One of the most important, yet most infrequent topics of conversation is that of death and dying.  There are many avenues to begin, and we’d like to ignite these conversations with you. Let’s start with a video where we can be astonished at the capacity of the human body; well at least this human body: http://www.youtube.com/watch?v=UYFDYX4i2EY&feature=related.

With your body feeling the flow, did you know that end of life expenses can cost up to $600,000 for the last two years of life, an end of life hospital stay at UCLA averages $94,000, while the Mayo Clinic is a bargain at $53,000 (per a 2008 study by Dartmouth Medical School.)  And these costs do not include funeral costs.  However, we do not want to give you the idea that funeral costs are so low that discussing them is a joke – they are rising too – and this article, the first in a series, is about funeral costs.   Funeral costs have risen so far and so fast lately that people who have been through it tell what may be the un-funniest joke in history: dying has become so expensive that nobody can afford it any more.

One reason for these cost increases is that many people fail to plan; poor planning is a major reason for high medical costs associated with end of life expenses too!  Most people do not plan for the funeral, the burial plot or cremation, the flowers and everything else before the fact.  Suddenly, the grieving family is forced to make complicated arrangements in one of the most highly-emotional moments of life, which often leaves them incapable of making a clear decision, much less bargaining over the cost.  In fact, it was so easy for funeral directors to sell unnecessary add-ons during these moments of vulnerability that the Federal Trade Commission created a “Funeral Rule” which requires mortuaries to present a price list of services to consumers before showing them products such as caskets.  More recently, the FTC has created not one but two brochures; one that summarize the rights of consumers (http://www.ftc.gov/bcp/edu/pubs/consumer/products/pro26.shtm), and another that functions as a guide to planning funeral arrangements from a consumer standpoint (http://www.ftc.gov/bcp/edu/pubs/consumer/products/pro19.shtm).  Among the little-known regulatory provisions is this:  a funeral provider may not refuse, or charge a fee, to handle a casket you bought elsewhere.

Why do people fail to plan their funeral?  The answers vary from one end of the spectrum to the other, beginning with the avoidance of death and dying altogether. Here are a few variations on the situation: There is a lot of guilt associated with loss in our culture.  Often children do not want to come across as vultures waiting for parents to die and inherit their wealth.  Others are too caught up in the emotion surrounding grief of losing a loved one, so they avoid the topic with the hope that avoidance will postpone the reckoning.  Of course, we all know that no one has ever leaves this earth alive.  Ironically, even though children of aging parents are often reluctant to bring up the subject of death, in many cases the parents would greet the discussion with relief.  Clarifying funeral preferences is not normally part of a person’s will or estate documents, and few people understand their choices, which can be complex.  Do you want a traditional full-service funeral which includes a viewing and formal funeral service (the most expensive option), a direct burial (no viewing and therefore no embalming) plus a graveside memorial service, or a direct cremation?

If you do use a funeral home, which one should you use?  The nonprofit Funeral Consumers Alliance (http://www.funerals.org/) has estimated that the exact same package of services at different providers can cost anywhere from $2,500 to $6,000.  The FCA is offering a new book, “Final Rights,” which offers tips on how to navigate what it calls the “death industry,” which takes in $15 billion a year.

These questions are just the beginning of creating the ending that you want for yourself and your loved ones.  This conversation and others are essential from many perspectives and we will continue to explore them together. For now, simply stated, holding this conversation could not only save money for the heirs of loved ones, it could also reduce the confusion around decision-making during a difficult time of grief.  We suggest starting the conversation with a discussion about a medical power of attorney, another important safeguard of everyone’s well-being.