Similar to DNRs, funeral home planning invites a potential conflict. On one hand, your agency may feel quite urgent about funeral home decisions happening early. On the other hand, it is a sensitive topic and patients and family members have the right to decide when they are ready.
Social workers can simplify the issue by taking a side. Ideally, there would only be one side, but in conflicts between your team-members preferences and what your patients/families can handle, there’s no debate for the social worker. We work for clients.
Here are some of the good reasons to encourage funeral planning on the soon side. As you can see, not all of them focus on the needs of the patient and family system.
1. Handling it at the last minute can complicate grieving
The only urgent reason is that advance planning removes a distraction from the initial grief. When plans are already in place, family members will be more able to focus on each other and their experience because there won’t be immediate logistical need to manage.
2. Advance discussion encourages acceptance
Encouraging end-of-life planning can encourage matter-of-fact thinking about how the life is approaching an end. This in turn can encourage acceptance.
3. Early funeral home planning can mean a better plan.
Patients and families are far more likely to form a plan that meets their criteria when they plan earlier. Unless everybody already knows what they want, it is good for them to discuss what the different approaches (burial, cremation, donation, choice of provider) can mean to them. Planning ahead also allows them to consider what options are affordable to them.
4. The myth that planning ahead prevents 8-hour death visits.
Some hospices don’t have social workers do on call, so many deaths are only attended by nurses. Nurses often have to make many visits during their on-call shifts, and also like to sleep. Understandably, they would prefer their visits have a more reasonable length than 5 to 8 eight hours. Also understandable is their fear that they’ll be there all night if the family still has to choose a funeral home.
This understandable fear is unfounded, in my experience. I’ve never seen a family take longer than a couple minutes to decide after the time has come. Those few minutes don’t compare to the unpredictable wait that happens when a funeral home has a busy night. The only factor that I’ve ever seen cause a death visit to take so long is when family members want to arrive from out of town to say good bye before the funeral home comes.
5. Nurses may not feel well equipped to engage in last-minute funeral home planning.
Fair enough. Funeral home planning is something that social workers can get good at facilitating. But it is ironic that many hospice nurses believe that they can handle most psychosocial patient/family support themselves. They do their best to provide counselling and bereavement support, and many of them prefer not to refer many issues to social workers.
But all that aside, nurse case managers are considered the leads of each patient’s team of hospice providers. If they’re responsible to supervise psychosocial efforts and can handle much of it themselves, they can engage in last-minute funeral planning when the stars align to give them such an opportunity.
Focus on the first 3 of these reasons for early funeral home planning
Your team members may feel primarily concerned about how a lack of planning will affect them. This can be difficult to overcome.
As much as we want to support our team members, our priority is to promote our patients’ and families’ wishes. This means that if their wish is to procrastinate, we let them. We continue to encourage planning gently, but without pressure.
Come back Thursday and we’ll talk about how to approach this topic, remaining supportive even when families are procrastinating.
Poll: your thoughts on funeral home planning
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