Boomers Begin To Look Beyond the Good Life To The 'Good Death'

Wall Street Journal, February 25, 2000

by Lisa Miller

Six months after he was diagnosed with liver cancer, Robert Nichols checked into the Zen Hospice...

"It was a beautiful, beautiful death," says Ms. Nichols... "The way he died enabled us to celebrate his life."

SEBASTOPOL, Calif. -- In a converted garage here, a new service industry is being born. Call it personal consultants for death.

Jerri Lyons is explaining to the dozen people gathered for a workshop in her tiny office-apartment that when they or their loved ones die, they don't have to call a funeral home. If they engage the services of her business, Home Funeral Ministry, Ms. Lyons will help them care for and memorialize their deceased at home: She'll help dying people make future arrangements for their plants or pets. She'll instruct friends and family members in how to fill out a death certificate. She'll deliver the cardboard casket needed for cremation, or recommend a casket purveyor.

Ms. Lyons helps people achieve the kind of death and funeral they envision. "I take care of what needs to be taken care of," says Ms. Lyons, who is 52. "It's like planning a wedding or anything else." Since Ms. Lyons started her business four years ago, she has helped 130 families with home deaths and funerals.

Home Funeral Ministry is part of a tiny but growing group of consultants who offer a new approach to the end of life. Convinced that the funeral industry, organized religion and the medical establishment fail to provide spiritual, fulfilling or intimate deaths, these professionals are stepping in to fill the void.

Here in Northern California, where many alternative movements are born, the death-guide industry is taking hold. Some practitioners operate like professional best friends, offering a sympathetic ear, practical advice and assurance that they will be there at the end. Others act more like clerics, helping people solve family problems. Another group, which includes Ms. Lyons, shepherds families through home death and memorial services, much as midwives did with natural and home childbirth in the 1970s.

In their fifties now, the baby boomers are thinking about mortality. Just as they revised their parents' vision of "the good life," insisting on spiritual and emotional health as well as material success, this generation is already preoccupied with dying a "good death," and they're willing to hire experts to help them achieve this.

Baby boomers have "written their own wedding vows," says Lisa Carlson, executive director of Funeral Consumers Alliance, in Hinesburg, Vt. Just as they've rediscovered breast feeding and home schooling, "now they want to personalize and take control of the death experience as well."

The ideal of a spiritual or "good" death is taking root in mainstream culture. Since 1994, hedge-fund manager George Soros has given $30 million to his Project on Death in America, which supports research projects that aim to alleviate the "physical, emotional, existential and spiritual" suffering of death.

In September, PBS will air a four-part series on death with Bill Moyers, which includes topics such as getting your spiritual life in order before you die.

"The Tibetan Book of Living and Dying," which describes death as a transition more than an end, has sold 50,000 copies every year since its publication in 1993, and a new book, Kathleen Dowling Singh's "The Grace in Dying," is being hailed as an updated, more spiritual version of Elisabeth Kubler-Ross's classic "On Death and Dying."

More people are teaching and taking classes on improving the experience of death. Medical schools and hospitals are beginning to train doctors about the nonclinical aspects of dying. From Duke University to the University of California at Santa Cruz, educational institutions are holding symposiums that talk about such topics as spiritual death, virtuous death, life after death and personally preparing for death.

Three years ago, Frank Ostaseski, founder of the Zen Hospice in San Francisco, developed a two-day, $150 workshop called "Facing Death: Being a Compassionate Companion," and 200 people signed up. Last year, 2,500 people did. Next year, Mr. Ostaseski plans to launch a certification program for professional death companions. Graduates will be called something like "midwives for death" or "mentors through dying."

The death-guide profession is still in its infancy, however. Its practitioners carry no special credentials and their fees vary as widely as their techniques. Patrick Thornton steps in months, or even years, before death. He charges a basic rate of $140 per 90-minute session to dying clients in his practice based in Santa Rosa, Calif. In the sessions, Mr. Thornton uses yoga and Buddhist meditation techniques to help people face fear and pain.

The Chalice of Repose Project Inc., on the other hand, sends classical harpists and vocalists at no charge to people as they are dying. Ancient, sacred tunes provide relief from fear and suffering, the Missoula, Mont., nonprofit says.

Similarly, Megory Anderson charges nothing for her service: custom-made deathbed rituals. Ms. Anderson, formerly an Anglican nun, will read from sacred texts, anoint with oil, light candles and say prayers suited to the dying person's cultural and religious background. Since 1994, she has sat with nearly 200 people -- and their families -- as they died. In lieu of payment, she accepts donations to her Sacred Dying Foundation in San Francisco.


These practitioners didn't invent the idea of a quality death, of course. In the 1970s, the hospice concept revolutionized the end of life by assisting dying people, mostly at home, with pain management and other quality-of-life issues. But some feel that the modern hospice, as it grows into a mature industry dependent on government dollars, has become too institutional.

Hospice has "lost its spiritual roots," says Dale Borglum, executive director of the Living/Dying Project in Fairfax, Calif., which trains volunteers to give spiritual support to the dying.

For ages, dying happened at home. Family and clergy were close at hand to minister to the dying person's practical and spiritual needs. In the old days, "nobody died in private," says Robert Burt, law professor at Yale University, who is on the advisory board of the Project on Death in America. "Everybody trooped in the deathbed room. And the higher your class, the more people you had in the room."

But by the 1950s, most deaths occurred in the hospital. More than 70% of Americans now die in a hospital or other institution, and the vast majority, once dead, are cared for by funeral homes. Relieved of their traditional responsibilities, family members have grown increasingly removed from their dying and their dead. And as ties to organized religion loosen, the cleric's role has diminished as well.

Today, dying people have two great fears. The first is physical pain, and the second is dying alone. The latter fear is well-founded. Over the next 10 years, the number of people older than 65 and living alone in America will rise nearly 10% to more than 10 million, according to U.S. Census Bureau projections.

With the breakdown of family and social-support systems, dying alone "is much more prevalent than it has ever been," says Betsy MacGregor, a physician at Beth Israel Medical Center in New York, who has a grant to study the inner lives of people who are dying. Yet the primal yearning of the dying to make human connections is as strong as ever, she says.

Dying is dying, of course, and it is often far from tranquil. Mr. Burt, of the Project on Death in America, warns against overidealizing beautiful death and the people who claim to deliver it: "I'm all for the idea of a good death . . . of peace and grace and spiritual transcendence," he says. "But when you're dealing with the symptoms of pain and vomiting, that's not easy to do."

But more and more people are seeking practical and existential companionship as they die. Earlier this month, David Gagat, who is 44, flew to Fairfax, Calif., from his home in Cleveland to attend a workshop called "Awakening the Healing Mind," given by Mr. Borglum. Mr. Gagat has amyotrophic lateral sclerosis, the terminal degenerative nerve and muscle disease also known as Lou Gehrig's disease. Divorced and living alone with physical therapists and caretakers, Mr. Gagat wanted to explore the nature of death more deeply. "Society isolates you when it comes to death," says Mr. Gagat, formerly an oil-company executive. "It's like people don't want to talk about it."

Sitting in a semicircle in front of a blazing fire, Mr. Gagat and the 20 other workshop participants introduce themselves. Several people want to be better companions to dying relatives. Neill Whitman, who is 75 and healthy, finds himself contemplating his own death -- "my next great adventure," he says. "I don't want to go into it unprepared."

During the workshop, Mr. Borglum describes what sages say death is like: a wondrous light, perhaps a loud noise, and then a melding with that light. He also teaches meditation techniques for being calm and compassionate in the face of death. In one exercise, pairs of participants face each other: No matter what one person says, the other can only respond with "How do you want to be healed?"

Participants in his workshops used to be "very young, and very experimental," says Mr. Borglum. Now, they "represent a cross section of middle America." Indeed, along with Messrs. Gagat and Whitman, attendees include a video producer and a woman who makes deliveries for Federal Express.

Some of the new death guides offer practical, rather than spiritual, help. On an unusually turbulent flight to London from Los Angeles last year, Todd Michael Krim, who is 30, saw his life flash before his eyes and realized he hadn't properly said "I love you" to his family and friends.

So in September, he launched FinalThoughts.com, Inc., and since then about 5,000 people have signed up for the free service. FinalThoughts members store private messages to loved ones on the Web site and designate a special "Guardian Angel" to push the "send" button after they've died.

Then, last wishes and unexpressed sentiments travel via e-mail to their destinations. Also on the Web site: information on estate and funeral planning and organ donation. "We're basically going to be the one-stop shop for all end-of-life issues," says Mr. Krim. FinalThoughts.com recently received about $500,000 in seed capital and plans to generate revenue through advertisements, sponsorships and referrals.

But Mr. Krim is an exception. Most of the new death consultants operate on shoestring budgets. "We are just paying our bills," says Ms. Lyons of Home Funeral Ministry. "This is heart work." Ms. Lyons and her business partner, Janelle Va Melvin, run two death-consulting companies so small that together they made less than $30,000 last year. Revenues for Home Funeral Ministry come from donations -- $350 for a cremation, $400 for a burial -- and from extras. Home Funeral Ministry charges $35 for a cardboard cremation box; $18 for plans that describe how to build a plain pine casket; and 69 cents a pound for the dry ice that will preserve a body through a days-long wake.

Ms. Lyons's other business, the Natural Death Care Project, is a division of a nonprofit company concerned with environmental and end-of-life issues. NDCP does workshops and lectures, sells informational brochures and books, and consults with people interested in home funerals: at $60 for an initial consultation.

On this springlike January day, Ms. Lyons and Ms. Melvin are leading a $40, four-hour workship under the auspices of NDCP. It begins with a slide show of "going-out parties," as Ms. Lyons calls home funerals. In the slides, families are grouped around a dead body on a bed, or in a casket or cardboard box. Ms. Lyons encourages family members to help decorate the caskets or cremation boxes, and many of them do. Caskets and cardboard boxes are lined with satin, painted like race cars or filled to overflowing with flowers.

After lunch, Ms. Lyons gets to the nitty gritty, explaining that you wash a dead body just as you would wash any bedridden person: with a soapy sponge. After washing, some people like to anoint their dead with scented oils, such as lavender or rose oil, she says, but this is purely an aesthetic preference. The proper use of dry ice-wrapped in brown paper and towels so it doesn't create a cloud of mist-will preserve a body for days. At times, the conversation becomes macabre. One participant, Sandra Waterman, is considering starting a small home-funeral business. But she doesn't own a van and wonders aloud whether her family car is big enough to transport dead bodies. Ms. Lyons says a van is preferable.

Ms. Lyons says it is legal to keep a body at home, in California, but in other states, laws about funerals, embalming (not required in most states) and keeping and transporting dead people vary considerably. A death certificate, signed by a doctor, is required almost universally.

Diana Nichols, who calls herself "an exceedingly rational person," wouldn't have taken seriously the idea of a quality death until four years ago. Six months after he was diagnosed with liver cancer, her husband, Robert, checked into the Zen Hospice, the Victorian house where Mr. Ostaseski puts many of his Buddhist ideas about death into practice. Psychologically battered from a "dreadful" hospital stay, Ms. Nichols says her husband relaxed the minute he came through the door.

The rooms were quiet and ambient, and the volunteers, trained in meditation and Buddhist precepts such as, "Welcome everything, push nothing away," conveyed a healing calm and fearlessness, Ms. Nichols says. "It isn't tangible," she adds. "But when my husband died, he was whole again."

Mr. Nichols died peacefully one morning, two weeks after he arrived, and the volunteers suggested Ms. Nichols create an altar on his nightstand. There she put flowers from his garden, his eyeglasses, and a poem he wrote. First, she and her daughter Robin washed his body. Then they prayed together at his bedside. "It was a beautiful, beautiful death," says Ms. Nichols, who is 68. And that has helped her move through her grief. "The way he died enabled us to celebrate his life," she says.

Copyright © 1999 Dow Jones & Company, Inc. All Rights Reserved.

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