Deathcare Explained

See also: Death care industry in the United States.

Deathcare (also death care, death-care or after-deathcare) is the planning, provision, and improvement of post-death services, products, policy, and governance. Here, deathcare functions to describe the industry of deathcare workers, the policy and politics surrounding deathcare provision, and as an interdisciplinary field of academic study.[1]

Deathcare, from the point of clinical death, has a diverse timeline. The first point of care often involves immediate healthcare professionals and responders closest to the person who has died, including doctors, nurses, palliative and end-of-life care workers.[2] From here, the care of deceased individuals has a culturally, religious, and personal course. This can involve a range of people from religious figures, morticians, to grave keepers – all of these roles formulating to what can be known as deathcare workers.[3]

Etymology

The word deathcare is a compound term from the words death and care. It can also take the form of death care,[4] however this is mostly used in the United States and Canada in the Anglosphere, where deathcare is a preferred variation elsewhere in the English speaking world reflecting on the preferred version of healthcare in places like the UK, Australia, India, etc.[5]

History

The provision of deathcare has historically[6] and often continues to be a highly decentralized and diverse practice combining multiple actors and stages.[7] [8] Nonetheless, trends in providers and purveyors of deathcare do exist throughout different eras: in the time prior to the American Civil War, for instance, the majority of care for the deceased was performed by one's own family members. Specifically, women in the family were expected, as a part of their domestic duties, to oversee and execute the sanitization, dressing, and ultimately burial of their families' corpses.[9] However, following the number of deaths during the Civil War, the practice of embalming became commonplace, as fallen soldiers had to be preserved before their bodies could be transported vast distances from the battlefield back to their hometowns. Following the war, it became the norm to have loved-ones bodies prepared and cared for by morticians, and spaces for services to be provided by funeral home directors.[10] Coinciding with the professionalization of the funeral industry, the advances of the medical field changed expectations around an infectious disease course. That is, rather than comfort care, medical providers began to offer life-saving, and thus life-changing measures, e.g. antibiotics.[11] This resulted in a change in the concentration of the placement of ill-people: rather than remaining at home, people began to rely increasingly on hospitals as a place of healing, especially in urban areas where hospitals were more accessible.[12] In areas that allowed for access to hospital systems, this inevitably resulted in a greater proportion of deaths occurring in hospitals rather than at home, thus bolstering the change from home-based care to professional, funeral home-based care of the deceased in the urban West.[13]

In other countries, the social practices around deathcare vary compared to the U.S. For instance, in Hindu culture, women have been barred from attending cremation rituals, and even from touching the deceased.[14] Before World War Two in Britain, women were "commonly responsible for laying-out the body", but following the war were barred from such a role given the expedient professionalization of the deathcare industry.[15]

21st century

Examples of government policy involvement include the impact of new burial methods like human composting[16] to pressures like COVID-19 placing on those involved with deathcare as well as their families.[17] [18] [19] In addition to government policy, the effects of COVID-19 have directly impacted those involved in deathcare: funeral directors were shown to have increased rates of burnout following the first wave of the pandemic.[20]

Delivery

Government

National and regional governments are often responsible for providing the legal framework for deathcare to operate within, including laws and guidance on what deathcare techniques, practices, and what individuals/ organisations are involved. However, this has a varying level of non-government organisations, third-sector, religious, and private organisations (such as funeral homes)[21] take part in both providing and shaping deathcare policy and practice.[22] [23] However, most research on state interactions within deathcare is limited to the US, with further research needed elsewhere.[24]

Governments can also become a major focal point for deathcare services in specific situations, such as with deaths in the military, prisons, or in extraordinary events. COVID-19 is an example of global governmental intervention to provide mass fatality management to cope with high human fatality around the world. This also brought up issues of inequality and inequity within deathcare as some deaths throughout the pandemic were treated as "more tragic" compared to others, highlighted as a public values failure as economic productivity and social worth overruled public health and humanity.[25]

Industry

Analysts have stated that the deathcare industry can be divided into three portions: the ceremony and tribute (funeral or memorial service); the disposition of remains through cremation or burial (interment); and memorialization in the form of monuments, marker inscriptions or memorial art.[26]

Deathcare industry is a multifactorial sector including, but not limited to: companies and organizations that provide services related to death memorials, funerals, and burials. Theses types of ceremonies includes service use of coffins, headstones, crematoriums, and funeral homes. Most of the death service industry has consisted of small businesses that have been consolidated as time has gone on.[27]

There is a global marketplace for deathcare in the produces, services, and insurance that surrounds someone's death. This is a market that has shown expanding fiscal growth in years 2020 to 2021 supported by a compound annual growth rate of 5.6%. The market is expected to continue to grow to a compound annual growth rate of 8% by year 2025 expecting to reach a value of 147.38 billion dollars up from 103.93 billion dollars in 2020.[28]

The deathcare process comes with multiple costs to allow for certain rituals to take place. Including to removal/transfer of remains to funeral homes (est $340), embalming (est $740), Hearse use ($340), metal burial casket (est $2500). The estimated median cost of funeral with burial and funeral was estimated by an NFDA news release to be $7640.[29]

Deathcare industrial complex (DIC) has been outlined as a concept, mirroring the military-industrial complex concept, in at least the US and potentially Western countries as an industry: "profit-driven, medicalised, de-ritualized and patriarchal [in] form, modern death care fundamentally distorts humans' relationship to mortality, and through it, nature".[30] The death care industry in the United States is deemed controversial due to high costs and negative environmental impacts.

Localized efforts to reform and offer innovative deathcare practices can be seen in the natural deathcare movements such as human composting to natural burials.[31] [32]

Environmental impact

Common funeral practices in Western society are associated with notable environmental impacts.[33] Metal caskets can deteriorate and release harmful toxins when buried, leading to contamination of land and water. Cremation also uses a significant amount of fuel consumption, releasing chemicals and carbon emissions.

With the threat of climate change, conversations about green death practices are becoming more prevalent. Natural burial methods are being developed to promote eco-sustainability in deathcare.

External links

Notes and References

  1. Marsh. Tanya. 2018. The Death Care Revolution. Wake Forest Journal of Law & Policy. 8. 1. 1–4.
  2. Hill. Christine. 1997-11-12. Evaluating the quality of after death care. Nursing Standard. en. 12. 8. 36–39. 10.7748/ns1997.11.12.8.36.c2487. 9418467. 0029-6570.
  3. Web site: Johns Hopkins Berman Institute of Bioethics. University of Colorado Boulder MENV. 2021-10-24. Essential Death care workers briefing book. live. 2021-10-24. https://web.archive.org/web/20211024194134/https://bioethics.jhu.edu/wp-content/uploads/2020/06/Essential-Deathcare-Workers-Final-Briefing-Book.pdf. 2021-10-24.
  4. Kopp. Steven W.. Kemp . Elyria . 2007. The Death Care Industry: A Review of Regulatory and Consumer Issues. The Journal of Consumer Affairs. 41. 1. 150–173. 10.1111/j.1745-6606.2006.00072.x. 23860018. 0022-0078.
  5. Web site: Healthcare vs. health care – Correct Spelling – Grammarist. 2021-10-24. grammarist.com. 10 May 2011 .
  6. Book: Spellman, W. M. . 2015 . 978-1780235042 . London . 905380333.
  7. Gordon . Michael . 2015-01-29 . Rituals in Death and Dying: Modern Medical Technologies Enter the Fray . Rambam Maimonides Medical Journal . 6 . 1 . e0007 . 10.5041/RMMJ.10182 . 4327323 . 25717389.
  8. Book: Brennan, Michael . The A–Z of death and dying : social, medical, and cultural aspects . 2014 . 978-1440803437 . Santa Barbara, California . 857234356.
  9. Olson . Philip R. . 2018-06-01 . Domesticating Deathcare: The Women of the U.S. Natural Deathcare Movement . Journal of Medical Humanities . en . 39 . 2 . 195–215 . 10.1007/s10912-016-9424-2 . 1573-3645 . 27928653 . 43800390.
  10. Finney . Redmond . Shulman . Lisa M. . Kheirbek . Raya E. . April 2022 . The Corpse: Time for Another Look A Review of the Culture of Embalming, Viewing and the Social Construction . The American Journal of Hospice & Palliative Care . 39 . 4 . 477–480 . 10.1177/10499091211025757 . 1938-2715 . 34219498. 235734505 .
  11. Web site: Lowey . Susan E. . 2015-12-14 . A Historical Overview of End-of-Life Care . en.
  12. Rainsford . Suzanne . MacLeod . Roderick D . Glasgow . Nicholas J . September 2016 . Place of death in rural palliative care: A systematic review . Palliative Medicine . en . 30 . 8 . 745–763 . 10.1177/0269216316628779 . 26944531 . 4682978 . 0269-2163.
  13. Olson . Philip R. . 2018-06-01 . Domesticating Deathcare: The Women of the U.S. Natural Deathcare Movement . Journal of Medical Humanities . en . 39 . 2 . 195–215 . 10.1007/s10912-016-9424-2 . 27928653 . 254701885 . 1573-3645.
  14. Baker . Hugh D. R. . December 1989 . Death Ritual in Late Imperial and Modern China. Edited by James L. Watson and Evelyn S. Rawski. [Berkeley, Los Angeles, London: University of California Press, 1988. 334 pp. $4000.] ]. The China Quarterly . 120 . 875–876 . 10.1017/s0305741000018658 . 155077233 . 0305-7410.
  15. Book: Howarth, Glennys . 2016. Last Rites . 10.4324/9781315224251. 978-1315224251 .
  16. Web site: 2020-02-16. Human composting could be the future of deathcare. 2021-10-24. The Guardian. en.
  17. Book: APPG PPG for Funerals and Bereavement. APPG 2020 2021 Annual Report. 2021-01-01.
  18. Web site: Columbia Business School – Eugene Lang Entrepreneurship Center. Digitization In Deathcare. 2021-10-24. Forbes. en.
  19. Denborough. David. Sanders. Cody J.. Death-care practices in the shadow of the pandemic: Can history help us?. International Journal of Narrative Therapy and Community Work. 2. 20–33.
  20. Van Overmeire . Roel . Van Keer . Rose-Lima . Cocquyt . Marie . Bilsen . Johan . 2021-12-10 . Compassion fatigue of funeral directors during and after the first wave of COVID-19 . Journal of Public Health (Oxford, England) . 43 . 4 . 703–709 . 10.1093/pubmed/fdab030 . 1741-3850 . 7989438 . 33635314.
  21. West Park Healthcare Centre, Ontario, Canada. Anderson. Barbara. 2017-05-17. Facilitating person-centred after-death care: unearthing assumptions, tradition and values through practice development. International Practice Development Journal. 7. 1. 1–8. 10.19043/ipdj.71.006. free.
  22. Web site: United States Government Accountability Office. 2011. Death Services: State Regulation of the Death Care Industry Varies and Officials Have Mixed Views on Need for Further Federal Involvement. live. 2021-10-27. https://web.archive.org/web/20210518083838/https://www.gao.gov/assets/files.gao.gov/assets/gao-12-65.pdf. 2021-05-18.
  23. Web site: UK Competition & Markets Authority. 2020. Funerals market investigation: Quality regulation remedies. live. 2021-10-27. https://web.archive.org/web/20210616091322/https://assets.publishing.service.gov.uk/media/5e32d33640f0b6090c63ab1c/Quality_regulation_remedies_FINAL.pdf. 2021-06-16.
  24. Entress. Rebecca M.. Tyler. Jenna. Zavattaro. Staci M.. Sadiq. Abdul-Akeem. 2020-01-01. The need for innovation in deathcare leadership. International Journal of Public Leadership. 17. 1. 54–64. 10.1108/IJPL-07-2020-0068. 228855678. 2056-4929. free.
  25. Zavattaro. Staci M.. Entress. Rebecca. Tyler. Jenna. Sadiq. Abdul-Akeem. 2021. When Deaths Are Dehumanized: Deathcare During COVID-19 as a Public Value Failure. Administration & Society. en. 53. 9. 1443–1462. 10.1177/00953997211023185. 236312716. 0095-3997. free.
  26. Web site: Lawton . William . September 12, 2022 . Industry Focus: Death Care . bot: unknown . https://web.archive.org/web/20220927205946/https://2016.export.gov/build/groups/public/@eg_main/@byind/@healthtech/documents/webcontent/eg_main_113189.pdf . September 27, 2022 . September 12, 2022 . 2016.export.gov .
  27. Cummins . Eleanor . How 'Big Funeral' Made the Afterlife So Expensive . en-US . Wired . 2022-09-12 . 1059-1028.
  28. Web site: PR Newswire. 2021. Global Death Care Services Market Report (2021 to 2030) – COVID-19 Impact and Recovery.. 2021-10-24.
  29. Web site: 2019 NFDA General Price List Study Shows Funeral Costs Not Rising As Fast As Rate of Inflation . 2022-09-12 . nfda.org . en-US.
  30. Westendorp. Mariske. Gould. Hannah. 2021. Re-Feminizing Death: Gender, Spirituality and Death Care in the Anthropocene. Religions. en. 12. 8. 667. 10.3390/rel12080667. free. 11343/289692. free.
  31. Olson. Philip R.. 2018-06-01. Domesticating Deathcare: The Women of the U.S. Natural Deathcare Movement. Journal of Medical Humanities. en. 39. 2. 195–215. 10.1007/s10912-016-9424-2. 27928653. 43800390. 1573-3645.
  32. Harker. Alexandra. 2012. Landscapes of the Dead: an Argument for Conservation Burial. Berkeley Planning Journal. en. 25. 1. 10.5070/BP325111923. free.
  33. Shelvock . Mark . Kinsella . Elizabeth Anne . Harris . Darcy . 2021 . Beyond the Corporatization of Death Systems: Towards Green Death Practices . Illness, Crisis & Loss . en . 30 . 4 . 640–658 . 10.1177/10541373211006882 . 1054-1373 . 9403370 . 36032317.