see no need to call 911. They will pick up the body to prepare it and get the necessary death certificates.
We preplanned my dad's a few years ago so that if he runs out of money, it would be paid for. He already had the plot next to my mom. Best decision ever.
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worriedinCali Sep 2019
Medicare guidelines are not quite strict these days. They don’t even require a prognosis of 6 months or less to live.
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It sounds like her wishes are simple, efficient, straightforward, low-cost and require no special accommodations.

You know her wishes. That is all you need. What if a funeral home you contract with goes out of business?

Regardless of where or how death happens, you will be provided inconvenience, hardship, stress and possibly some tough memories.

Several people in my husband’s family prearranged for the passing and funeral care of an elderly, but otherwise alert and healthy family member (without her knowledge). I personally felt it was disturbing and motivated by greed. That act was worse than any level of inconvenience they would have had if taken by surprise. I think differently of them now.

If my kids, at any age, initiated the pre-arrangement of my services, I would feel like a burden to them.
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GM
Have a family meeting specifically stating when this happens who is to be called etc. My mom is on hospice and the agency’s number is in full sight to call and I am next for the call. This scenario of course is different but same concept.
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Yes, that is exactly what happened with my mom. But we bought a preplan for her to qualify for Medicaid when we were trying to get her into a nursing home (which did not work out, but we did get aides through Medicaid in the home, which was a thousand times better than nursing home). My dad bought a pre-plan cremation with the local funeral home (yes, funeral homes have their hands out for money always and you cannot avoid them by dealing directly with the crematorium, at least not in NYS). When my mom passed, we called the hospice nurse first and then the funeral home and they took her quietly away and by that time the entire family was there to say goodbye. Everyone went one by one to kiss her and say goodbye. No service (and no burial) except later we had a small informal family gathering in a park and said a few words after a family lunch at a restaurant. But I guess for you it would be to lock in a price. But otherwise you should have her DNR on the fridge. That is SOP for the elderly. Always put the DNR on the fridge. That is always where they look for it.
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YES!
You will not be under pressure or stress.
As a matter of fact since she knows exactly what she wants you could even bring her to help make choices.
And the big plus..you can pay for it all now..at today's prices and if she dies 2 years from now you will not have to pay more. (other than what would be charged to open a plot or columbarium)

There are requirements that have to be followed. Talk to her doctor about what the requirements are. As a matter of fact talk to the Funeral director about what the requirement is. It may be possible that all you would have to do is contact them, they may have someone that can "legally" pronounce a death.
It is also possible that if you contact Hospice and place her on Palliative Care or other service the staff there can pronounce the death and that would eliminate the need to contact emergency services. (911)
My Husband was on Hospice and when he died I called Hospice, they had a nurse come out she filled out the paperwork and the nurse even called the Funeral Home for me. (I had arranged his funeral about a month before)
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I had pre planned and paid services for my folks. When mom died it was such a relief to not have to deal with all the funeral and burial details.

And yes, hospice is the way to go. You’ll have none of the 911 EMT craziness upon death. Plus your mom will get excellent care .
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You are lucky to have your mom that long. I would give my soul to the devil if I could have mine in that condition. Mine is bedridden, total dead weight, cannot talk, and kept alive with a peg tube and she is 90 years old, and she has been an enormous physical, emotional and financial burden for the past 5 years. Mom cannot even sit up on her own. Nothing. She's still alive, but she's also gone. Everyday I miss her. Pre-planned funeral or cremation is the way to go. Not only will this save you a lot of money, but the funeral parlor won't gouge you taking advantage of your grief--preplanned is when a person is level headed. To wait until the loved one dies--they are a business and they will take advantage of grieving. In addition preplanned flat rate is locked in. Preplanned has cost savings--they will give you discounts.
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Windyridge Sep 2019
Excellent point about getting gouged by the funeral home shortly after the death of a family member. My younger sister and older brother both died suddenly about 3 years apart. Twice, I watched my poor, grieving, elderly mother write HUGE checks for elaborate funerals, coffins, limos, and the whole nutso package.

After my folks FINALLY moved to assited living I did a little on line research about funeral and burial state law and costs. I then called the same funeral home to arrange prepaid services and burials for my parents. The funeral director told me the cheapest casket availability was $2800 . I told him I’d get one on line and have it shipped to them. He double checked, turns out he had one for $900. And so it went. My folks had been quite clear about having the simplest services possible. I was able to pre arrange this for them at a reasonable price and at a time when I wasn’t grieving and trying to deal with a thousand other things.
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Your mother, in essence, has made the plans. Whether you make arrangements now or in the future, you are carrying out her wishes. Personally, I think prior arrangements are very practical. It allows you to make decisions when you are clear-headed instead of during a very stressful time of grief. My mother has made some of her wishes very clear, but has resisted make pre-planned arrangements which I do not understand at all.
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