When someone dies, friends, family, and the community naturally want to pay their respects to the deceased in a dignified way. Funerals are a universal way to mark our collective recognition and respect for our common humanity. They can also be distressing to plan emotionally and financially. Facilitating early communication about preferences and pre-planning impacts the grieving process of the survivors in a positive way and decreases death avoidance if the loved one has been able to be involved.
More and more, we are seeing people pre-arrange and pre-pay their funerals. One study on end of life decision making showed that 95% of respondents who had been diagnosed with a serious illness had pre-arranged their funeral but only 20% had completed an advance directive. Despite this, many families find themselves needing to make arrangements with no input from their loved one on their preferences.
The average funeral costs $5,000-$7,000 and cemetery costs can be in excess of $10,000. Direct cremation ranges from $700-$1500. Cremation rates have been increasing; in 2018, 53% of people in the US and Canada were cremated compared to 29% in 2003. A more transient family system leading to fewer people visiting gravesites—rather than individuals holding a deep connection to a community—may impact the desire for burial.
US News and World Report provides the following cost ranges for an average funeral:
- Casket $2,000-5,000
- Embalming $200-$500
- Makeup and body prep $250
- Headstone $1,000-$5,000
- Flowers $500-$700
- Transportation $350
- Facilities and staff $400-$500
The following are average cemetery costs:
- Burial plot $500-$10,000 depending on location
- Opening and closing the grave $300-$1500
- Vault/Grave liner $1300
- Perpetual care may have an additional fee depending on the cemetery.
Funerals are often distress purchases: plans are made and money is spent while family and friends are in the grips of grief. Too often, irrational decisions are made while the bereaved are emotionally overwhelmed and in the natural shock, denial, and disorganization of grief. Many are unaware of the process of making final arrangements and have little time to visit several funeral homes to compare services and prices. If someone has never planned a funeral, they may be unaware of planning etiquette and may be reluctant to compare prices or bargain for the best price. Feelings of guilt that they’re not giving “the best” to their loved one leads to overspending and debt. One study showed that younger people in service or clerical work were more likely to take on debt related to arranging a loved one’s funeral, whereas older people in professional occupations were less likely to do so. Furthermore, previous experience with funeral planning further lowered the likelihood of incurring debt.
As hospice staff, it is incumbent upon us to ensure the patient or family has chosen a funeral home and, if there is enough time, encourage them to make arrangements prior to the death event. In my clinical practice, I ask the patient and family if they have chosen a funeral home. If they had, I would ask if they had met with the funeral director to understand their options and make choices and encouraged them to do so. If they had not, using the phrase “it’s not a decision I want you to have to make in the moment” seems to have an impact. It both reinforces that a decision will need to be made eventually and that that moment will come. In a best-case scenario, you will have time over the course of care to work with the family on this task.
Using pre-planning as a therapeutic tool with your patient can be beneficial. Many feel a loss of sense of self and autonomy or do not want to talk about their illness, vulnerability, and mortality. Perhaps your patient and family do not know how to talk about it with each other.
Gain an understanding of family dynamics, culture and preferences. If there is discord between the family now, this can cause further disagreement about how grand or how simple arrangements will be or who will pay for them. Encourage, when possible, the patient themselves to express their wishes to the family so everyone knows they are following his/her wishes and not their own. Inquire if there are cultural norms or customs which should be respected and which the funeral director should be made aware as this may impact planning.
Encourage the patient and family to visit several funeral homes. The Federal Trade Commission requires that funeral homes provide price lists to anyone who asks for one in person and to give any cost requested by phone. Most funeral homes are generally in line with each other but seeing the price range of different items and being aware of the number of expenditures can be helpful.
Determine the budget. Locate any life insurance policies; ensure that they are up to date and assess the value of each. If the deceased is a Veteran, see our Funerlocity article on Veterans Benefits. See our Funeralocity article on public benefits to identify alternate sources of funding. Identify if any family, friends, or religious organizations are willing to put forth financial support. Crowd sourcing with websites like GoFundMe are becoming more popular as a means of fundraising to pay for funeral expenses.
Make note in advance of information which will be required for the death certificate:
- Full legal name
- Social security number
- Date of birth (If unknown, request a copy of their birth certificate)
- Last address
- Armed Forces history
- Marital status at time of death
- If married, surviving spouse’s maiden name
- Father’s legal name
- Mother’s maiden name
- Highest level of education
Effective and early conversation surrounding final arrangements, managing the expectations of the patient and the family as well as having realistic financial boundaries can make a significant impact on life closure, feelings of autonomy and control for the patient, as well as have a positive impact on the grieving process of their loved ones.
As a clinician, tactfully bringing up the topic, being as engaged in the process as they would like and in doing so, giving permission to discuss it can be an effective way of removing the stigma and open the door to communication. Actively promoting funeral planning be done as a family increases feelings of control and lessens death anxiety. It may even open doors to other conversations or closure activities. You can start by acknowledging the resistance and begin with small, incremental steps. Asking questions about what they see as the primary purpose of a funeral (i.e., disposal of the body, public recognition, religious ritual, support of the grieving and paying of respects) can be a good way to begin the conversation. Does the patient want to be buried or cremated? Do they want to donate their body? Would they want a viewing? Would they want a memorial service at their favorite park, place of worship, or even the local pub? This also gives the family a framework to work with when they are meeting with the funeral director and not feel compelled to overspend on items or services that the deceased did not want.
Banks, D. A. (1998) The economics of death?: A descriptive study of the impact of funeral and cremation costs on U.S. households. Death Studies, 22 (3), 269-285. doi: 10.1080/074811898201597
Bern-King, M., Ekerdt, D. J., & Wilkinson, D. S. (1999). What families know about funeral-related costs: Implications for social work practice. Health and Social Work, 24 (2), 128-137.
Castex, G. M. (October 2017). Social workers’ final act of service: Respectful burial arrangements for indigent, unclaimed, and unidentified people. Social Work, 52 (4), 331–339. doi: 10.1093/sw/52.4.331
Funeral Costs and Pricing Checklist (n.d.). Retrieved from https://www.consumer.ftc.gov/articles/0301-funeral-costs-and-pricing-checklist
Industry Statistical Information (n.d.). Retrieved from https://www.cremationsassociation.org/page/IndustryStatistics
Kemp E., Kopp, S.W. (Winter, 2010). Have you made plans for that big day?: Predicting intentions to engage in funeral planning. Journal of Marketing Theory and Practice, 18 (1), 81-90.
McManus, R. & Schafer, C. (2014). Final arrangements: Examining debt and distress. Mortality, 19(4), 379–397. doi: 10.1080/13576275.2014.948413 Williams, G. (2019, April 30). Funeral costs to plan for. U.S. News and World Report. Retrieved from https://money.usnews.com/money/personal-finance/saving-and-budgetig/articles/funeral-costs-to-plan-for