Planning for Death and Dying: Helping Friends and Family to Fulfill Death-Care Instructions

Death is a natural process and everyone successfully dies.  Teachings of the Buddha say that rather than fearing death, a person can see death as an opportunity to obtain a fortunate rebirth in a pure land for the benefit of all sentient beings.  In order to be open to this opportunity, a person should develop pure faith and devotion from their heart (samaya) by preparing with spiritual instruction and practice during their lifetime. Then a person can die with confidence in a calm and open manner with no hope, fear, anger, or attachment.  The key point before death is to find a spiritual teacher, receive instructions for transference of consciousness (phowa), and practice these instructions so that at the moment of death the dying person is confident.  
This manual is a collection of ordinary thoughts and concepts that may assist the death-care givers to maintain a calm, relaxed space for the dying person.  Planning for dying and death is beneficial for reducing attachment and helping relatives and friends deal with grief and the remaining body, belongings, and dependents.  Use the lists of tasks outlined below to collect all the necessary information and completed planning documents.  Store these documents in an accessible place and show where they can be located by care givers.  Links throughout this manual lead to further information and resources.  Lists for organizing important documents and their locations may be downloaded from  http://www.elderindustry.com/downloads.html  This death-care guide is written for conditions in Oregon. http://www.osbar.org/public/legalinfo/1190_DeathRelative.htm  Laws, customs, and terminology vary in each state and country and should be consulted.  Be flexible and adjust the death-care to the circumstances at hand, being careful to maintain compassionate motivation.  Buddhist spiritual practice is assumed in this manual and any other spiritual practice tradition (Christian, Jewish, Islam, Hindu, or others) may be followed as is appropriate for the dying person’s wishes.
Months, Weeks, and Days Before Death
Contact: Contact the spiritual teacher that was chosen by the dying person and indicate that death is imminent.  Discuss appropriate spiritual practice for this time.  See "Aspiration Prayer for Great LIberation through Hearing in the Intermediate State after Death".  Review spiritual instructions; for example see “Instructions for the Transitional State” published by Mirror of Wisdom Press.  http://vimalatreasures.org/instructions-for-the-transitional-state.aspx     Contact medical personnel and hospice for assistance with medical care for the dying person and for help with signing the death certificate (see below).  http://www.oregonhospice.org/index.htm  

Movies, Part 1 and Part 2 of reading four aspiration prayers in English for liberation through hearing in the intermediate state, with images seen in the bardo after death are seen here and here.  


Reassure and Remind the Dying Person:  Remind the dying person of their spiritual practice and support them with your practice.  Reassure the dying person that death is a natural process and that they will succeed without doubt or hesitation.
Review Forms for ‘Advance Medical Directive’, ‘Health Care Representative’, and ‘Physician Orders for Life-Sustaining Treatment (POLST)’:  Review these documents with the dying person to confirm that their wishes are current and properly recorded.  Forms can be obtained at your local hospital.  Also consult  http://www.oregonhealthdecisions.org/  to order an excellent workbook for making decisions about the Advanced Medical directive.  See these links for additional information.  http://www.ohsu.edu/polst/programs/oregon-details.htm  http://www.osbar.org/public/legalinfo/1120.htm
Locate Will and Death Instructions: Ask the dying person if they have a will that includes written instructions for their death and the disposition of their body, possessions, and dependents and where that will is located.  Control of disposition of the body follows ORS Chapter 97.130. http://www.leg.state.or.us/ors/097.html  Review the will to insure that their wishes are current and properly recorded.  http://www.oregon.gov/DSL/ESTATES/index.shtml  http://www.osbar.org/public/legalinfo/wills.html  Legal assistance with drafting wills for low income people can be accessed through Legal Aid.  http://www.osbar.org/public/ris/LowCostLegalHelp/LegalAid.html
Death Under the Care of a Physician:  If death will occur in a hospital, care facility, or with hospice care in a facility or at home, discuss with medical staff the need for leaving the body undisturbed for as long as possible while phowa is performed at the time of death.  When death is at a medical facility or at home with hospice care, then a qualified medical practitioner (attending physician or certified nurse practitioner) can certify the cause of death and there is no need for the police and medical examiner to make an investigation of the death.  If a request is made for the dying person in a hospital or care facility to be sent home to die, arrangements should be made for the attending physician to sign an order to that effect and later, to sign the death certificate after the death has occurred at home.  If the deceased is at home without hospice care or other professional home health care, then arrangements should be made before death for a qualified medical professional to certify the death as an expected one.  Failure to make prior arrangements for a qualified medical practitioner to sign the death certificate requires that the police and medical examiner investigate the death as being unattended (see below).  Questions for the Oregon medical examiner can be answered by calling 971-673-8200 or consulting  http://www.oregon.gov/OSP/SME/index.shtml
Organ or Body Donation: Some spiritual teachers say that the benefits and motivation of organ donation can outweigh the effects of disturbing the body shortly after death.  If organ donation is a consideration, talk to the doctors or hospital staff about the requirements for donating organs, tissue, or corpse and ask them to check the state online donor registry, www.donatelifenw.org.  More information on organ donation is available at http://www.donatelifenw.org/  Also check the Oregon driver’s license or identification card for the letter "D," which shows that the person wanted to be an anatomical donor.  Body donation for scientific study may be made through the OHSU program.  http://www.ohsu.edu/xd/education/schools/school-of-medicine/bodydonation/
Pronouncement of Death
Call the Spiritual Teacher:  Contact the teacher that was chosen by the dying person as their spiritual teacher and inform them of the death.

Near the Moment of Death: If the teacher can be present at the death, that is best.  Sit the dying person upright if possible, or lying on the right side in the sleeping lion posture.  Remind the dying person of their spiritual practice.  Maintain a calm space for the dying person and make sure that people are calm and relaxed in the presence of the dying person.  Disruptive people and circumstances should, if possible, be removed from the presence of the dying person.  Relief of pain with medication is helpful if needed and reduces distraction for the dying person.  If the dying person is an experienced spiritual practitioner, avoid giving them medications that induce unconsciousness before the moment of death, as these will make their meditation on the natural state difficult.  Remind the dying person to visualize the spiritual teacher above their head and repeat the refuge and bodhicitta vows (We take refuge in the Three Jewels, for the benefit of all sentient beings).  The phowa should be performed by the teacher with whom the dying person has pure samaya (pure faith and devotion from their heart) or a qualified dharma practitioner with pure samaya.  Otherwise, someone with a pure relationship to the dying person should continue to remind the dying and deceased person of their spiritual practice.  Strongly develop the attitude of loving kindness, compassion, and awakened mind for all sentient beings (bodhicitta).    
Pronouncement of Death: Oregon requires a qualified medical professional (medical examiner, physician, or certified nurse practitioner) to be notified and to make the official pronouncement of death.  If death occurs in a medical facility, the attending physician or certified nurse practitioner will certify the death.  If death occurs at home with hospice care, then the hospice nurse practitioner can be called to certify the cause of death.  Police and the medical examiner will not need to be notified because a physician has already certified that the person was likely to die within six months from a specific cause or set of causes in order to be on hospice and therefore it is not an unexpected death.  This is one of the benefits of being on hospice services.  People can die at home in a natural and peaceful way surrounded by those of their own spiritual tradition with their own practices and minimal disturbance by outside interference.  Hospice contacts the medical examiner and the attending physician.
Call the Medical Examiner: If death occurs at home without hospice care or is unattended or not supervised by prearrangement with a qualified medical professional, then an investigation of the cause and manner of death must be made by the police and medical examiner.  You must in a timely manner call the State Police or Medical Examiner’s Office for the county where death occurs; or dial 911 if you want the support of emergency personnel. Caution, the paramedics will attempt resuscitation unless there is a completed POLST form available.  Resuscitation is a severe disturbance to the deceased.  Police will call the medical examiner to the scene to conduct the investigation.  You must not disturb the body and its personal effects until the medical examiner has conducted the investigation (ORS Chapter 146.103). http://www.leg.state.or.us/ors/146.html   The medical examiner determines whether an autopsy is needed.  If an autopsy is necessary, then discuss with the medical examiner the possibility for delay until after a traditional resting period (may be one to three days depending on tradition), when the consciousness is considered to have left the body. 
Notify Family and Friends: Ask them to help you with some tasks, including notification of other family and friends.  Contact information may be in an address book or in planning documents.  The Red Cross will help notify family members if the deceased was in the military or if the relative to be notified is in the military. http://www.redcross.org/
Deceased’s Instructions: If not located before death, look through the deceased’s papers (and potentially their safe deposit box, see below) to find if they: had specific instructions for death practices; had a prepaid burial plan; belonged to a memorial society; had written instructions regarding their funeral arrangements.

Arrangements for the Body: If the death occurs at a hospital or care facility, the body should be left undisturbed for as long as permitted by staff.  During this time, perform phowa and continue spiritual practice with pure samaya.  Then when necessary, transport the body home or to a funeral home.   
If the body is taken home or is already at home for a home funeral, then 24 hours after death it must be cooled and kept at less than 36oF (for instructions see http://www.homefuneralmanual.org/ or “Instructions for the Transition State” http://vimalatreasures.org/instructions-for-the-transitional-state.aspx ) and a death certificate must be obtained (see below).  Spiritual practice can be performed at home without disturbance and after a traditional resting period (one to three days), the body should be transported to the funeral home for burial or cremation.  A home funeral requires advance planning and designation of an unpaid funeral service practitioner.  Information on home funerals can be found at http://www.crossings.nethttp://www.finalpassages.orghttp://www.spiraloflife.orghttp://www.naturalburialcompany.comhttp://www.homefuneralmanual.org/  and at the Oregon Mortuary and Cemetery Board.   http://www.oregon.gov/MortCem/Related_Sites.shtml
If the body is taken to a funeral home soon after death, a death certificate is processed by mortuary staff and arrangements can be made to refrigerate the body and allow viewing and spiritual practice to occur during the resting period.  The body should not be embalmed.  If an autopsy must be performed, then it should occur after the resting period. 

One to Three Days after Death


Continue the Spiritual Practice Suggested by the Teacher
Complete the Funeral and Burial Arrangements: Ask a trusted friend or family member to go with you to the mortuary to advise and support you in making the funeral and burial or cremation arrangements.  If the deceased was a member of a funeral society, you can obtain a lower rate on cremation or funeral services. http://www.fca-oregon.org/   Planning for a funeral service will need information about the deceased; name, date of birth, place of birth, parents, date of marriage, name of spouse, children, grand children, other relatives, occupations, hobbies, military service, residences, date and place of death, date and place of funeral service, place of internment, music, scripture, people to speak, short life story, number of people at service, and obituary.  Contact fraternal and religious organizations that may conduct funeral services and other organizations of which the deceased was a member.
Financial and Other Assistance: If the deceased was on public assistance, burial assistance may be available. Contact your local county Department of Human Services or http://www.oregon.gov/DHS/index.shtml as soon as possible. Total expenses of burial will be limited to qualify for the benefit so investigate this possibility before contracting for funeral arrangements.  If the deceased was in the military or is the spouse or dependent child of a person in the military, contact the VA cemetery or VA office for burial benefits.  http://www.va.gov/   The mortuary will call the VA at your request.  If you have questions or concerns that you cannot resolve with the funeral director or management of the funeral home, contact http://www.oregon.gov/MortCem/Related_Sites.shtml 
Chores: Choose someone to: answer the phone; collect mail; care for children and pets; take care of perishable property (clean refrigerator, water plants); stay at the home during the funeral to guard against break-ins occurring when the family is at the funeral; provide food for family and friends after the funeral.


One to Ten Days after Death


Death Certificates: Death certificates must be signed by a qualified medical professional within two days after death and submitted for agency processing within five days after death.  The most common and quickest way to obtain a death certificate is through the funeral director when the body has been transported to a funeral home soon after death.  Alternatively, an individual acting as an unpaid funeral service practitioner (ORS Chapter 97.130) http://www.leg.state.or.us/ors/097.html with the body at home can obtain the death certificate.  Information on Oregon guidelines for being a funeral service practitioner (Private Burial Information Packet) can be obtained from Darcy Niemeyer, Oregon Department of Human Services (971-673-1160).  The private funeral service practitioner must follow the sequence of events that is stipulated in ORS Chapter 432.307 to 432.333 http://www.leg.state.or.us/ors/432.html  Also consult the table called ‘The Life Cycle of the Oregon Death Certificate’ at the end of the document in http://egov.oregon.gov/DHS/ph/chs/registration/docs/thedeathcertificateandyou/deathcertandyouApril05.pdf   The application for the death certificate can be obtained from the Oregon Center for Health Statistics (971-673-1190).  http://www.oregon.gov/DHS/ph/chs/registration/instructions.shtml  and is submitted for processing to the county Department of Health and Human Services in the county where the death occurred.  Information about the decedent that is needed to fill out the application includes: name, date of birth, sex, age, social security number, county of death, birth date and place, education, race, residence address, marital status, spouse’s name, occupation, father’s name, mother’s maiden name, place of death, and method and place of disposition.
The cost is usually higher for the first death certificate. Additional certified certificates can be obtained at a lower price. In order to know how many to order, you should estimate the number of different assets held by the deceased or institutions that will require a certified death certificate. If you do not order enough, you can get more death certificates later through the Environmental Health, Vital Statistics Department in the county where the death occurred or through the Oregon Department of Human Services http://www.oregon.gov/DHS/ph/chs/order/index.shtml
Contact the following persons or institutions:

       • police, to occasionally check the house of deceased, if vacant
       • attorney, to learn how to transfer assets and assist with probate issues
       • accountant or tax preparer, to determine if an estate tax return or final income tax returns should be filed
       • investment professionals, to obtain information on holdings/assets
       • bank, to locate accounts and safe deposit box
       • insurance agent, to obtain claim forms
       • Human Services, to learn of benefits
       • Social Security, to stop monthly check and learn of potential benefits
       • Veterans Affairs, to stop monthly check and learn of benefits
       • agency providing pension services, to stop monthly check and obtain claim forms
       • guardian, conservator, agent under a durable power of attorney, to notify of death and the end of their responsibility
       • utility companies, to alter or discontinue service
       • employer, to notify of death and learn of benefits
       • newspaper, to stop subscription and/or submit an obituary
       • post office, if necessary, to forward mail

Prior to Appointment as the Personal Representative: If you are named personal representative (formerly called “executor”) in a will, you have the power, before you are appointed by the court, to carry out written instructions of the deceased relating to the body, funeral, and burial arrangements. You may begin to take steps to protect and safeguard the deceased’s property. Do not remove or distribute property before the opening of the probate estate. Other information is available from the Oregon Bar Association http://www.osbar.org/public/legalinfo/elder.html that explains the duties of the personal representative and how the personal representative is appointed when there is no will.

Search for the Will: The original will is usually in a safe deposit box, in the attorney’s office, or in a file at home. Check for a strong box or file cabinet. When the signed original will is found, you must file it within ten days with the Probate/District Court in the county where the deceased lived.  It is also possible the will was filed, during the deceased’s lifetime, with the court for safekeeping. You should contact the District Court in the county which the decedent died to see if the will was lodged prior to death. If you are only able to find a copy of the signed will, it may be possible to offer it to probate. However, the signed original will is preferable.  If the deceased has dependents, the will should give instructions for their guardianship and care.  
Entering the Safe Deposit Box: Any person whose name is also on the box may enter it at any time. An agent under power of attorney does not have authority to enter the box because the agency relationship ends at the deceased’s death. An heir or beneficiary named in a will can ask the bank to enter the box to search for the will, a deed to a burial plot or burial instructions. A representative of the bank will open the box in the presence of the heir or beneficiary and remove any will that is found. The bank will retain possession of the will and forward it to the court. After the will is filed in court, the personal representative named in the will can petition the court to appoint her or him.
If There is No Will:  Notify and consult with the Department of State Lands which administers estates without a will (intestate).   http://www.oregon.gov/DSL/ESTATES/index.shtml and  http://www.leg.state.or.us/ors/146.html
Search for Other Documents: The personal representative is the court officer who has authority to search for important papers. The search should include the home, office, place of business, safe deposit box and with advisors such as accountants, investment professionals and attorneys. Any information indicating that an asset exists or that bills are unpaid should be kept for use in the administration of the estate.

Look for:

       • funeral and burial plans
       • safe deposit rental agreement and keys
       • trust agreements
       • nuptial agreements
       • life insurance policies or statements
       • pension, IRA, retirement statements
       • income tax returns for several years
       • gift tax returns
       • marriage, birth, and death certificates
       • divorce papers
       • military records and discharge papers
       • computer passwords and bookkeeping records
       • certificates of deposit
       • bank statements, checkbooks, and check registers
       • notes receivable and payable
       • motor vehicle titles
       • deeds, deeds of trust, mortgages, and title policies
       • leases
       • stock and bond certificates and account statements
       • bankruptcy filings
       • partnership or corporate agreements
       • unpaid bills
       • health insurance
Take Care Against Unethical Persons

In the period following the loss of a loved one, be careful before accepting any telephone or mail solicitation. Fraudulent invoices may be received and should be carefully scrutinized for validity. Avoid lifestyle changes for a period to allow for reflection on how the loss will affect the surviving family and friends.

Avoid Immediate Collection of Benefits

Avoid transferring title to assets or making claims as a beneficiary until considering whether either a tax or non-tax reason exists for refusing to receive an asset. Even though the account executive wants to be helpful, you may lose an important tax advantage if you accept an asset. An attorney can help you find the best approach.

Veterans Benefits and Social Security

The mortuary may assist you with the paperwork for both VA and Social Security benefits. For information on VA benefits, call the nearest VA listing for Benefits Information and Assistance. http://www.va.gov/  For Social Security benefits, call the Social Security Administration (800) 772-1213. http://www.socialsecurity.gov/
Be prepared to identify the deceased’s:

       • relationship to you
       • Social Security or VA claim number
       • date of birth
       • date of death
       • place of death
       • surviving spouse or next of kin
       • medical history that bears on whether the death is service related or not

If you do not know the VA number, then provide:

       • service number
       • dates of active service

Your call will stop the monthly payments. Usually the VA will automatically withdraw any payments made via direct deposit after the date of death. If this does not happen, you must return the check for the month of death. Social Security monthly benefits are available to the surviving spouse and to children under 18 and certain disabled children. Benefits include a lump sum death benefit. Ask for the “Social Security Survivors” brochure.
Veterans benefits may be available to the surviving spouse. Benefits may include a lump sum death benefit, if death was service connected, a continuing monthly payment to the surviving spouse, and financial assistance with funeral expenses and cemetery plot, or burial in a national cemetery.  Ask for the “Federal Benefits for Veterans and Dependents” publication.
IMPORTANT: Money, personal possessions, and other property that is in the estate or the trust should not be distributed to family, friends, or other beneficiaries until the personal representative or trustee has discussed the situation with a lawyer. Likewise, creditors and people who claim that money is owed to them should not be paid until after the personal representative or trustee has consulted a lawyer. Certain creditors and claims have priority for payment.  Legal guidance may be obtained at http://www.osbar.org/public/legalinfo/elder.html
Oregon Statutes Relevant to Death-Care:  Chapter 97, Rights and duties; Chapter 146, Investigation of deaths; Chapter 432, Home Health and Hospice Programs, Chapter 443; Vital Statistics; Oregon Administrative Rules, Mortuary and Cemetery Board, Division 30.
Dedication Prayer
We offer this boundless virtue so that all obstacles dissolve, and that at the time of our death, each of us may find ease in dying and swift rebirth in the pure land of Great Bliss.  May all beings quickly recognize timeless awareness and be liberated into the natural state.
Disclaimer:  This manual is a repository of information concerning death-care for buddhist practitioners and others with samaya in a spiritual tradition.  The authors (yesheflowersatgmail.com) of this manual assume no legal, financial, or spiritual responsibility for death-care arrangements by readers or for unauthorized alterations of the original text.  Readers are encouraged to supplement the manual with further research, education, and training specific to their circumstances.  All or parts of this manual may be freely copied and distributed and may not be sold or traded.