Coronavirus (COVID-19) and funerals: Your questions, answered

Filed Under: Costs, Patients

By MOLLY TAFT and JEANNE PINDER

It’s awful: You are grieving a loved one and need the services of a funeral home in the era of coronavirus. You don’t have any idea what to expect. Here are some key questions.

Remember, funeral homes are used to dealing with grieving people. But they don’t have experience with coronavirus any more than the rest of us do. Some are putting up handbooks on their websites to help people understand the process. Here’s one from Woodlawn Cemetery in the Bronx, N.Y., and here’s another, from Pollock-Randall Funeral Home in Port Huron and Marysville, Mich. Your funeral home may have something similar.

Any funeral is emotional but yours is likely to be even more emotional, because — whether coronavirus was the cause of death or not — the funeral industry in impacted areas is overwhelmed. 

Here are a few questions and answers.

Can we have an open-casket viewing? 

That depends on the funeral home, and also on the restrictions in place in your area. Chances are that state or city regulations governing how many people can gather at a time will affect your choices.

The Centers for Disease Control (C.D.C) has recommended that mourners refrain from touching, kissing, hugging or otherwise interacting with the body of a covid-positive loved one. If you are able to have a viewing, be aware that the funeral home may ask you to keep a certain distance from the casket.

Can I be at my grandma’s funeral?  Can we all drive to the cemetery and watch from afar? 

The “social distancing” rules in the era of coronavirus will affect the answers to this question. The Michigan funeral home mentioned above says on its site, “the Michigan Funeral Directors Association in compliance with federal guidelines,  has strongly recommended that NO events of more than ten people in one room at a single time be held.” 

Some families are choosing to do a memorial online via the videoconferencing platform Zoom, and some are doing an interment in which the families drive to the cemetery and watch from afar, observing the 6-foot social distancing rule. 

How are funeral directors dealing with the possibility of catching COVID-19 from their work? Are there precautions that funeral workers must take in handling/removing a body? 

National and state funeral directors’ agencies, including the National Funeral Directors Association (N.F.D.A.), have issued guidance on basic hygiene for funeral workers transporting, handling, and embalming covid-positive bodies, based on C.D.C. recommendations. Your funeral home is likely following rules on hand-washing, personal protective equipment  and cleanup to keep workers safe.

But according to a FAQ provided by the N.F.D.A., the C.D.C. hasn’t issued recommendations on several important questions around COVID-19 and funeral homes, including whether or not refrigeration of a body effectively halts the virus’s spread, whether or not morticians should wait a certain amount of time before preparing the body for burial, and if formaldehyde, one of the most popular embalming chemicals, can neutralize coronavirus.

What’s more, the N.F.D.A. announced last week that the C.D.C. and the World Health Organization have issued differing recommendations on embalming: the C.D.C. says that embalming is safe with adequate protection, but the WHO recommends against embalming “to avoid excessive manipulation of the body.”

A funeral home employee in the coastal Mississippi region tells ClearHealthCosts that the lack of guidance and conflicting recommendations has been worrisome for her and other funeral home directors:

I have been discussing these procedures with my coworkers and other funeral home employees at firms outside of my own. We have all been brainstorming trying to tweak our normal procedures and cleaning methods to ensure the greatest amount of safety. 

Our funeral home had [disinfecting] supplies when cases began rising in New Orleans…but were unable to order more when we realized the gravity of the situation. The supply was simply unavailable at that point. We have enough for the time being, and hopefully will be able to get more before we run out. There is a lot of uncertainty surrounding future availability. I have made trips to large stores in an attempt to get more disinfectants and bleach, but so far without luck. With citizens panic buying the stores out, there is simply none left for us.

I am sure we will incur additional expenses as a result of the pandemic, as we will be using more gloves and other P.P.E. than we normally do. That’s just a given in a situation like this.

The biggest issue is that we have never faced a situation like this, and everyone is learning how to handle it by the day. No one expected it, and everyone was woefully underprepared.

Under the Health Insurance Portability and Accountability Act (HIPAA),  hospitals are not obligated to tell funeral homes the cause of the patient’s death in many states. You may want to tell your funeral home about your loved one’s illness so they can safety prepare.

What happens if you can’t pay? 

The pandemic and the recession have already hit millions of families hard. The cost of a funeral – which averages between $7,000 and $12,000 – can be astronomical for many in normal circumstances. Even direct cremation, the simplest and cheapest option, can still cost hundreds of dollars

Families with no way to come up with funds can call their county coroner for assistance, but funds to help lower-income families with burials have been cut from state budgets in recent years. The Associated Press reported last year that several funeral homes have been charged in recent years with improperly storing remains after families were unable to pay to have their loved ones buried.

Some life insurance policies will cover burials, and funeral sites also encourage those with good credits to look into loans to pay for the funeral. Donating a body for medical science, which is free or with a minimal cost for body transportation, is also an option. The American Association of Tissue Banks, an accredited trade tissue organization, has more information on how to donate a whole body. 

There’s always crowdfunding. In the third week of March, the CEO of crowdfunding platform GoFundMe said 1 in 3 fundraisers started in recent weeks were related to the coronavirus, and a quick search on the site shows that dozens of families have already started using the platform to raise money for their family members’ funerals.

How can you save money? 

The Funeral Consumers Alliance is a nonprofit organization that says it’s “dedicated to protecting a consumer’s right to choose a meaningful, dignified, affordable funeral.” It has a guide to planning a funeral that some might find helpful. Another resource: The Funeral and Memorial Information Council, a funeral industry trade association, has a checklist of questions at talkofalifetime.org. Remember that F.C.A. is a consumer group and F.A.M.I.C. is an industry group.

The comparison shopping site parting.com has, well, comparisons, for full funeral, direct burial and direct cremation in many major U.S. cities. Here’s the one for full funerals in the New York area.

The choices you will make are numerous — what kind of casket? If you’re cremating, you don’t need an expensive casket. You can also buy a casket at Costco, and the funeral home is required by law to accept an outside casket. (Some restrictions apply.) Amazon also sells caskets.

If you’re cremating, there may be choices of where to do it, varying by cost. It’s worth asking. 

If you’re cremating, do you need to pay embalming fees? That can add hundreds of dollars to your bill.

Shop around. We know it sounds crazy, but prices can vary significantly. Here’s a useful tool for reading a price list from a funeral home: You could call several places and ask for several price lists.

The F.C.A. website says: “Funeral directors are business people who deserve to be paid for what they do. However, it is your job as a funeral consumer to be well-educated about your options, to determine the kind of funeral or memorial service that meets the needs of your family, and to locate an honest, flexible funeral director who will honor your choices with caring and dignity.”

The Federal Trade Commission Funeral Rule of 1984 requires that a general price list be issued to a consumer, including these points, according to the F.C.A. 

“According to the Funeral Rule, prices for the following goods and services, if offered by the funeral home, must be shown on the General Price List,” the F.C.A. says.

  • Direct cremation
  • Immediate burial
  • Basic services of funeral director and staff, and overhead
  • Transfer of remains to funeral home
  • Embalming
  • Other preparation of the body
  • Use of facilities and staff for a viewing, funeral ceremony and/or memorial service.
  • Use of equipment and staff for a graveside service
  • Hearse
  • Limousine
  • Forwarding remains to another funeral home
  • Receiving remains from another funeral home
  • Caskets
  • Outer burial containers (vaults)

You might find a price list online, though that is the exception rather than the rule. Here’s one from the William G. Neal Funeral Home in Washington, Pa. (screenshots below)