 My hope is that at the end of this evening that all of you will have perhaps a lot of questions answered, maybe learn something new and perhaps have time to share some funny stories actually from our industry. So I think with that said, I thought during the course of the day, you know, what should I start with, you know, because we have different speakers. And I thought, let me perhaps just share some San Francisco history, you know, funeral related. While I don't have any props to show, but I've had this little sheet of paper on my desk from 1967, long before computers, the gal at the San Francisco Health Department. She used to type out manually all the funeral homes on this list and she had a little graph to month by month how many permits or in other words how many funerals each funeral home was handling. And the interesting thing on this little sheet of paper is in 1967, we had 41 funeral homes listed in San Francisco. 41. Today we have eight. And so even when I give speeches to other funeral professionals, they think, gosh, you know, Fred, what's happening, you know, has our population shrunk? No, no, I haven't, you know, but times have changed, you know, greatly in these years. And so in my 40 years, I thought, well, let me just kind of maybe talk about from a historical standpoint, you know, what's happening while, you know, as a young man, you know, starting an apprenticeship in Portland 40 years ago, I served in an embalming apprenticeship there. And I came to San Francisco where I continued another two-year embalming apprenticeship, became licensed as a funeral director and I initially started with a very, very traditional setting. You know, my employer back in those days owned five funeral homes in the Bay Area. Three of them were in San Francisco. And back in those days it was largely, you know, different ethnic groups, different religious groups, you know, that we all primarily cater to. And I would say by and large those were predominantly traditional burials with a little sprinkling of cremations here and there. Fast forward, you know, 40 years later, this is now just kind of the opposite. Now we have, you know, predominantly cremations with a sprinkling of traditional services. So as a funeral director, as a manager, you know, I handle all of these different groups. And I think still kind of representing the traditional funeral home. I think I probably won't spend any time talking about what others here are doing. But yes, times have changed. And I would like to maybe talk about the importance of, you know, what happens, you know, when you pass away? We have people dying more and more at home. You know, years ago, I would say maybe a couple of decades ago, people were primarily dying in nursing homes and in hospitals. Today we have thanks to hospice. More and more people are passing away at home. Sometimes they're under hospice care. Today I had a gentleman that walked into our office and his dad passed away. And I said, oh, okay, where's he at? I just assumed he must be in a hospital. And he said, no, no, he's still at home. And I said, oh, okay. I said, was he under hospice care? And he said, no, no. And I said, oh gosh, okay, well, you know, then we have to call 911. So I had to walk him through this whole process. You know, what happens, you know, once that one dies unexpectedly at home, you know, which is a big, big difference. So unfortunately, I said, you know, you're going to get the sirens, you know, you're going to get the paramedics showing up. Their job will be to confirm that dad has passed away. I said, I'm a funeral director. I'm not a paramedic. I'm not a doctor. You know, I can't confirm, you know, showing up to somebody's residence that they in fact have passed on. So I said, that's what they're going to do. And I said, but before they leave, they will already dial the San Francisco Medical Examiner's office. And I said, so probably an hour or two, you will get a white van pulling up. And the deputies that will show up at your residence, their job now will be to decide what has happened to the deceased. You know, was this a natural death? You know, was this, was there an accident? Was this a homicide, a suicide? So those deputies will start asking you questions, you know, did dad see a physician? And it will be their call essentially to decide, will they take the deceased down to the medical examiner's office for an autopsy, for an investigation? Or will they release the body to the family's funeral home of choice? So that's what happens, you know, when you pass away at home. I would say one of the things that I'm really passionate about, that I have seen in the city, you know, where we don't necessarily have, you know, especially a few years ago, a lot of untraditional families or relationships. I would get on every month, individuals coming in here trying to make an arrangement for a loved one. They had no legal relationship to this individual. They didn't have power of attorney. They were not related by blood. And I would have to say to them, I said, you know what? You have no legal authority to make any sort of arrangement. And unfortunately, over the years I have watched these individuals having to contact a natural family, perhaps in another state, coming into San Francisco and having to make an arrangement for a son, for a daughter, that oftentimes did not reflect that which the deceased would have wanted. And I thought this is so terrible. I've seen so many terrible services, I have to say, that I would just cringe. And so years ago, you know, being a member of the Upper Market Merchants Association, we had workshops. And I've encouraged different merchants and friends and neighbors. You really have to understand the importance of having at least power of attorney for health care, perhaps for finances. You know, your advanced health care directive is something that you can just download right off the Internet. And it's hugely important. I think everyone in this panel will confirm that in the state of California, when someone passes away, the legal decision maker, according to Health and Safety Code 7100, is if the deceased himself, he or she did not make those arrangements with some funeral home, then it's whoever has this advanced health care directive. It also has power of attorney for health care. So that individual, the buck stops with them. That supersedes any other relationship, be it a spouse, siblings. So it's hugely important. And I would really, really like to encourage everyone. This is a free form that you can just download, but it's a very, very important form. And it's surprising how many people don't have this form in place. And if you don't, again, you're having to leave this up to a natural family to make decisions for you. So anyways, that's something I just thought, let me just convey this. And as far as I think changes that I have seen, you know, even though we have gone really from very, very traditional services, you know, I still handle lots of traditional services, but these are primarily pockets in San Francisco of different ethnic groups or different religious groups that still have a strong feeling on the traditional service. That's where we exist as a funeral home. We still handle lots of untraditional services. I would say the cremation rate for us is probably now like at 70%. We shipped bodies this last week. We had a family that came from the Ukraine. They had a son that was not well. They were not able to help him in this country. So I had to send this four-year-old boy back to Kiev. I had a gentleman that just got off the airplane from Germany, and he died just after he checked into a hotel. I had to send him back to Germany. I had a middle-aged lady that was visiting from India, and I had to send her back to India. So these are some of the functions that, you know, we still do as a traditional funeral home. You know, I have to work with consulates or with embassies. My job is to know international shipping laws because each country has different varying laws. So that's basically my function as a San Francisco funeral director. I'm kind of a dying breed, if you will, because of changing times, you know. While I have high respect in a Claudette who works for the Will Body program, both of us used to work together, and it can perhaps even share a story. You know, because Claudette speaks Spanish, I historically handled three different convents in San Francisco. Two of them are cloistered convents where the nuns never, Catholic nuns never leave the building. And so I would have to come in with our staff, and Claudette, who spoke Spanish, and a lot of these nuns spoke Spanish, were very useful, you know, where up until a few years ago, one of the nuns would pass away. They didn't want for the nun to leave the convent. They wanted for us to prepare the body and embalm them there. So my late employer, the late Mr. Sullivan, would prepare the body there. Nowadays, we would bring the body to the mortuary, have the nun prepared, brought back on a gurney, and Claudette would help us dress there in the convent. And anyways, I see that I'm being told that my time is up. Anyways, I'll be happy to answer any questions, and thank you all for coming here. And as I said, I hope you guys will get some answers to some questions that you may have had. Thank you. Good evening. I'm Janeth Gomez. I work with Furnwood Cemetery. We are a funeral home, crematory, as well as a funeral home. What happens to our body when we die? Imagine your life being celebrated by your loved ones. This is our chapel. Where will you be buried in a meadow or amongst trees? One of the benefits of green burial is conservation and restoration of land. Natural burial grounds involve practicing land stewardship and restoration planning. Furnwood practices sustainable and ethical burials in addition to protecting open space, wildlife, and natural habitat of the grounds. They are a national wildlife federation certified wildlife habitat. This is part of our, we have, traditional as well as green burial. This is what you normally see, traditional gravestones. When you go to your common cemeteries, this is usually the site that you will see. At Furnwood and Green Burial, your body is shrouded in woven natural fabrics, such as cotton, linen, bamboo, or silk. This body is shrouded, there is no casket, there are no liners. You're lowered into a grave. Some people, one of the things about green burial is there is no chemicals, no metal, no plastic goes into the ground. Your loved ones are able to place flowers or other biodegradable items with you. Through green burial, you're closer to the earth, a part of the earth, with no concrete vaults or metal caskets separating you from nature. Fresh graves appear mounded but flatten with time as the body naturally decomposes and unifies with the earth. Tyler Cassidy created Furnwood to be a place where memory, ecology, and community thrive, a place where burial and cremation rituals are interwoven with land stewardship and restoration. Furnwood is a test of the revolutionary notion that cemeteries could use burial as a means to conserve and protect natural spaces and land. The way he came up with this concept was in 2004, he visited and was inspired by the woodlands burial lands outside of London, England. He saw that green woodland burial was viable and was attractive in a cremation dominant culture. It wasn't until the Civil War when bodies were being transported from battlefield to home that current funeral practices such as embalming became popular. So in many ways, green burial are simply a return to traditions of the past and some religious groups adhere to those practices even today. Green burial is different from natural burial. Natural burial strictly refers to the burial process. Green burial is a burial process as well as the cemetery in which the burial occurs. A green burial cemetery was meet certain eco-friendly criteria. Again, green burial does not involve using formaldehyde, a known carcinogen that poses health risks to the people who work in funeral homes. Nontoxic materials are used for sanitation and preservation such as orange blossom, rosewater and essential oils. As you look across in a green burial cemetery you'll see several stones that look like they're just a part of the landscape. What they actually are are gravestones. One of the things that we do is we don't use traditional. It's traditional granite. They're usually unfinished stones. This is just an example of stones that families are able to choose from or bring in one of their own. Fernwood also has a scattering garden. So there are people that if they don't want to be buried they're able to just have their ashes scattered in this garden and your family is able to come and visit. And I'll be available after for questions. Thank you. Hi there. My name is Jerry Grace Lyons. I live in Sebastopol, California. And my journey began in 1994. I was doing a completely different career job of type of body work at a medical center and a friend who was a nurse and a Reiki master went to work one morning and to take care of an 80-year-old woman. And after breakfast said she wasn't feeling well. They called 911 and the paramedics came quickly but they weren't able to resuscitate her. She was 56 years old and she had a history of asthma and they pronounced her on the way to the hospital. But in her wallet they took her purse with her and in her wallet they found a card that said in the event of my death call this person Norma Wilcox in San Francisco. The woman who died, Carolyn, lived in Santa Rosa but had been close friends with Norma for over 20 years. And so they called Norma and told her and Norma phoned somebody up in our area and quickly the word got out. And we all met at Carolyn's home that night and Norma explained to us that Carolyn had written out her instructions of how she wanted to be taken care of when she died. And those instructions said she did not want to be sent off to a mortuary. She wanted her friends to bring her home from the hospital if that's where she died. That she wanted those friends to wash her body and dress her and do ceremony with her in her own home and to play this music that she loved and have flowers that she loved around her and take care of her body there. And that was of course a big huge surprise to all of us. I mean we were not only in grief and shock over her sudden death but now we're finding out that we're going to bring her home and take care of her body. And we had never heard of that. I'm curious to know how many in this room have heard of people taking care of their own loved one at home. Quite a few of you. And of those hands that went up were any of those people recently cared for at home or how many of those were taking care of more recently where you've actually seen them in the home? Just one or two. So for the most part these are stories perhaps you heard of parents or grandparents who used to do this. And this is what I call tradition in our country and that is people caring for their own dead. So this was my first experience and I along with all our friends did not know that it was legal to do this. So we brought her home and we had this most incredible experience caring for her body in a very personal, very intimate and very loving way. And we found it wasn't hugely difficult. It was just like washing the body of a friend or a relative who is sick and you are giving them a bed bath. That's what we did. And we did it in a very loving and honoring way. And then we had her at home and we had let other people know that she had died suddenly and after we cared for her body people started to come by to say their goodbyes and to pay homage to do what people do when they are in deep grief and we had ceremony there just like Caroline asked for. We brought her out into the living room on a little futon mattress and we sat around her and we told stories, we laughed, we cried, we talked about how we knew her and many experiences we had with her. And then we took her to the crematorium on the third day and there they had a box prepared for us to place her in and they cremated her. So that was my initiation into this work and it was so profound for me such an awakening for me that this was something you could do that really helped all of us deal with our grief and deal with our shock to be able to touch her body in this loving way and carry her right to the crematorium was very, very special and amazing and I started thinking about why more people weren't doing this and how precious that time was that we had caring for her body and getting used to the fact that she was dead because it was impossible for our minds to accept her death instantly. We just can't do that as human beings. We hear this information and we kind of go into shock but it's hard to take it in that the person is no longer alive. Well this led me on a whole journey and a year and a half later started a non-profit called Vinyl Passages and today I have and my husband and a number of other people that we now have in a core council that we are training as interns we have all guided over 400 families through family directed home funerals. The family has the legal authority to make all of these decisions and that authority is given to us in a little booklet that's put out in every funeral home in the state of California on page 7 I think it is it's called Home Death Care and you can find it online through the Cemetery and Funeral Bureau in the state of California and it says that families can make their own arrangements care for the body at home and they can even fill out and file the death certificate and the disposition permit documents that need to be filed with our state of California the county in which the person died and that you can then transport the body to a crematorium or cemetery of your choice. So this has been an incredible, incredible journey it was really hard when I began because it has just been enough generation since we all cared for our own loved ones because people had forgotten that you could or what it was like or how to begin or even feel comfortable at home doing it and I recognize that right away so that's when I formed a group at my home and we started going out and talking to families and guiding them once we found out all the laws and how to stay within the law and how to fill out the paperwork correctly we could then teach the families how to guide them through this and then each family that we helped would go through it and have the same transformative experience that I had with Carolyn every single one of them at the end said I can't imagine doing it any other way now that I've been through this in this way just a family we helped last week the women said at the end I had no idea how comforting it would be to have my beloved home with me for a couple of days past her death and there's no time limit so in California you have unlimited time most families keep someone at home three days but we've had four or five and six day weeks we use dry ice to preserve the body and it does a very very good job and again we're educating the family on how to do all of this and we're walking beside them so they feel comforted and know what to do so I'm just going to show you a few quick slides so you have a sense of what a home funeral looks like this is a pine box that one of our young women she was 32 when she died she bought the pine box from a woman who makes plain pine boxes and she began to stencil it with the help of her friends people can decorate the cardboard cremation casket in whatever way they want so this is a group of family members doing just that they painted it green because it was just brown cardboard and then they started decorating it this is their person after they washed his body and dressed him and brought him in to a certain room in the house and decorated him with flowers and you can see he's looking very honored there young man, the 11 year old Jules his 38 year old mother died from melanoma and he and all his friends were decorating the box these are just a way of people expressing their grief through art therapy you can decorate the box any old way you want and we've seen hundreds and hundreds of different ways this person was a quilter so her friends all took different squares and all made it look like a quilt children love to participate in the home funeral they find their role in every different way I had a 5 year old lead someone into a room and tell the persons they could sit there talking to her grandfather and said it's okay you can sit here and talk to grandpa it's just fine and children love to decorate that's the inside of the box where the person was going to be lying in honor these people used Day Kapaj this young woman decorated the inside of the caskets her mother would be looking up at clouds and then the lid, the top lid beautiful families have used all kinds of vehicles for their loved ones cars, vans, trucks including this one so Sarah sadly got cancer and her husband then built a pine box and friends helped him decorate it and then he drove her on that favorite truck of his to the crematorium people go right into the crematorium and they say their final goodbye there sometimes and watch the casket go inside the retort or chamber where the persons can be cremated again this is Jules and his friends filling in the grave where his mother was buried very cathartic experience for young men all people really and there's an example of a crematorium where people are watching the casket go in and helping sometimes push it in and start the machine and these are a few green bureau pictures which you just got to hear about no grave liner and we do a lot of education around this and we have a whole three tiered program of courses where people can learn how to be a guide like myself and or just explore death and dying for themselves and how to prepare for it as well as help somebody else through a transition and again just some more green bureau pictures okay that's it thank you very much I'm Claudette and I'm here from sorry can everyone hear me I'm here from the UCSF World Body Program if you've ever wondered what happens when a person donates their body to science they come to us we accept whole body donations for research or education we accept donors from all over northern California from the Oregon border down to San Luis Obispo and we also provide specimens for universities, community colleges hospitals in all of northern California as well oh sorry you have to get right up close oh okay is this better yes yes yes yes thank you what was I saying a lot of people wonder if we're the same as the Oregon donation people and those are the sticker on your driver's license folks and we're not they provide living organs for living people those are transplants so if anybody needs a kidney or a heart or something like that that's the that's donor network west the willed body program accepts whole body donations and these are used for research for surgical training for instruction in universities but the people who donate never donate organs to another living person if a person wants to register I left some registration packets over there I see that they're gone but if you can always go to our website or call our office and we can mail something out and our registration packet asks some personal information and this is all information that would go on a death certificate but it asks some additional information about medical history and I'll explain why we ask that in a minute what's important in registering is that you tell your family what your wishes are and have a discussion with them first we would hate for anybody to be blindsided at the moment of your death and find out that you're going to be taken away and they're never going to see you again if you donate your body to science it's not possible to have a traditional service like what Fred would provide it's not possible to do a six day home funeral we don't return cremated remains and that's a deal breaker and that's understandable so it's important to have that discussion that way if you do decide to donate they can plan something ahead of time often times families will call and say hey John died he's a registered donor with your program can you hold off on picking him up for a day so that we can have people wait until the next day so we can have people come over and say goodbye and of course we can do that whenever possible so things like that we can accommodate but that's only possible if you have the discussion with your family so that they can they can think about that before the time comes let's say someone does decide to donate and they come to our program they'll come to our facility and we'll decide how each donor gets used and there are several areas that are more ways that a donor can be used and how I'll decide is by looking at the needs at the time we might have a course coming up where they're doing tons of spine surgery or we might have a huge need for embalmed cadavers and then I'll look at the donor's medical histories and I'll also assess the donor I'll take a look at every person and look at their scars if somebody has an 8 inch scar on their knee that probably means they had a knee replacement so we won't send them for knee surgery but if somebody's had a hysterectomy I'm not going to send her for hysterectomy work because there's no uterus there I wouldn't send a man either we'd send the appropriate donor for the appropriate use some different uses that we have are things like surgical training if any of you have had a surgery recently or know someone who has you know that a lot of it's laparoscopic now and laparoscopic surgeries where they make you know a few small incisions and they'll use a camera to do the surgery and we need to have surgeons trained on the new technology we need to have them trained on the new procedures and there are a lot of facilities here in the Bay Area that provide this training and we provide the cadavers for that training people fly out here from all over the world to get experience in this new technology and we all stand to benefit from it surgeries eventually I think something that I personally find really exciting in the area is new procedures that are being developed and maybe devices that aren't on the market yet to give you an example we have a vascular surgeon that works out of General Hospital who invented a device and his invention was so good that he received some money to continue developing it and this is if you've had dialysis or you're familiar with somebody who's had dialysis you know that an access point is necessary before somebody begins treatment and this is a surgical procedure it's an arterial venous fistula and this is where they connect a vein and an artery together and that's the access point and a lot of dialysis patients have some trepidation before going into this surgery it's a surgery you go under anesthesia it takes about six weeks to heal and there is a chance of infection and this surgeon developed an implant or I'm sorry a device that can be implanted percutaneously so just under the skin this would be an office visit this would be something that could be done in one to two hours it would have very little healing time much better outcomes and it would reduce cost and the CDC put out a statistic that over 25% of people over 65 have diabetes in the United States type 2 diabetes in the United States so these are the things that matter and so what he asks of us is to send him arteries and veins so I'm constantly harvesting arteries and veins from arms and sending him to him so that he can continue developing this and I'm really excited to see where this goes and to see this help people and eventually help me probably because one in four is a lot of people so if I don't get diabetes then maybe the next the other thing that our cadavers are used for is for bioskills work or biomechanics so that's new implants like for knee replacements, hip replacements if you need shoulder work, spine work all of these things and all new implants that are developed have to be tested on cadavers first or new residents also have to train on cadavers first before actually doing this on a living person so in these few ways I think we've all been impacted by people who've donated their bodies the bulk of the work that we do and what we provide the most of is embalmed cadavers in medical schools and community colleges and quickly embalming is a process where we inject a solution that contains formaldehyde into the body, we'll use the body's own vascular system so we'll inject through a vein and this will distribute through the body and into the capillaries and preserve the human being and like Janet was telling you we do it for long-term preservation at a funeral home, it's for cosmetic purposes so we'll send out these embalmed cadavers to different schools all over Northern California and medical students are often nervous their first day working with a dead body some of them have never seen a dead body before as days progress and they continue learning more and more from this person they create a connection they start to see how the person lived through the way their body looks they start to learn about the person maybe through their disease or their abnormalities or whether they've had children or not they start to think this is a person who was alive and had thoughts and feelings and loved and was loved and this teaches our medical students compassion which is something that a book can't teach them this is something that virtual reality or computer simulation doesn't teach and that's the value in having people donate their body to science that's our future physicians actually learn how to relate to people and how to respect humans and a reverence for life more than they would have if they had just learned this from a book personally I think it's important for us to see the weirdness in people we're all a little different and working with humans who have donated their body to science rather than a machine shows us diversity that we wouldn't see otherwise we wouldn't see in a book and I don't just mean diversity in the sense and the way that we commonly talk about it as far as race or gender I was making a skeleton once and this doctor donated his body to science and he was really excited to donate his body to science and I sent him for surgical training and he came back to our facility and I thought he would want to be a skeleton like this guy would love to be a skeleton so I decided to make him a skeleton and I was cleaning off the bones and I was going through the bones in the feet and I couldn't find two of the phalanges the bones in your fingers and your toes one bone from each pinky toe was missing and I was looking everywhere and I was horrified and I was angry and how do you lose that I'm the only one here you can't lose something it's a locked facility and then I thought what are the chances that I would lose the same bone on each foot so I googled it this has to be a thing and it turned out that it's a thing that the population is missing a joint and their pinky toe a lot of you that are laughing right now are missing a bone in your pinky toe and it's little things like that little weirdness about us we've gotten we had a man come in that had cytosine verses which is where your organs are are inverted they're like mirror images of each other so your heart's on the left his heart's on the right his liver's on the left we had another man come in with four functioning kidneys and these things are benign these things they cause no there's no problem for him he was living his life he probably had to pee all the time but he had a good life when you get people like that who are different but fine it's fun and we like to preserve these people and send them to future physicians so that they can see it's important to learn about what's going to kill us but it's fun to find out what's not going to kill us and that's what human donation provides that's what working on people as opposed to animals or as opposed to computer simulation or virtual reality provides thank you one more minute I guess in closing this may be a thing for you this may be something you're interested in it might not be either way keep in mind people that donate their body to science or heroes because we've all benefited in some way from people who have given us this gift thank you very much hi everyone our next speaker has arrived we introduce to you Amy Jones Amy has been with the Neptune Society of Northern California for five years before that she worked in disability and life insurance she has also been a hospice caregiver Amy is passionate about helping individuals handle this issue for themselves so that their wishes are clear and so that their survivors avoid the stress of making arrangements while grieving please welcome Amy Jones to the Neptune Society welcome good evening everyone it was great to be here and have a chance to talk to you can you hear me okay? all right cool well I think the best way for me to start is how I often start with someone asking me why in the world are you working for a cremation company whatever possessed you to do such a thing and strangely enough I think it actually started when I was about eight years old my family is a very traditional black Baptist denomination and of course we went to church all the time and even as a child I went to the funerals and we had our own celebrations our own processes just like every other ethnic group but the fact when my grandmother died I watched all of these grownups that I'd heard about heard them spoken lovingly about the scoundrel stories about that character they never were on the scene when we had gathered as a family for festive occasions but when somebody died here they come brand new clothes brand new cars showing up and hanging out for days on end and I thought that was ridiculous it just didn't make sense to me but I was also a child that cut all my hair off my head so I've recognized that my thinking is different so cremation isn't for everyone but through my life I've experienced that not everyone has family has friends there to grieve and to support and as I came into this industry I realized that many people just they may have those people in their lives but they don't want them involved they want to get everything set up and they want to leave strict orders many of them don't even want their body viewed once they're gone and so we at the Neptune Society and other full service cremation companies offer folks the opportunity to set up arrangements in advance so that you can not only explicitly state what it is that you want but we can help you prepare the paperwork in such a way to ensure that your wishes are honored at the time if you're deaf I would also like you to know that a lot of folks are reluctant to talk to me about cremation because I'm either not serious enough in my presentation this is a rare day when you see me wear black and brown at the same time usually I'm wearing a very bright color or I wear a lot of blue and they say you're the cremation lady, yeah but I don't deal with death I deal with the preparation of death so let's talk about it from that standpoint but also now I've lost my train the wishes are honored and that everything is in place and that no one has to make any decisions for them I've even encountered quite a few people especially in San Francisco that don't want their relatives to be notified that they've died and so just like every other aspect of our lives different people have different needs we're here to provide the support for what you need I have nothing to no judgment to make and none of the people in our staff come at it from that standpoint we're here to support you to let you know what your rights are let you know what your family's rights are and I'm here to assist you in getting you where you need to be so cremation is an option for people that are looking for something a little differently to be handled a little differently and to support things like procedures at home, home celebrations that's where I was going a lot of people don't want to talk to me when they see that I'm with an Neptune Society because they associate my company with our boat out at Pier 39 and they assume that we only do things a certain way we do whatever we need to do and frankly maybe 20% of our families use the boat actually the boat is probably used predominantly by people that don't want a formal service they just want to remain scattered post cremation if there are any family members remaining they want us to notify them when it was done and how it was done that's it so I am excited to have to be a part of this panel to have an opportunity to talk to you about really what a decision that is yours to make is your body as you inferred earlier this evening we have kind of skipped over the last few generations we've forgotten about how things used to be done and we've forgotten that the old folks always said this is what I want and this is how I want it done we need to take that responsibility back it's our body this is my body and I don't want anyone else making a decision about how it's to be handled and I don't want to burden those folks that are left behind whether it's a judiciary or a relative I don't want them to have to make a decision well okay is it going to happen on Tuesday or Wednesday or is it going to be a viewing or not come on take care of your own business whatever it is and then make sure you talk to someone so that all the ducks are lined up in a row and nobody can come behind you when you're gone and you can no longer speak for yourself okay we got a plan alright let's do it thank you thank you speakers, thank you audience now it's time for Q&A please hand me your blue cards Chelsea on this side and Randy over there and we'll collect them and give the speakers your questions if I may just listening to our panel here I'm saying to myself boy I just want to live so I have a question and it's can people walk stroll in your wild life open space area if you're just general public and have no loved one buried there absolutely one of the things that our owner likes is that it is a community space we are actually located next to Golden Gate National Forest we have a lot of hikers bikers that come through the area we have people walking dogs so it's definitely you're definitely welcome to tour and like I said we have a lot of the community that uses it even our room of remembrance is used for celebrations we've had birthday parties not just funerals not just celebrations of life in Mill Valley it's on the others just north of Golden Gate Bridge so here's a question it says most all deaths SF County be referred to the ME or medical examiner no only just actually very recently from the various from county to county so I'll just speak about San Francisco City and County anyone that passed away at home all home deaths all home deaths used to be reported to the medical examiner's office nowadays this just occur this last year if the individual who passed away is under hospice care then that is no longer reportable but anyone else yes this absolutely I'm dealing with again the gentleman this morning I'm having to talk to a physician who hasn't seen this deceased for about two months but the medical examiner's office was rather adamant that the doctor who was treating this patient for about like 20 years signed off on a death certificate so yes those have to always be reported to the medical examiner's office another question is what is the cost to bury or to burn so again we are a crematory our cremation start at about $1,000 by law you are required when you cremate to have a rigid container such as Jerry was talking about we've had the same thing where families come in they decorate the cremation container in order to bury the burial plot start at $8,000 another question is how long before you start to smell so the the body starts to go through changes almost immediately but bombing is not required by law it is a temporary preservation I was an embalmer for I've been an embalmer for about 16 years so I'm familiar with that process as well but basically you need to either be refrigerated or the body just needs to be cooled down and we've had people that want to stay at home for a day or two and they just need to be encouraged the families to get dry ice that again is another way of refrigeration when we bring them into our care the family is not prepared to immediately have a ceremony but we do also encourage families to come in and do the bathing and do the shrouding and really be a part of it and then they also it says pay now dig later so we do have pre-need services which is as a lot of the people on the panel have been talking about I congratulate all of you for being here and speaking about it I think that's one thing that too many families are left with the shock of the death and they don't know what their loved one wanted they don't know what their loved ones wishes were as Fred was talking about it's very important to have that advanced health care directive the one person that you've assigned that can make those decisions for you after death but there are as some of them have talked about you are able to place your wishes come in with any one of us and we can help you with that the forms that need to be put in place or what is your plan that way you have a decision on what happens after you die well I'd like to comment on what was just being said I have a different perspective given all the hundreds of families that I've helped with taking care of the bodies of their loved ones in their own home we see a very slow decomposition most of the time I'm not going to say 100% but in the 90% people as long as their body is washed well and dry ice is brought in to use to preserve the body we see very subtle changes over the first three days and surprisingly most families point to their beloved who died and said look they are smiling almost every time so and what makes me sad is that families often miss that they don't see they think they are going to see something where the body is just breaking down and looking terrible and instead what they see is an expression come over their face and often look like they are smiling so I just want to say that from my own personal experience this question I'm not sure I understand but I will try how has the concept of control over your body after life impacted the changes of the concept of control over your body versus AMA control over your body wow that's a little complex isn't it how that impact of the change of the concept of control over your body versus AMA I don't know I I guess all I can say is that it is our body and we do have some control over what is being done to it both when we are alive hopefully and following our death and I think the more people that take responsibility for their own bodies and make these plans make these advance directives and write down what it is we want the easier it is on all the people around us that's what we found out with Carolyn that in our shock in our grief we didn't have to try to sit there and figure out what she would have wanted and try to make a lot of decisions when we were all in shock instead we could just follow her wishes her plan and that made it so easy on us yeah I don't know about the AMA's control over your body I mean yeah if you're in the hospital I'll just say that if you're in a hospital and a family wants to take care of the body after the person died you have a couple of choices one is you can either ask the hospital if you can go in and have some time to wash the person and take care of their body dress them and have a little ceremony before they're taken away by a funeral home or you can request to take them and take care of them yourself and that is entirely possible and we just did that for family last week I don't know whether that she