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End-of-life rituals: Pandemic impedes on funerals, hospice care

New Hampshire Union Leader - 3/22/2020

Mar. 22--Last week, the New Hampshire State Veterans Cemetery held a funeral service with full military honors for a 97-year-old Air Force veteran and former POW from World War II. A bugler played taps, a firing detail offered a rifle salute and a member of the honor guard presented a folded flag to the man's widow.

This is how we say goodbye to our heroes.

But in a time of pandemic, even our end-of-life rituals are changing.

Starting Monday, the veterans cemetery in Boscawen will no longer have committal services and military funeral honors. Families will be allowed to witness interments, but there's a limit of 10 visitors, and they will be asked to maintain social distance, according to Shawn Buck, director at the cemetery.

Committal services and military honors will be scheduled when this is all over, Buck said.

Buddy Phaneuf, president of Phaneuf Funeral Homes & Crematorium, said many families are postponing large funeral gatherings until the current health crisis ends. "People are just very scared, and they just don't want to impose additional risk," he said. "They're doing private services; they're pushing services off."

Phaneuf said his company has been asking families to make arrangements and sign documents online. And for those who aren't computer savvy and want to come in person, the funeral home is limiting the number of people at such meetings.

People are being practical in the face of the coronavirus threat, Phaneuf said. There are no big public wakes, in keeping with the state's emergency order barring gatherings of 50 people or more. And with widespread concern about travel, he said, long-distance relatives are unable to attend.

"We're not sidestepping the grief," he said. "It's just smaller gatherings. It's not going to be the friends and distant relatives and work associates.

"It's just a different experience."

New Hampshire has one of the highest cremation rates in the country, around 75%, Phaneuf said. And that means most families can postpone funeral services until everyone can attend.

For instance, one family last week chose to wait because one son lives in California. "We're going to put the service off until things get back to some semblance of normalcy," he said.

Saying goodbye to a loved one is difficult enough. But the health crisis is bringing additional challenges, said Tina Andrade, director of development at Home Health & Hospice Care in Merrimack.

Its Community Hospice House is a 10-bed facility for people receiving end-of-life care. And nurses from the agency currently are visiting about 125 hospice patients in their homes, Andrade said.

Because of the coronavirus threat, all visitors and staff are screened as they enter the hospice house, she said. And if any staff members have traveled recently, she said, "Those staff members will not be able to work for 14 days."

They've had to curtail volunteer visits and visits from therapy dogs.

Only immediate family members are allowed to visit now, but staff members are using technology to connect patients with friends and relatives who can't visit in person, such as with conversations via Facetime and Skype.

"We understand this is a very special time," Andrade said. "People very much need to connect with the people that they love, so we're doing everything in our power to make sure that our patients can do that."

As for home visits, Andrade said infection control has always been a key part of what her agency does, knowing that its patient population is especially vulnerable.

"With a hospice patient at the end of life, it has always been a place you had to be very, very careful," she said. "The staff has always practiced heightened infection control."

With the current threat, her organization's senior staff is in daily communication with local hospitals and the state Department of Health and Human Services, and following the latest state and federal guidance, Andrade said. They also are calling patients to make sure there's no one in the home who has traveled or who is showing symptoms.

What families are experiencing right now is uncharted territory, Andrade said. But she said human connection and compassion are timeless. "We're all going to get past this," she said. "And we're going to come out stronger ... ."

Amid the heightened stress, those involved in end-of-life care say there are moments of beauty.

The hospice house has been finding creative ways to continue some of its supportive activities, such as music therapy. Patients' rooms have French doors that can be opened and beds can be wheeled outside onto a patio, Andrade said. "With the weather getting better, we can have musicians out on a person's terrace," she said. "That's such a gift."

While the veterans cemetery is limiting services for now, the grounds remain open. And with churches and other places of worship closed, Buck said, "The veterans cemetery is not a bad place to be spiritual."

Visitors can stroll along the memorial walkway, or visit their family graves.

"It's a good place for small, independent solitude and prayer," Buck said. "They can continue to visit here, keep their social distance, and visit the heroes."

swickham@unionleader.com

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