Survivor's Guide Indiana University Health Bloomington - A loved one's guide after someone dies.
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Indiana University Health Bloomington Survivor’s Guide A loved one’s guide after someone dies. © IU Health 2014 4/14
____________________________________________________
This booklet was compiled and edited by Katherine Bultman, MSW, LCSW
With special thanks to the Social Work staff of
IU Health Bloomington Hospital and IU Health Bloomington Hospice.
© IU Health 2014 4/14
2 Survivor’s Guide: A loved one’s guide after someone dies.We at IU Health Bloomington would like to share our heartfelt condolences for your loss and have composed this guide as a way to help you navigate the challenges in the days, weeks and months ahead. We understand that this is a difficult time for you and hope this guide will provide some sense of relief. It is a hard time to remember what to do next, and we would like you to have some little part of us to take with you in hopes that we may help you along the way. The following information is being offered to you in case you feel a need to contact a member involved with your loved one’s care. We want to make the process of answering any questions you may have easier for you. Patient’s Name: _____________________________________________________________________ Patient’s Date/Time of Death: _________________________________________________________ Hospital Phone Number ......................................................................................................... 812.353.6821 Doctor: _______________________________________________ Office Tel: ___________________ Nurse: ________________________________________________ Unit Tel: _____________________ Social Worker: _________________________________________ Tel: _________________________ Chaplain: _____________________________________________ Tel: _________________________ If you are unable to inform us of your selection for a funeral home you may call the Patient Care Director and inform her of your choice. If there is no answer, please make sure to leave a message. A Patient Care Director is on staff 24 hours a day, 7 days a week. If possible, please let us know your funeral home choice within 24 hours of your loved one’s passing. Patient Care Director .....................................................................................................812.353.9030 Survivor’s Guide: A loved one’s guide after someone dies. 3
4 Survivor’s Guide: A loved one’s guide after someone dies.
Table of Contents
Service of Remembrance and Hope (SORAH) ...........................................................................................7
Funeral Planning .............................................................................................................................................7
■ Who Has the Right to Make Funeral Arrangements in Indiana?.................................................7
■ Funeral Planning Tips .........................................................................................................................7
■ Funeral Fees ........................................................................................................................................ 9
■ Calculating the Actual Cost of a Funeral ...................................................................................... 10
■ Services and Products ..................................................................................................................... 10
Burial and Funeral Funds ........................................................................................................................... 13
■ Social Security .................................................................................................................................. 14
■ Veteran's Administration ................................................................................................................ 14
■ Indiana Violent Crime Victim Compensation Fund ..................................................................... 15
■ Children Involved with the Dept. of Children and Services (DCS) ............................................. 16
■ Medicaid Burial Allowance ............................................................................................................. 16
■ Whole Body Donation ...................................................................................................................... 17
■ Persons with Extreme Financial Hardship ................................................................................... 18
■ Employees with Benefits through Their Employer ...................................................................... 18
Coroner’s Cases ........................................................................................................................................... 19
■ FAQ on Death Investigation ............................................................................................................ 20
Organ Donation ............................................................................................................................................ 21
■ Who Receives Donated Organs and Tissue? ............................................................................... 21
■ Organizations Involved in Organ or Tissue Donation .................................................................. 21
What to Do When a Loved One Dies ......................................................................................................... 22
■ To Do Immediately........................................................................................................................... 22
■ Planning the Funeral ....................................................................................................................... 23
■ To Do before the Funeral ................................................................................................................ 24
■ To Do after the Funeral ................................................................................................................... 25
■ Necessary Papers ............................................................................................................................ 27
Coping with Grief and Loss ........................................................................................................................ 28
■ Understanding the Grieving Process ............................................................................................. 28
■ What is Grief? ................................................................................................................................... 28
■ Everyone Grieves Differently .......................................................................................................... 28
■ Are there Stages of Grief? .............................................................................................................. 29
■ Common Symptoms of Grief.......................................................................................................... 30
■ Coping with Grief and Loss ............................................................................................................. 31
■ When Grief Doesn’t Go Away ......................................................................................................... 32
Survivor’s Guide: A loved one’s guide after someone dies. 5■ The Difference between Grief and Depression ........................................................................... 33
■ Can Antidepressants Help Grief?................................................................................................... 33
■ When to Seek Professional Help for Grief ................................................................................... 33
■ Common Reactions to Grief ........................................................................................................... 34
■ Coping with Grief during Holidays ................................................................................................. 36
Children and Grief ........................................................................................................................................ 38
■ Helping Children Understand Death, Loss and Grief .................................................................. 38
■ Informing a Child of a Significant Death ...................................................................................... 40
■ Children and Funeral or Memorial Service Attendance ............................................................. 41
■ Complicated Grief in Children and Teens ..................................................................................... 41
■ How to Help Children Following a Death ...................................................................................... 43
Bereavement Resources ............................................................................................................................ 46
Community Mental Health Centers .......................................................................................................... 47
Books on Grief and Healing ....................................................................................................................... 50
■ General Bereavement ..................................................................................................................... 50
■ Adults Helping Grieving Children ................................................................................................... 51
■ For Grieving Men .............................................................................................................................. 51
■ For Grieving Women ........................................................................................................................ 51
■ LGBTQ ................................................................................................................................................ 51
■ Death of a Child ................................................................................................................................ 52
■ Sudden Death ................................................................................................................................... 52
■ Death of Spouse or Partner ............................................................................................................ 52
■ Death of a Parent ............................................................................................................................. 53
■ Death of a Sibling............................................................................................................................. 53
■ Holidays and Grief ............................................................................................................................ 53
■ Helping Friends and Loved Ones ................................................................................................... 54
■ Children’s Books about Death and Grief ...................................................................................... 54
■ Books for Teens about Death and Grief ....................................................................................... 56
Helpful Websites for Grief Issues ............................................................................................................. 58
■ General Bereavement Links ........................................................................................................... 58
■ Children/Siblings/Teens ................................................................................................................. 61
■ Infant/Child Loss Links ................................................................................................................... 62
■ Fathers ............................................................................................................................................... 63
■ Spanish .............................................................................................................................................. 63
■ Faith Based ....................................................................................................................................... 64
■ Other .................................................................................................................................................. 64
6 Survivor’s Guide: A loved one’s guide after someone dies.Service of Remembrance and Hope (SORAH)
Twice each year – the last Sunday of April and the first Sunday of November – IU Health
Bloomington Hospital and IU Health Hospice hosts its Service of Remembrance and Hope at 2:00
p.m. in the hospital’s Wegmiller Auditorium. The service honors and remembers those patients
who have died while in the hospital or in hospice care in the past year. However, a general
invitation is extended to anyone in the community who has recently lost a loved one. The service
includes readings, words of encouragement, prayers, a candle lighting ceremony, and music
performed by local singers and musicians. Additionally, Hospice bereavement counselors are on
hand to offer one-on-one assistance. The service affords an opportunity for family members,
friends and health providers to come together to support and encourage one another.
To find out more about this service, you may contact the Pastoral Services office at
812.353.9463.
Funeral Planning
Who Has the Right to Make Funeral Arrangements in Indiana?
http://www.consumer.ftc.gov
Indiana law (Indiana Code § 29-2-19-17) determines who can make decisions about funerals and
body disposition -- that is, burial or cremation -- after someone dies. This right and responsibility
goes to the following people, in order:
■ the person named in a “funeral planning declaration” made before one’s death
■ the appointed agent under a health care power of attorney
■ the surviving spouse
■ an adult child
■ a surviving parent
■ Next of kin.
Funeral Planning Tips
Many funeral providers offer various “packages” of goods and services for different kinds of
funerals. When you arrange for a funeral, you have the right to buy goods and services separately.
That is, you do not have to accept a package that may include items you do not want. Here are
some tips to help you shop for funeral services:
Survivor’s Guide: A loved one’s guide after someone dies. 7■ Shop around in advance. Compare prices from at least two funeral homes. Remember
that you can supply your own casket or urn.
■ Ask for a price list. The law requires funeral homes to give you written price lists for
products and services.
■ Resist pressure to buy goods and services you don't really want or need.
■ Avoid emotional overspending. It's not necessary to have the fanciest casket or the most
elaborate funeral to properly honor a loved one.
■ Recognize your rights. Laws regarding funerals and burials vary from state to state. It's a
smart move to know which goods or services the law requires you to purchase and which
are optional.
■ Apply the same smart shopping techniques you use for other major purchases. You can
cut costs by limiting the viewing to one day or one hour before the funeral, and by dressing
your loved one in a favorite outfit instead of costly burial clothing.
■ Shop in advance. It allows you to comparison shop without time constraints, creates an
opportunity for family discussion, and lifts some of the burden from your family.
“Traditional” Full-service Funeral
This type of funeral, often referred to by funeral providers as a "traditional" funeral, usually
includes a viewing or visitation and formal funeral service, use of a hearse to transport the body to
the funeral site and cemetery, and burial, entombment, or cremation of the remains.
It is generally the most expensive type of funeral. In addition to the funeral home's basic services
fee, costs often include embalming and dressing the body; rental of the funeral home for the
viewing or service; and use of vehicles to transport the family if they don't use their own. The costs
of a casket, cemetery plot or crypt and other funeral goods and services also must be factored in.
Direct Burial
The body is buried shortly after death, usually in a simple container. No viewing or visitation is
involved, so no embalming is necessary. A memorial service may be held at the graveside or later.
Direct burial usually costs less than the "traditional" full-service funeral. Costs include the funeral
home's basic services fee, as well as transportation and care of the body, the purchase of a
casket or burial container and a cemetery plot or crypt. If the family chooses to be at the cemetery
for the burial, the funeral home often charges an additional fee for a graveside service.
8 Survivor’s Guide: A loved one’s guide after someone dies.Direct Cremation The body is cremated shortly after death, without embalming. The cremated remains are placed in an urn or other container. No viewing or visitation is involved. The remains can be kept in the home, buried, or placed in a crypt or niche in a cemetery, or buried or scattered in a favorite spot. Direct cremation usually costs less than the "traditional" full-service funeral. Costs include the funeral home's basic services fee, as well as transportation and care of the body. A crematory fee may be included or, if the funeral home does not own the crematory, the fee may be added on. There also will be a charge for an urn or other container. The cost of a cemetery plot or crypt is included only if the remains are buried or entombed. Funeral providers who offer direct cremations also must offer to provide an alternative container that can be used in place of a casket. Funeral Fees The Funeral Rule allows funeral providers to charge a basic services fee that customers have to pay. The basic services fee includes services that are common to all funerals, regardless of the specific arrangement. These include funeral planning, securing the necessary permits and copies of death certificates, preparing the notices, sheltering the remains, and coordinating the arrangements with the cemetery, crematory or other third parties. The fee does not include charges for optional services or merchandise. Charges for other services and merchandise, include costs for optional goods and services such as transporting the remains; embalming and other preparation; use of the funeral home for the viewing, ceremony or memorial service; use of equipment and staff for a graveside service; use of a hearse or limousine; a casket, outer burial container or alternate container; and cremation or interment. Cash advances are fees charged by the funeral home for goods and services it buys from outside vendors on your behalf, including flowers, obituary notices, pallbearers, officiating clergy, and organists and soloists. Some funeral providers charge you their cost for the items they buy on your behalf. Others add a service fee to the cost. The Funeral Rule requires those who charge an extra fee to disclose that fact in writing, although it doesn't require them to specify the amount of their markup. The Rule also requires funeral providers to tell you if there are refunds, discounts, or rebates from the supplier on any cash advance item. Survivor’s Guide: A loved one’s guide after someone dies. 9
Calculating the Actual Cost of a Funeral
The funeral provider must give you an itemized statement of the total cost of the funeral goods
and services you have selected when you are making the arrangements. If the funeral provider
doesn't know the cost of the cash advance items at the time, he or she is required to give you a
written "good faith estimate." This statement also must disclose any legal cemetery or crematory
requirements that you purchase specific funeral goods or services.
The Funeral Rule does not require any specific format for this information. Funeral providers may
include it in any document they give you at the end of your discussion about funeral
arrangements.
Services and Products
Embalming
Many funeral homes require embalming if you're planning a viewing or visitation. But embalming
generally is not necessary or legally required if the body is buried or cremated shortly after death.
Eliminating this service can save you hundreds of dollars. Under the Funeral Rule, a funeral
provider:
■ May not provide embalming services without permission.
■ May not falsely state that embalming is required by law.
■ Must disclose in writing that embalming is not required by law, except in certain special
cases.
■ May not charge a fee for unauthorized embalming unless embalming is required by state
law.
■ Must disclose in writing that you usually have the right to choose a disposition, like direct
cremation or immediate burial, which does not require embalming if you do not want this
service.
■ Must disclose in writing that some funeral arrangements, such as a funeral with viewing,
may make embalming a practical necessity and, if so, a required purchase.
Caskets
For a "traditional" full-service funeral:
A casket often is the single most expensive item you'll buy if you plan a "traditional" full-service
funeral. Caskets vary widely in style and price and are sold primarily for their visual appeal.
Typically, they're constructed of metal, wood, fiberboard, fiberglass or plastic. Although an
average casket costs slightly more than $2,000, some mahogany, bronze or copper caskets sell
for as much as $10,000.
10 Survivor’s Guide: A loved one’s guide after someone dies.When you visit a funeral home or showroom to shop for a casket, the Funeral Rule requires the
funeral director to show you a list of caskets the company sells, with descriptions and prices,
before showing you the caskets. Industry studies show that the average casket shopper buys one
of the first three models shown, generally the middle-priced of the three.
So it's in the seller's best interest to start out by showing you higher-end models. If you haven't
seen some of the lower-priced models on the price list, ask to see them — but don't be surprised if
they're not prominently displayed, or not on display at all.
Traditionally, caskets have been sold only by funeral homes. But more and more, showrooms and
websites operated by "third-party" dealers are selling caskets. You can buy a casket from one of
these dealers and have it shipped directly to the funeral home. The Funeral Rule requires funeral
homes to agree to use a casket you bought elsewhere, and doesn't allow them to charge you a
fee for using it.
No matter where or when you're buying a casket, it's important to remember that its purpose is to
provide a dignified way to move the body before burial or cremation. No casket, regardless of its
qualities or cost, will preserve a body forever. Metal caskets frequently are described as
"gasketed," "protective" or "sealer" caskets. These terms mean that the casket has a rubber
gasket or some other feature that is designed to delay the penetration of water into the casket
and prevent rust. The Funeral Rule forbids claims that these features help preserve the remains
indefinitely because they don't. They just add to the cost of the casket.
Most metal caskets are made from rolled steel of varying gauges — the lower the gauge, the
thicker the steel. Some metal caskets come with a warranty for longevity. Wooden caskets
generally are not gasketed and don't have a warranty for longevity. They can be hardwood like
mahogany, walnut, cherry or oak, or softwood like pine. Pine caskets are a less expensive option,
but funeral homes rarely display them. Manufacturers of both wooden and metal caskets usually
offer warranties for workmanship and materials.
For cremation:
Many families that choose to have their loved ones cremated rent a casket from the funeral home
for the visitation and funeral, eliminating the cost of buying a casket. If you opt for visitation and
cremation, ask about the rental option. For those who choose a direct cremation without a
viewing or other ceremony where the body is present, the funeral provider must offer an
inexpensive unfinished wood box or alternative container, a non-metal enclosure — pressboard,
cardboard or canvas — that is cremated with the body.
Under the Funeral Rule, funeral directors who offer direct cremations:
■ may not tell you that state or local law requires a casket for direct cremations, because
none do;
Survivor’s Guide: A loved one’s guide after someone dies. 11■ must disclose in writing your right to buy an unfinished wood box or an alternative
container for a direct cremation; and
■ Must make an unfinished wood box or other alternative container available for direct
cremations.
Burial Vaults or Grave Liners
Burial vaults or grave liners, also known as burial containers, are commonly used in "traditional"
full-service funerals. The vault or liner is placed in the ground before burial, and the casket is
lowered into it at burial. The purpose is to prevent the ground from caving in as the casket
deteriorates over time. A grave liner is made of reinforced concrete and will satisfy any cemetery
requirement. Grave liners cover only the top and sides of the casket. A burial vault is more
substantial and expensive than a grave liner. It surrounds the casket in concrete or another
material and may be sold with a warranty of protective strength.
State laws do not require a vault or liner, and funeral providers may not tell you otherwise.
However, keep in mind that many cemeteries require some type of outer burial container to
prevent the grave from sinking in the future. Neither grave liners nor burial vaults are designed to
prevent the eventual decomposition of human remains. It is illegal for funeral providers to claim
that a vault will keep water, dirt, or other debris from penetrating into the casket if that's not true.
Before showing you any outer burial containers, a funeral provider is required to give you a list of
prices and descriptions. It may be less expensive to buy an outer burial container from a third-
party dealer than from a funeral home or cemetery. Compare prices from several sources before
you select a model.
Preservation Processes and Products
As far back as the ancient Egyptians, people have used oils, herbs and special body preparations
to help preserve the bodies of their dead. Yet, no process or products have been devised to
preserve a body in the grave indefinitely. The Funeral Rule prohibits funeral providers from telling
you that it can be done. For example, funeral providers may not claim that either embalming or a
particular type of casket will preserve the body of the deceased for an unlimited time.
Comparison Shopping for a Funeral Home/Provider
Comparison shopping doesn't have to be difficult, especially if it's done before the need for a
funeral arises. Thinking ahead can help you make informed and thoughtful decisions about
funeral arrangements. It allows you to choose the specific items you want and need, and to
compare the prices several funeral providers charge.
12 Survivor’s Guide: A loved one’s guide after someone dies.If you visit a funeral home in person, the funeral provider is required by law to give you a general
price list (GPL) itemizing the cost of the items and services the home offers. If the GPL does not
include specific prices of caskets or outer burial containers, the law requires the funeral director
to show you the price lists for those items before showing you the items.
Sometimes it's more convenient and less stressful to "price shop" funeral homes by telephone.
The Funeral Rule requires funeral directors to provide price information on the phone to any caller
who asks for it. In addition, many funeral homes are happy to mail you their price lists, although
that is not required by law.
When comparing prices, be sure to consider the total cost of all the items together, in addition to
the costs of single items. Every funeral home should have price lists that include all the items
essential for the different types of arrangements it offers. Many funeral homes offer package
funerals that may cost less than buying individual items or services. Offering package funerals is
permitted by law, as long as an itemized price list also is provided. But you can't accurately
compare total costs unless you use the price lists.
In addition, there's a trend toward consolidation in the funeral home industry, and many
neighborhood funeral homes may appear to be locally owned when in fact, they're owned by a
national corporation. If this issue is important to you, you may want to ask if the funeral home is
independent and locally owned.
Burial and Funeral Funds
The high cost of a funeral may be financially draining and a major strain on families and friends
trying to find dignified arrangements for their loved ones. Unfortunately, financial assistance
programs for burial expenses are very limited. Some funds require that the family use the
deceased person's savings, life insurance, and assets for funeral expenses before they offer any
financial support. The following groups of people may be eligible for financial assistance for their
burial expenses:
■ Social Security recipients
■ Veterans, their spouses, and their minor or disabled children
■ Victims of violent crimes
■ Children involved with the Department of Children and Families (DCF)
■ Employees with benefits through their employer
■ Medicaid recipients
■ Persons with extreme financial hardship
Information about benefits for each group is listed below.
Survivor’s Guide: A loved one’s guide after someone dies. 13Social Security
If the deceased had paid into Social Security for at least 40 quarters, two types of benefits are
possible:
■ Death benefit: $255 for burial expenses is available to eligible spouses or dependent
children. The survivor can complete the necessary form at the local Social Security office,
or the funeral director may complete the application and apply the payment directly to the
funeral bill.
■ Survivor's benefits: A variety of benefits are available depending on the age and
relationship of any survivors. You may be eligible for benefits if you match any of these
circumstances:
− Spouse age 60 or older
− Disabled surviving spouse age 50 or older
− Spouse under 60 who cares for dependent children under 16 or disabled children
− Children of the deceased under the age of 18 or who are disabled
For more information, visit the Social Security Administration online at www.ssa.gov or call
800.772.1213 for an appointment with the nearest office to inquire about benefits and eligibility.
When applying for survivor's benefits, you will need to have birth, death, and marriage
certificates, Social Security numbers, and a copy of the deceased's recent federal income tax
return.
Veteran's Administration
If the deceased was receiving monthly payments already, you will need to notify the VA of the death.
If the deceased was a veteran who received a discharge other than dishonorable, survivors may get
$300 toward funeral expenses and $150 for burial costs. Burial in a national cemetery is free to a
veteran, spouse, and dependent children. Veterans are also eligible for a headstone or grave
marker.
The surviving spouse and dependent children of disabled veterans may also be entitled to other
benefits.
For more information, visit the Veteran's Administration online at www.va.gov.or check with
the regional VA office about your eligibility for the different types of veteran's benefits and the
documents you will need to apply for benefits. You may also call 1.800.827.1000.
14 Survivor’s Guide: A loved one’s guide after someone dies.Indiana Violent Crime Victim Compensation Fund
Indiana Code defines a violent crime as a felony or Class A misdemeanor that results in bodily
injury or death to the victim. Persons eligible for assistance from this fund include:
■ Innocent victims of any violent crime, including a motor vehicle crash caused by a drunk
driver;
■ A parent, surviving spouse, dependent child, or other legal dependent of an innocent victim
who has been killed as a result of any violent crime, including a motor vehicle crash caused
by a drunk driver; or
■ A person who is injured or killed trying to prevent a violent crime or giving aid to a law
enforcement officer.
Other requirements include:
■ The crime must have taken place in Indiana;
■ The victim must have incurred a minimum out-of-pocket loss of $100;
■ The crime must have been reported to the police within 72 hours;
■ The victim or survivors must have been cooperative in the investigation and prosecution of
the crime;
■ Application for benefits must be filed no later than 180 days after the crime occurred;
■ Medical expenses must be incurred within 180 days of the crime, but can be extended
under certain circumstances.
A maximum award of up to $15,000 MAY be available to help cover expenses resulting from any
one injury or death. Eligible crime related expenses include:
■ Medical bills;
■ Up to $5,000 for funeral and burial or cremation expenses for victims of certain crimes
involving motor vehicle accidents (regardless of marital status);
■ Up to $3,000 for counseling;
■ Lost wages;
■ Loss of support to legal dependents of an employed crime victim who is killed;
■ Reasonable child care services;
■ Attorney fees;
■ Emergency shelter services.
Survivor’s Guide: A loved one’s guide after someone dies. 15Emergency funding is available to assist victims of crime who are faced with an immediate
financial hardship resulting from the crime that has led to the need of services. An application
must be filed before an emergency award determination is made.
Applications are available by contacting your local law enforcement agency or the Victim
Services department of your county prosecutor's office. Completed applications can be
mailed, hand delivered, or faxed to the Indiana Criminal Justice Institute at: 101 W.
Washington Street, Suite 1170 East, Indianapolis, IN 46204; Fax: 317.233.3912. If you have
questions about filling out the application please contact the Violent Crime Victim
Compensation division at 800.353.1484.
Children Involved with the Dept. of Children and Services (DCS)
The Indiana Department of Child Services (DCS) will ensure the death of a child is handled within
acceptable standards when the child is adjudicated a Child In Need Of Services (CHINS) and is
placed in out-of-home care. This includes any death that is sudden or unexpected, and those
deaths due to a medical condition.
The Family Case Manager (FCM) will explore resources such as insurance policies and Medicaid to
assist with fees associated with burial or cremation. Contact the DCS caseworker to make
arrangements.
Medicaid Burial Allowance
Burial Assistance is available regardless of where the recipient's death occurs or whether the
funeral and interment takes place in Indiana or elsewhere. Burial Assistance is available for an
individual who was receiving TANF cash benefits, or Medicaid for the Aged, Blind or Disabled at
the time of death, or who applied for benefits prior to his death and was subsequently determined
eligible. Not all funeral homes will accept Medicaid payments. Medicaid benefits will cover
$600.00 towards funeral director expenses and $400.00 towards burial and/or cremation
expenses. Medicaid will not cover the cost of a headstone.
Funeral Director Expenses can include:
■ Reasonable expenses connected with preparation of the body, including cremation;
■ Purchase of necessary clothing;
■ Funeral services;
■ Transportation of the body;
■ Professional services of the Funeral Director.
16 Survivor’s Guide: A loved one’s guide after someone dies.Cemetery & Burial Expenses can include:
■ Purchase of a burial plot;
■ Opening and closing the grave;
■ Purchase of a cemetery vault;
■ Purchase of a casket and flat concrete marker (in absence of a headstone) when required
by the cemetery authorities;
■ The cost of renting a lowering device; and tent and artificial grass, if required by the
cemetery authorities.
Whole Body Donation
Whole body donation makes it possible for doctors, researchers, and educators to find treatments
for diseases such as cancer, Alzheimer’s, multiple sclerosis, and more. Those who decide to
bequeath bodies to the health sciences make a significant contribution that benefits the quality of
life and care of the living. The decision to donate can be pre-arranged or made upon one’s death.
The legal next-of-kin may provide consent for bequeathal. The following organizations make the
gift of donation possible. These organizations will generally pay for the cost of transportation,
obtain the death certificate, and return the cremains if desired. There are no fees for donation.
Direct Donor Program of the IU School of Medicine - Anatomical Education Program
317.274.7450
http://anatomy.iupui.edu/education/anatomical-education/
The Direct Donor Program was created so that donors may bequeath their remains to the
Indiana University School of Medicine without the time and expense required to make
arrangements with a funeral home. Families using the Direct Donor Program may simply call
the Anatomical Education Program at 317.274.7450. They will retrieve the remains, file the
death certificate, assist in placing the obituary, and notify social security. Following the use of
the body for teaching, the remains will be cremated, and either inurned in Crown Hill
Cemetery or, upon request, returned to the family. If your family wishes to use a local funeral
home, you may. However, you will be responsible for all of their fees.
Anatomy Sharing Network
866.241.5410, 877.912.2735
www.anatomysharing.com
When Doctors, Researchers, and Educators have access to anatomical tissue all may benefit with
an improved quality of life. Through research, further advances in medicine will provide cures to
life ending diseases, such as cancer and heart disease. The final gift, of whole body donation, will
benefit both current and future generations. Whole body donation is not for every family. Whole
body donation has been called the humanitarian alternative to burial or cremation.
Survivor’s Guide: A loved one’s guide after someone dies. 17Persons with Extreme Financial Hardship
Some people will find themselves without any resources to pay for a funeral. IU Health
Bloomington Hospital does not have funds to assist with any expenses. Community resources
that can be contacted for possible assistance are, but not limited to:
■ Township Trustee’s Office*;
(Please look in your local phonebook under Government Offices, Township name, Trustee to get phone number.)
■ Community foundations;
■ Community clubs;
■ Churches;
■ Salvation Army;
■ Goodwill;
■ Whole Body Donation. (see page 17)
*The Trustee may provide for mortuary and burial expenses at the lowest possible cost, not
to exceed $1000.00 The Trustee will appoint an overseer of the arrangements. Family
members may be required to attest that no relatives have resources (including insurance
policies of the deceased) available to them with which to pay said expenses.
Employees with Benefits through Their Employer
Many employers provide life, health, or accident insurance. The deceased may be due a final
paycheck for vacation or sick leave.
Be sure to contact all past employers, including federal, state or local governments, to see if you
are entitled to death benefits, continued health insurance coverage for the family, or payments
from an annuity or pension plan.
If the deceased belonged to a union or professional organization, check to see if they offer death
benefits for their members. Also find out about any credit union balances.
18 Survivor’s Guide: A loved one’s guide after someone dies.Coroner’s Cases
The County Coroner's Office performs death investigations in accordance with nationally
recognized standards. The various types of investigation include:
■ Autopsy: Autopsy performed by a Forensic Pathologist.
■ External: Body taken into custody. Only external examination performed.
■ SOS: Scene Sign-Outs i.e. Body released at scene to next of kin.
■ Consults: The office is notified of death, but case is declined due to not fitting Coroner's
criteria.
The various steps involved in the process of death investigation are as follows:
■ Death Scene Investigation: The Coroner will gather scene information, take photographs,
and arrange for removal of the body from the scene. The family should contact a funeral
home at their earliest convenience to arrange for funeral services. The funeral home then
initiates the death certificate, which is then electronically received by the Coroner’s office
through the Indiana Death Registration System.
■ Post-Mortem Examination: The decedent's body is physically examined by a certified
forensic pathologist who may perform a full autopsy on the body as necessary. Body
fluids/tissues may also be sent for lab analysis such as toxicology and histology. Following
the examination, the body is made available for pick-up by the funeral home. A
comprehensive pathology report will be generated by the forensic pathologist identifying
the cause and manner of death.
■ Death Certification: The Coroner's office will review the findings and certify the cause and
manner of death in the death certificate.
The Manner of Death can be:
■ Natural
■ Accidental
■ Suicide
■ Homicide
■ Undetermined
Most cases that are investigated by the Coroner's office are reviewed and closed within 14-21
days. If a case is pending toxicology or microscopic examination, a cause and manner of death
could take up to 8 weeks for final results.
Survivor’s Guide: A loved one’s guide after someone dies. 19FAQ on Death Investigation
Q: Why is the Coroner involved in the death of my loved one?
A: The following is a list of death in which the Coroner's office is contacted*:
■ Sudden death of a healthy child;
■ Death occurring within 24 hours of admission at a hospital or health care facility;
■ Physician unable to state cause of death, after careful review of medical chart, or decedent
does not have a physician;
■ Known or suspected homicide;
■ Known or suspected suicide;
■ Related to or following known suspected self-induced or criminal abortion;
■ Following an accident or injury primary or contributory, either old or recent;
■ Drowning, fire, exposure, acute alcoholism, drug addiction, strangulation, aspiration or
malnutrition;
■ Accidental poisoning (food, chemical, drug, therapeutic agents);
■ Occupational disease or occupational hazards;
■ Known or suspect contagious disease constituting a public hazard, excluding A.I.D.S.;
■ All deaths where patient is under anesthetic;
■ Incarceration;
■ All deaths of unidentified persons.
* The Coroner will determine if the death will be investigated or if the death certificate can
be routinely signed by the attending physician.
Q: Is an autopsy always performed?
A: Not always. If the death is a "Natural Death" and cause of death can be determined by past
medical history or from an external exam, the Coroner will normally not perform an autopsy.
Q: Why are autopsies performed?
A: There are a number of reasons autopsies are performed. However, the basic reason is to
determine the medical cause of death. Often this information is used to gather evidence for
presentation in a court of law.
Q: Can I come see him/ her?
A: Due to legal and health issues, visitation of the loved one is done only at the funeral home after
the body is properly prepared.
20 Survivor’s Guide: A loved one’s guide after someone dies.Q: What about funeral arrangements?
A: Contact the Funeral Director of your choice as soon as possible and advise him/her what has
transpired. Your funeral director will then coordinate further arrangements with the Forensic
Pathology Department and help you begin the preparations for your loved one's funeral.
Q: How long does the office take to close its cases?
A: Most cases that are investigated by the Coroner's office are reviewed and closed within 14-21
days. If a case is pending toxicology or microscopic examination, a cause and manner of death
could take up to 8 weeks for final results.
Organ Donation
People of all ages and medical histories are potential donors. As medical science advances,
donation opportunities change. Federal law requires hospitals to contact recovery agencies in the
event of a death or imminent death. The donation process begins when a hospital reports a death
to a donor referral hotline. One’s medical condition at the time of death will determine what
organs and/or tissue can be donated.
Who Receives Donated Organs and Tissue?
Organs are matched based on medical information such as blood type, body size, and tissue type
through a national computer system operated by UNOS (United Network for Organ Sharing).
Tissue is distributed based on patient need, availability, and medical criteria.
■ Consent for donation is confirmed by either verifying the person’s enrollment on a state
registry or obtaining written consent from the family. The donor’s family is asked to
participate in the process by providing a medical history.
■ A surgical procedure is used to recover donated organs and tissue. The body is always
treated with great care and respect.
■ Donation will not delay or change funeral arrangements, and will not interfere with an
open-casket funeral viewing.
■ Tissue is needed to replace bone, tendons, and ligaments lost to trauma or cancer and
other diseases.
■ Corneas are needed to restore sight.
■ Skin grafts help burn patients heal and often mean the difference between life and death.
■ Heart valves repair cardiac defects and damage.
Organizations Involved in Organ or Tissue Donation
■ Community Tissue Services (CTS) ................................................................ communitytissue.org
■ Indiana Lions Eye and Tissue Transplant Bank (ILETTB) ....................indianalionseyebank.org
■ Indiana Donor Network ………………………………………………………………indianadonornetwork.org
Survivor’s Guide: A loved one’s guide after someone dies. 21What to Do When a Loved One Dies
This checklist could help you cope with practical tasks during an emotional time.
By: Stacy Julien | Source: AARP.org | June 4, 2012
When a loved one dies, you might face the overwhelming responsibility of closing out the person's
life. There are many things to attend to, from providing a proper tribute to closing bank accounts
to canceling a gym membership. And many of the tasks require attention to detail — adding stress
to what is already a pretty emotional time.
To cope, cut yourself some slack: Don't try to handle everything yourself if you don't have to.
"This burden shouldn't be placed on one individual," says Sally Hurme, an AARP elder law attorney
and author of The ABA Checklist for Family Heirs. "When people ask what they can do to help,
take advantage of the offer. Delegate."
To do so, you need to have a full, clear picture of what needs to be done. Here's an ordered
checklist to make your task easier. As you review what's in store, consider which undertakings you
can hand off and who can best handle them.
To Do Immediately
■ Contact immediate family. Of course you want to update key family members. Bringing
them together in person, by phone or electronically (via mass email, Skype or Facebook
Family page), is an opportunity not only to comfort one another but also to share
information about important decisions that must be made — some of them immediately.
Do any of you, for example, know of an arrangement for the funeral or other source for
burial wishes?
■ Follow body bequeathal instructions. If the person made arrangements to donate his or
her body to a medical school, the family must respect those wishes. An advance directive,
living will or health proxy may guide you to a particular institution. If the person hasn't
made arrangements, the next of kin can donate the body, but the decision needs to be
made as early as possible.
■ Consider funeral preparations. If possible, bring together key family members for an early
conversation. This is especially helpful if the deceased left no advance instructions or
possibly made an unreasonable request. Factors to consider:
− What did the deceased want?
− What can you afford?
− What's realistic?
− What will help the family most?
22 Survivor’s Guide: A loved one’s guide after someone dies.Planning the Funeral
■ Consider whether you need or want other financial assistance for the funeral and burial.
Help might be available from a number of sources, including a church, a union or a fraternal
organization that the deceased belonged to. Phone or send an email to the local group.
■ Enlist help for the funeral. Relatives and friends may be needed to serve as pallbearers, to
create or design the funeral program, cook meals (for a repast gathering or simply for the
household of the deceased), take care of children or pets, or shop for any items needed for
the funeral or household of the deceased.
■ Arrange for headstone. You can typically purchase a headstone through the cemetery or
from an outside vendor of your choice. Consult the cemetery about rules, regulations and
specifications such as color and size, particularly if you go with an outside vendor.
■ Organize a post-funeral gathering. Depending on your tradition, it's called a repast or a
wake. It can be held at the church, a banquet hall or someone's house. Enlist the help of
friends and relatives to plan.
■ Spread the word about the service. Once a date and time have been set for the service,
share the details with those on your contact list. Include an address to send cards, flowers
or donations.
■ Make a list of well-wishers. Keep track of who sends cards, flowers and donations so that
you can acknowledge them later.
■ Prepare an obituary. The funeral home might offer the service or you might want to write
an obituary yourself. If you want to publish it in a newspaper, check on rates, deadlines and
submission guidelines. Don't include such details as exact date of birth that an identity
thief could use.
■ Handle the ethical will, if there is one. An ethical will isn't a legal document, but rather a
letter of sorts written to your family and friends that shares your values, life lessons and
hopes for the future. If the deceased left one, arrange to share it, maybe even have it printed.
■ Choose a funeral home. Most people want a funeral home to transport the body from the
morgue to its facility. The deceased may have identified which home to use — and even
prepaid for funeral services. If there's been no conversation about arrangements, the
choice will be up to the family.
■ Notify close friends and extended family. Make a list of as many people as you can. Find
contacts through email accounts and personal telephone books. Contact an employer and
organizations the deceased belonged to, if necessary.
■ Secure property. Lock up the person's home and vehicle. Is the car parked in a secure and
legal area? Will the home be vacant? If so, you may want to notify the police (dial a non-
emergency number), landlord or property manager. Have someone care for pets until a
permanent arrangement is made.
■ Notify the post office. Use the forward mail option. This will prevent accumulating mail
from attracting attention. It can also inform you about subscriptions, creditors and other
accounts that need to be canceled.
Survivor’s Guide: A loved one’s guide after someone dies. 23To Do before the Funeral
■ Meet with the director handling the funeral or memorial arrangements. Use instructions
your loved one might have left and the earlier family discussion to guide the many
decisions to be made.
− Will the body be embalmed or cremated?
− Will there be a casket, and if so, will it be open or closed?
− If body will be cremated, will the ashes be scattered? If the ashes are deposited
in an urn, will it be placed in a mausoleum?
− Where is the burial site?
− Do religious traditions need to be respected?
− Will there be contributions to charities in lieu of flowers?
■ For a veteran, inquire about special arrangements. A range of benefits can help tailor a
veteran's service. You may be able to get assistance with the funeral, burial plot or other
benefits. Call Veterans Affairs at 1.800.827.1000 or your local Veterans agency, often
included in local government listings. You can also inquire about veteran's survivor benefits.
■ Consider whether you need or want other financial assistance for the funeral and burial.
Help might be available from a number of sources, including a church, a union or a fraternal
organization that the deceased belonged to. Phone or send an email to the local group.
■ Enlist help for the funeral. Relatives and friends may be needed to serve as pallbearers, to
create or design the funeral program, cook meals (for a repast gathering or simply for the
household of the deceased), take care of children or pets, or shop for any items needed for
the funeral or household of the deceased.
■ Arrange for headstone. You can typically purchase a headstone through the cemetery or
from an outside vendor of your choice. Consult the cemetery about rules, regulations and
specifications such as color and size, particularly if you go with an outside vendor.
■ Organize a post-funeral gathering. Depending on your tradition, it's called a repast or a
wake. It can be held at the church, a banquet hall or someone's house. Enlist the help of
friends and relatives to plan.
■ Spread the word about the service. Once a date and time have been set for the service,
share the details with those on your contact list. Include an address to send cards, flowers
or donations.
■ Make a list of well-wishers. Keep track of who sends cards, flowers and donations so that
you can acknowledge them later.
■ Prepare an obituary. The funeral home might offer the service or you might want to write
an obituary yourself. If you want to publish it in a newspaper, check on rates, deadlines and
submission guidelines. Don't include such details as exact date of birth that an identity
thief could use.
■ Handle the ethical will, if there is one. An ethical will isn't a legal document, but rather a
letter of sorts written to your family and friends that shares your values, life lessons and
hopes for the future. If the deceased left one, arrange to share it, maybe even have it printed.
24 Survivor’s Guide: A loved one’s guide after someone dies.To Do after the Funeral
■ Get duplicate death certificates. You may need a dozen certified death records to
complete upcoming tasks, though some will require less expensive copies. Your funeral
director may help you handle this or you can order them from the vital statistics office in
the state where the death occurred or from the city hall or other local records office. Each
certified record will cost around $10 or $20.
■ Send thank-you notes. From the contact list that you acquired earlier, send thank-you
notes and acknowledgements. Consider delegating this task to a family member.
■ Notify local Social Security office. Typically the funeral director will notify Social Security
of your loved one's death. If not, call 1.800.772.1213 or contact your local office. If your
loved one was receiving benefits, they must stop because overpayments will require
complicated repayment. Even a payment received for the month of death may need to be
returned. If the deceased has a surviving spouse or dependents, ask about their eligibility
for increased personal benefits and about a one-time payment of $255 to the survivor.
■ Handle Medicare. If your loved one received Medicare, Social Security will inform the
program of the death. If the deceased had been enrolled in Medicare Prescription Drug
Coverage (Part D), Medicare Advantage plan or had a Medigap policy, contact these plans
at the phone numbers provided on each plan membership card to cancel the insurance.
■ Look into employment benefits. If the deceased was working, contact the employer for
information about pension plan, credit unions and union death benefits. You will need a
death certificate for each claim.
■ Stop health insurance. Notify the health insurance company or the deceased's employer.
End coverage for the deceased, but be sure coverage for any dependents continues if
needed.
■ Notify life insurance companies. If your loved one had life insurance, appropriate claim
forms will need to be filed. You will need to provide the policy numbers and a death
certificate. If the deceased was listed as a beneficiary on a policy, arrange to have the
name removed.
■ Terminate other insurance policies. Contact the providers. That could include homeowner's,
automobile and so forth. Claim forms will require a copy of the death certificate.
■ Meet with a probate attorney. The executor should choose the attorney. Getting
recommendations from family or friends might be the best approach, but an online search
can also be an efficient way to find an attorney. If there is a will, the executor named in it
and the attorney will have the document admitted into probate court. If there isn't a will,
the probate court judge will name an administrator in place of an executor. The probate
process starts with an inventory of all assets (personal property, bank accounts, house, car,
brokerage account, personal property, furniture, jewelry, etc.), which will need to be filed in
the probate court.
■ Make a list of important bills (mortgage payments). Share the list with the executor or
estate administrator so that bills can be paid promptly.
Survivor’s Guide: A loved one’s guide after someone dies. 25You can also read
