The Good Death

Many residents of the Highlands have embraced the “death-positive” movement, which hopes to shape the endings of our stories.

When a doctor told Lisette Cheresson’s family that their mother was no longer eligible for a liver transplant, they decided to take her home immediately.

“The doctor was flabbergasted,” says Cheresson, a Beacon resident whose mother died in 2018 in North Carolina. “He said: ‘Are you sure? We can keep her alive.’ ”

“We had to honor what we promised her,” she recalls. “Mom didn’t want to die in a hospital.”

They hired a private ambulance to take her home that evening. Family members were at her bedside when she died the next morning.

“It was one of the most profoundly beautiful moments of my life,” says Cheresson. “It is transcendent when people are given an opportunity to experience these sacred intimate moments in ways that are meaningful to them.”

As part of a growing movement that has been described as “death positive,” people in the Highlands and around the country are looking for ways to embrace life’s final moments and turn death into something beautiful and meaningful. The movement is driven by death doulas, podcasters, hospices, writers, singers, funeral directors and “death café” facilitators.

In part motivated by her experience with her mother, Cheresson joined an army of doulas, also known as death midwives, who help families talk openly about dying and individuals achieve a “good death.”

Hudson Valley Hospice, which serves Dutchess and Ulster counties, has trained about 80 end-of-life doulas since 2017, said Lisa Wilson, a spokesperson. Wilson said the doulas help plan and manage the final days of patients’ lives to ensure they have a good death, including the friends, music and even smells they want present in their final moments. “They talk with them about how they want the end to go,” she says.

Doulas also help with legacy projects such as farewell videos and letters. She says a doula helped a Fishkill woman in her 90s assemble a board of photographs to be displayed at her wake.

Words and music

Talking about death is the idea behind the death café that Ryan Biracree began last summer at the Desmond-Fish Public Library in Garrison, where he works as the digital services librarian. “Discuss death, dying and the dead — with tea and cake,” read his promotion for a session held Feb. 25. (The next one is March 17.)

Since 2011, there have been more than 17,600 such gatherings worldwide, according to deathcafe.com, a site created by Jon Underwood in London after he was inspired by “café mortals” held at bistros in Geneva by a Swiss sociologist, Bernard Crettaz. When Underwood died suddenly in 2017 at age 44, his mother and sister took over. (Underwood also founded a consumer site for people to review funeral directors.) The first death café in the U.S. took place in Columbus, Ohio, in 2012.

“Death cafés allow people space to talk about things without getting weird looks from family and friends,” says Biracree. The sessions typically draw 20 to 30 people.

Rather than talking, singing to the dying is the idea behind the Threshold Choir, co-founded 10 years ago by Cat Guthrie, a Garrison singer-songwriter. The choir visits the bedsides of the sick and dying to perform a repertoire that might include “We Are All Walking Each Other Home,” “Rest Easy” and “I Am Giving You Light.”

The first Threshold Choir sang in California in 2000; today there are more than 200 worldwide. Guthrie’s choir sings twice a month at bedsides around the Hudson Valley, including at the Rosary Hill Home for terminal cancer patients in Hawthorne.

“Music puts you in a different place,” says Guthrie, who, along with other family members, “sang out” to her parents when each died years ago. “We have stepped away from being present for people when they are sick and dying,” she says.

Ashes to Ashes
Cremation has become as common as burial — or you could be composted

When Anthony Calabrese of the Clinton Funeral Home in Cold Spring became a funeral director 20 years ago, about 10 percent of people opted to be cremated after they died. Today, he says, it’s about 50 percent.

That is consistent with the experience of other local funeral directors, as well as nationwide. The National Funeral Directors Association says 60 percent of bodies are cremated and that figure is expected to top 80 percent by 2045.

In addition, the association estimates that 8 percent of burials are “green,” where the body is interred without embalming and permitted to decompose naturally, sometimes without a casket. Nationwide, it says 60 percent of people showed interest in that option in 2022, up 5 percent from the year before. (Locally, funeral directors say they’ve collectively had only a handful of such requests.)

One of the challenges with green burials is the limited number of “natural” cemeteries that allow them, although over the past five years they have doubled to about 200, according to a green burial directory at the site US Funerals Online.

The closest dedicated green cemeteries to the Highlands are in Sleepy Hollow and Rhinebeck, and Wappingers Rural Cemetery has a green burial section.

Bill Halvey of Straub, Catalano and Halvey in Wappingers Falls is the only local director who has had a request for human composting, which became legal in New York in 2022. The body is placed in a container with straw, alfalfa and woodchips, he says, and over about three months, microbes transform the body into about a cubic yard of compost.

Because New York has no facilities that compost the deceased, Halvey sent the body to Washington, one of five other states that allow the practice.

Death positive

The term death positive was coined by Caitlin Doughty, a podcaster who runs a Los Angeles funeral home and created a site called The Order of the Good Death. “Why are there a zillion websites and references to being sex-positive and nothing for being death-positive?” she tweeted in 2013.

More broadly, the movement to provide good deaths dates at least to the 1970s, when hospices and palliative care took hold to aid the dying process. “In America, we don’t handle death very well,” says Wilson at Hudson Valley Hospice. “Hospice is a way of helping people die a death with dignity.”

Patrick Halvey, director of the Riverview Funeral Home by Halvey in Beacon, sees the death-positive movement as a throwback to the home funerals that his grandfather managed when he started the business in the 1930s. In those days, Halvey said, death “wasn’t scary or taboo” and families were intimately involved.

Over the years that changed with the culture, he says. The alienation from death has been so pronounced for some, that many families opt out completely, he says. “A lot of families say, ‘Let’s do nothing. We’ll have a cremation and do nothing.’ ” He sees the movement as a good thing, “an attempt to get more involved in death and demystify the death and dying process.”

As part of that trend, Joe Schuka, the managing director at Libby Funeral Home in Beacon, says that over the last 20 years, he has seen a growth in families getting more involved in preparing the body of a loved one for a funeral, including washing and dressing.

“They want to take care of their loved one every step of the way,” Schuka says, noting that the internet offers tutorials on how to prepare the body.

In addition, more terminally ill people, such as Cheresson’s mother, are choosing to die at home. About five years ago, homes surpassed hospitals as the most common place to die as more people opted for a “good death,” according to data from the Centers for Disease Control and Prevention and the National Center for Health Statistics cited in The New England Journal of Medicine.

The good death is a key theme of The Watched Pot, a play by Garrison playwright Keith Hershberger that was produced last month at the Philipstown Depot Theatre in Garrison. It tells the story of the final days of Sarah, who is attended to by her life partner, Mary, and other family members as she dies at home.

Hershberger says his play drew from his own experiences at the bedsides of five people as they died, including his father, Earl, in Michigan in 2010.

Hershberger and his siblings had gathered at their sleeping father’s bedside when one of his brothers had the idea of toasting his life with his favorite scotch. Hershberger woke his father and said: “We’re all here to celebrate your life with you and wish you well, and we have your favorite whiskey.”

“His eyes shut and his mouth opened like a baby bird,” Hershberger recalls with a laugh. They soaked a sponge in scotch. “He sucked and sucked and wouldn’t let go,” Hershberger says. “I said, ‘Dad there’s more,’ and his mouth sprung open. He ‘drank’ three or four of those sponges. We thanked him for being a part of our lives and we wished him well on his journey. He went to sleep and, in the morning, he died.

“It’s a profoundly moving and meaningful thing to be able to share a person’s last moments with them,” Hershberger says. “It’s a gift to be able to give them a peaceful ending.”

Part 2: New ways of grieving