Similar to my previous post, Autopsy Explained, here are several things you need to know about cremation and arranging a cremation for someone.

As a professional, I have learned it is impossible to dumb things down too much. Certain things which seem obvious to me – such as “cremation is irreversible” and “cremated remains are gray powdery ash” – are actually NOT obvious to all people who are arranging a funeral for the first time, and lawsuits have been brought against funeral homes for not explaining the cremation process thoroughly enough.

The first thing you need to know is that cremation is most definitely irreversible, and its irreversibility is what makes the funeral arrangements a mess of paperwork. This mess is especially large in cases where the decedent has several surviving children or siblings making the arrangements. A certain number of these siblings or children need to give their written consent for the cremation to take place. In some states, they all must consent; in other states, half or a majority must consent, and this consent must be obtained even if they are in jail or working in Africa where there are no phones or they were total jerks who never really cared about Mom and aren’t even paying for any of this.

The body needs to be identified somehow, and different funeral homes have different acceptable forms of identification. The most preferable is a viewing by the next of kin. However, this is likely to cost a little extra because of the time needed to wash and dress the body. Even if you do not want embalming, you probably don’t want to see your mom after she’s been with me for a few days in refrigeration. We do what is called a “minimum preparation” or “basic sanitation” where the body is washed, dressed in a hospital gown or something provided by the family, and placed on a table for viewing. We also close the eyes and mouth, or in other cases, remove gaseous buildup via abdominal puncture or repair autopsy incisions or other trauma. ASK what will be done during the basic sanitation if you think there is anything you may object to. Basic sanitation almost never includes the use of any chemicals other than the spraying of the body with a disinfectant solution.

If you do not wish to view the body – and I think you are making a mistake – then you may be asked to submit some form of identification, such as a driver’s license, so that I may compare that with the body in my care. (Yes, I can match a picture to a face even with a 20-year age gap.)

Other funeral homes are content to use hospital paperwork as ID – they say he’s Bob Jones; he must be Bob Jones. This is also a mistake. Please view the body! If you can’t afford the extra cost, ask if they will consider waiving it. On a slow day and on a body with no trauma and only a hospital gown for viewing, they just might waive the fee.

Before cremation, the body will be checked for jewelry and pacemakers, which must be removed prior to cremation to prevent damage to the crematory. The pacemaker is removed via a shallow incision in the chest, and is done by me. It is then recycled. Any jewelry is returned to the family, cremated with the body, or placed in the urn, whichever the family prefers.

The body must be cremated on or in a rigid container. I know of no crematories that put human bodies on the hearth without some sort of box or tray. This is done not only for ease of handling, but also dignity. You are allowed to provide your own container if you do not wish to purchase one from the funeral home. The only requirements are that it encase the body; it be combustible and it be rigid. A thin wooden tray or thick cardboard box will usually suffice. Infants and fetuses are cremated in a small metal pan and do not require the purchase of a container, but the family may select a casket if they wish. Most infant caskets are cloth-covered wood or cardboard and are suitable for cremation.

You are allowed to have items placed with the body for cremation, such as photos, stuffed animals, books, blankets or other things. I encourage this.

One thing that does not occur to many is that the burning of the body is not the end; the body does not simply disappear. About five to ten pounds of bone matter remains; I open the chamber to a full human skeleton. The bone matter is swept out and the chamber vacuumed to remove as many fragments as possible, though it will never be possible to recover every bit. This means with every cremation, a little bit of your family member is left behind, and a little bit of someone else’s family ends up in your mom’s urn.

Metal implants such as hip and knee replacements are discarded, unless the family wants to keep them, and some do. Tooth fillings turn to gas; there is no recovery of the gold fillings.

The bones are then pulverized in what looks like a large food processor, until only the familiar gray powder remains and is placed in the selected urn. If you do not wish to purchase an urn from the funeral home, you are allowed to provide your own, which can be literally anything. Plastic bag, cardboard box, cookie jar, music box…anything. I encourage this as well. It will be more meaningful and will save you potentially hundreds of dollars. This is acceptable when you are scattering the cremated remains or keeping them at home. If you wish to have the urn placed in a cemetery or mausoleum, you will need to adhere to their regulations regarding the size, material and style of urn. Nearly all of them will ask you to avoid wooden urns.

Most families want to scatter cremated remains, which is legal almost anywhere as long as what is potentially found is not recognizable as cremated remains. One consideration: often members of a large family will agree to scatter the cremated remains, only to realize years later that they would have taken comfort in a place with their loved one’s name where they could go to reflect. It would be wise to retain a small portion of cremains for yourself in case you would like to inter them somewhere at a later date. Or, another option is to have a memorial plaque set in a cemetery or other location. Many people are comforted by simply having their loved one’s name set at some sort of official grieving place.

Cremated remains can be divided up into many smaller containers; the most I have ever done was 100. They were little tiny glass bottles with corks and were filled by hand with a funnel and needle. If anyone charges you extra to do something like this, you have chosen a bad, bad funeral home.

Many religions practice what is known as a witnessed cremation, where the family is present for the actual cremating of the body. They do not witness the body burning, but they push the tray or casket into the chamber and can also push the buttons, and remain for the duration of the cremation. The first one of these I did was for an infant and the family wanted to watch the processing and the cremains being sealed into the urn. They chose to watch from behind a window, but other families will be right in the room with me. This option is available to all families (and I recommend it) but it will cost extra because of the scheduling necessary with the crematory staff and funeral home.

It is very difficult to arrange a rushed cremation, because the body cannot be cremated until the doctor signs the death certificate and legally, the doctor has three days to sign. (And they will take their precious three days…) After the signatures are obtained, the cremation needs to be scheduled with the crematory. It usually takes around a week to get someone cremated; it can take up to ten days. Anything longer than ten days and you have likely chosen a bad funeral home.

Finally, cost. I firmly believe that if all you want is your mom returned to you in a plastic box and maybe a few death certificates, you should not be paying over $1000. There are places that will charge you a tad over $500 (ask, ask, ask what all is included!) and places that charge over $3000 for the same service. A $3000 cremation is robbery. Most likely, those who cremate bodies for $500 are employees of the larger funeral home who charges $3000, meaning for $500 you get the same service at the same facility by the same people. If you ask the price and it’s $2000, ask if you can get a lower price. If it’s $3000, do not ask anything. Do not say anything. Walk out the door and call another funeral home to pick up the body.