End-of-life planning includes new options

By Shelley Widhalm for Aging at Altitude

Planning for hospice care and end-oflife services during happier moments frees up the decision at a time when friends and families already might be grieving.

“There isn’t second guessing on the family’s part that they’re doing the right thing,” said Seth Viddal, co-owner and chief executive officer of The Natural Funeral.

When it comes to end-of-life planning, the conventional decision is either burial or cremation, but in recent years, body composting and water cremation have become additional options.

The Natural Funeral, a holistic funeral home and cremation services provider, opened in March 2019 shortly after the state approved water cremation, expanding to natural organic reduction in September 2021 when the state approved it for body disposition. The Natural Funeral provides both procedures at its ecological center in Arvada and has funeral homes in Lafayette, its global headquarters, and Loveland.

“They both are very environmentally friendly, and they return our bodies to the earth in the form of gifts,” Viddal said. “It changes the last act from something that pollutes to something good for the earth.”

Water cremation, scientifically known as alkaline hydrolysis, is a process that involves placing the body in a chamber and using water, heat and alkaline chemicals to accelerate natural decomposition. In three to four hours, the body becomes a sterile liquid containing no DNA or pathogens, but only scientifically measurable elements. Those include macronutrients like nitrogen,

Planning for hospice care and end-oflife services during happier moments frees up the decision at a time when friends and families already might be grieving phosphorus and potassium and micronutrients like calcium and magnesium that can nourish growing plants. There isn’t any pollution, like with flame cremation, and it’s more energy efficient because natural gas does not have to be burned to incinerate the body. The Natural Funeral is the first company in Colorado to offer the service and has provided the service to 400 families so far.

Natural organic reduction, commonly called body composting, is a process that uses biology instead of chemistry. It works like garden or industrial composting, where microbes break down biological and biodegradable materials into a nutrient-rich, organic material that can be put back into the soil.

“This is a two- to fourmonth-long process. We call it the long goodbye,” Viddal said.

The process takes place in a chrysalis vessel in a controlled environment, where temperature, air flow and moisture levels are monitored. Body composting sequesters more than a thousand pounds of carbon from the environment and does not use any energy or cause any pollution, Viddal said.

“This is by far the funeral choice with the most positive environmental footprint available to anyone in the world,” Viddal said.

Greenwood & Myers Mortuary in Boulder added water cremation and body composting in 2022. The mortuary opened in 2011 and added a Frederick location in 2022 and two years ago began offering receptions in Boulder.

“Families can do everything in the same place without having to relocate to a restaurant or someone’s home,” said Mike Greenwood, co-owner of Greenwood & Myers Mortuary

Individuals considering end-of-life options can make the prearrangements by sitting down with a funeral director or counselor. They can decide if they want the funeral service at their home or a funeral home; how they want the casket or urn to look; and what they want during the service, such as music, liturgies and floral arrangements. They also may want to honor their spiritual beliefs, customs and traditions, as well as their values, such as being environmentally friendly or acknowledging their love of nature or being on the water.

Prepaying for the arrangements and service locks in the current price and removes the financial burden from the family, especially at a time of grieving.

“It’s about documenting it and making sure the plan you want is what you get,” Viddal said.

Preplanning involves four stages, starting with deciding on a burial or cremation and the type of service, whether a traditional funeral, memorial or interment, said Jeffrey Hunter, owner of Peace of Mind Services in Brighton. The other stages include deciding what to spend, determining to pay now or at the time of death, and sharing a filled-out planning guide with loved ones.

“It’s letting loved ones know who to call, what your wishes are and where the information is kept,” Hunter said. “That’s the biggest thing is helping people make sure their affairs are in order, and preplanning is a wise thing to do.”

Alternatively, hospice planning starts with eligibility and a patient decision, said Chad Hartmann, director of access and palliative services for TRU Community Care, a nonprofit based in Louisville. To be eligible, patients need two physicians to sign an order stating they have a terminal illness life expectancy of six months or less and that they do not seek curative or prolonged treatment, he said.

The patients opt for comfort care and agree to not seek hospitalization except for unrelated things. They receive their care at home or where they may be staying, such as a nursing home or assisted living facility, or at TRU Care’s in-patient unit for symptoms needing 24-hour oversight or up to five days of respite care for caregivers.

“A lot of it is educating the community what hospice is,” Hartmann said. “People think you die right away, but once patients are in hospice care where their symptoms are managed or their pain is under control, they might live longer than previously thought.”

Hospice care looks at the entirety of care for patients through an interdisciplinary team approach that includes a physician, RN, CNA, social worker and chaplain.

“It is encompassing the whole being, not just the illness the patient is going through,” Hartmann said.

“It’s allowing for us to help those patients live their last six months the way they want their life to be lived.”