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Act 39 – See “Vermont Act 39.”

Advance Directive:  An advance directive is a written document that outlines your wishes for medical treatment in the future.  It includes your wishes if you are no longer able to make those decisions. It serves as a guideline for healthcare professionals to honor your wishes..  Please be sure to fill an advance directive out and register it at your doctor’s office and/or local  hospital. For more information and download your own go to this link. 

Affordable Care Act: also known as “Obamacare” and “ACA.” Federally mandated and state implemented, the Affordable Care Act provides healthcare subsidies based on financial need, and also in some states, expands the Medicaid program based on income.  Verrmont Affordable Care info  

After death vigil: Also known as “Post Mortem Vigil” or “Wake” –  Many cultures and faiths believe that the soul needs time to depart from the body at death. A day-and-night vigil may last for more than a day, and include readings, poetry, music and prayer.

Alkaline Hydrolysis is also called biocremation, resomation. Alkaline Hydrosis is a form of body disposal using chemicals. It is an alternative to burial or cremation, and it produces less pollutants than cremation or burial. Click on this link. 

Allow Natural Death (AND): is a medical term defining the use of life-extending measures.  These orders emphasize patient comfort and pain management instead of life extension. https://en.wikipedia.org/wiki/Allow_natural_death

Anatomical Gift – also known as organ donation, or donating body to science.  In Vermont, contact UVM Medical Center or your physician for more information to donate your organs or your entire body. See also: http://donatelifenewengland.org

Burial or committal:  A committal service is the last part of a funeral.  It consists of a short ceremony just before the person is buried or cremated. Most committal services involve readings, poems or songs.

Calling hours: See “Viewing”

Casket: A casket has four sides.

Charnel ground meditation: A visualization contemplation or mediation where the death of yourself or others is examined. This is done in order to break attachments to the body and to alleviate fear of death. This is part of the death meditation practices, also known as contemplations on death or contemplations on impermanence.

Coffin – A coffin has six sides

COLST form:  Also referred to as a “DNR”  – This is a doctor’s order for guidelines on measures to be taken to resuscitate including chest compressions, etc. See Vermont COLST Form.

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Comfort Care: The goal of care is to control pain and attend to the patient's emotional and social needs as well. Comfort Care may include Palliative care and Hospice Care.

Composting or Body Composting: Part of the green burial movement, this is where human remains are broken down into fertile soil in “Recompose” vessels.  Bones are reduced to a fine powder by equipment after the soil is removed from the Recompose vessel. Non-organic items found, such as implants, are recycled whenever possible.  As of this writing, in 2023,  In the United States, human composting is legal in Washington, Colorado, Oregon, Vermont, California, New York, and Nevada.  https://en.wikipedia.org/wiki/Human_composting. Although legal is some states, you may have to call around to find a place that does this.

Cremation

Death (or Clinical Death) 

Death Café: http://deathcafe.com a discussion group, open to all, free admission, that gathers to talk about death. It is an international organization with conversational guidelines for discussion. Death Care Practitioner – a non-licensed individual who assists people with death planning and time of death. 

Death Certificate:  State law will require that a death certificate be filed with the state’s office of vital statistics. Although a physician assistant, or advanced practice registered nurse is responsible for filing the death certificate, the job may be, and often is, delegated to the funeral director.  https://en.wikipedia.org/wiki/Death_certificate  Electronic Death Registration System (EDRS), it is registered and the death certificate is available to the town clerk’s office for filing. 

Death Declaration (and paperwork surrounding death)

Death Doula or Death Midwife: https://en.wikipedia.org/wiki/Death_midwife – This is a specially trained person with expertise in the nitty gritty details and practicalities surrounding death and dying.  Death Doulas may help by creating death plans, logistics, helping with services and providing guidance to family  members as well.  They may be licensed in some states. If they don’t know the answer to your question, they will know where to find the answer. 

Death Notice A death notice is a paid notice (like a classified advertisement). In most cases, a funeral home will handle this. It can run the newspapers you choose. If you choose to do it yourself, please contact your local newspapers for information on their guidelines. Death notices announce that the person has died, and offer information on funeral services, where donations can be made in the name of the person who died, and minor biographical information. 

Death Vigil: see Vigil

Death with Dignity Act – see Vermont Act 39.

DNR ORDER or COLST FORM (Called POLST form in some other states): This is physician’s order that clarifies medical interventions of intubation, chest compression and other steps taken to resuscitate a person in cardiac arrest. See Vermont COLST form. 

DNR Bracelet, or DNR Jewelry: If you get a medical order for DNR (a COLST form) you may order a bracelet or other form if you choose.
  https://www.stickyj.com/category/dnr-jewelry-bracelets 

Doctor: Synonymous with Physician. A doctor of medicine has a medical degree and may be licensed to practice medicine. A doctor makes medical diagnoses, and may write prescriptions. A doctor may make a referral to a Hospice organization for end of life care.

DPOA –  Durable power of attorney, also Power of Attorney.  (Not to be confused with medical power of attorney,  Healthcare agent or guardianship, although there may be crossover in the terminology). These designations contain a wide range of  responsibilities. Legal issues are beyond the scope of this website, but I encourage you to familiarize yourself with these terms and to get these decisions and the paperwork done sooner rather than later.  Please see an Elder Law Attorney to help with these decisions and the paperwork. Click here for more details. 

Eco-Friendly death practices   These are practices designed to be environmentally friendly. They include some interesting new practices, such as the Infinity Burial Suit, also known as the Mushroom Death Suit.

Eldercare Attorney- aka Elder Law Attorney. These are attorneys specially trained in Administration and management of estates and trusts, Estate planning and probate, Trusts, wills, and other financial documents, Long-term care placements in senior living communities and nursing homes, Medicare and Social Security appeals and claims, Elder abuse and fraud, The preservation or transfer of assets to avoid spousal impoverishment when a spouse enters a nursing home.  See https://en.wikipedia.org/wiki/Elder_law_(United_States)

Embalming: Embalming is the art and science of preserving human remains by treating them to delay decomposition. The intention is to keep them suitable for public display at a funeral, for religious reasons, or for medical and scientific purposes such as their use as anatomical specimens. Vermont law does not require embalming.

Estate Planning Ethics – a branch of philosophy that involves systematizing, defending, and recommending concepts of right and wrong conduct. See also medical ethics.

Executor – The word executor refers to a person named by the creator of a will to carry out the instructions in the will. 

Fetal Demise: Also known as miscarriage, spontaneous abortion. A miscarriage can result in anxiety, depression or stress for those involved and can affect the whole family. Many of those experiencing a miscarriage go through a grieving process. https://en.wikipedia.org/wiki/Miscarriage

Gatekeeper (phones, door): A gatekeeper may be stationed outside the dying person's room to answer phone, greet visitors, allow guests in, or keep visitors out when a dying person may want privacy.

Green Burials – also called Natural Burials and  Eco-friendly death practices, Green burial practices are an eco-friendly alternative to conventional steel-lined caskets and embalming. Green burial practices have risen in popularity within the funeral industry in recent years. https://www.greenburialcouncil.org/green_burial_defined.html

Grief – Grief is a natural response to loss. See also the work of Elisabeth Kubler Ross.

Home Burial – aka backyard burial. You will need to consult with your town’s attorney or local zoning authorities, as there may be local ordinances. For information on caring for your own dead in Vermont, including home burial, start here by clicking on this link.  

Hospice –  As a descriptive term for end-of–life care, a home providing care for the sick, especially the terminally ill. This term is used this way mostly outside the United States.Hospice care is a type of care and philosophy of care that focuses on the palliation of a chronically ill, terminally ill or seriously ill patient’s pain and symptoms, and attending to their emotional and spiritual needs.  Sometimes the term “Hospice” refers to a building or a facility where end of life care is given. 

Hospice (proper noun, the name of standardized nonprofit organizations providing end-of-life care) –  Within the United States the term is largely defined by the practices of the Medicare system and other health insurance providers, which make Hospice care available (care specializing in palliative care and end of life care), either in an inpatient facility or at the patient’s home. https://www.nhpco.org/about/hospice-care  In the US, a client needs a doctor referral to be put on hospice.  

Insurance coverage of Death with Dignity care and drugs. See Vermont Act 39. Insurance practices differ with different insurance companies, so check with your insurance to see if the cost of using Act 39 is covered by your insurance.

Interment – Synonym of burial.

Jar-burials (I put this in just for fun) are stone-age human burials where the corpse is placed into a large earthenware and then is interred.  This was done in some stone age cultures and in modern stone-age cultures like Borneo. 

Living Will: A Living Will is a written statement detailing a person’s desires regarding their medical treatment in circumstances in which they are no longer able to express informed consent.  Synonymous with Advance Directive; Advance Health Care Directive; Advance Medical Directive.  https://en.wikipedia.org/wiki/Advance_healthcare_directive 

Living Will Agent:  While making a living will, you will select an agent to enact your wishes when you’re incapable. Terminology may vary, and please make sure to understand the scope of the living will agent, as the term may or may not be synonymous with healthcare proxy (I have encountered several definitions of this term).  Please consult an elder law attorney if you need clarification of your role as a living will agent.  Click here for details on living will agent. 

LNA: Licensed Nurse Aide, also known as CNA, Certified Nurse Aide, or NA, Nursing Assistant. They provide or assist with basic care under the direction of nursing staff. They will monitor health status, feed, bathe, dress, toilet.

Long Term Care Insurance: Long-term care insurance can help cover the expenses of day to day living associated with getting skilled care for an extended amount of time. It’s not the same as Medicare. While Medicaid can cover these kinds of costs, not all facilities accept Medicaid payments. https://www.cnbc.com/select/what-is-long-term-care-insurance/  

LPN: Licensed Practical Nurse.  Provide general nursing skills such as recognizing symptoms, administering medicines and treatments, and collaborating with other staff, families and doctors to optimize patient care. In Vermont, the scope of practice of an LPN is nearly identical to that of an RN, with an exception being that an LPN may not declare a death unless there is a specific doctor's order. Many nursing homes employ LPNs.

Medicaid: Medicaid is a mix of federal and state funded assistance, usually based on financial need. https://en.wikipedia.org/wiki/Medicaid   http://www.vtmedicaid.com/#/home

Medicare: Medicare is healthcare insurance for ages 65 and up, federally funded, usually for aging and disabled. https://en.wikipedia.org/wiki/Medicare

Memorandum of Personal Property 

Morals – a person’s standards of behavior or beliefs concerning what is and is not acceptable for them to do.

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Natural Burial (or Natural Green Burial) Natural burial is the interment of the body of a dead person in the soil in a manner that does not inhibit decomposition but allows the body to recycle naturally. It is an alternative to other contemporary Western burial methods.

Natural Death

NDE – Near-death experiences (NDEs) are profound mystical experiences that may occur close to death, and they are usually followed by dramatic reductions in fear of death.  Common cross-cultural experiences in NDEs include a feeling of inner peace, an out of body experience, traveling in a dark environment, reviewing one's life from childhood, seeing a bright light, entering “other realms,” and communicating with other beings.

Nurse

Obituary– An obituary (obit for short) is a news article that reports the recent death of a person, typically along with an account of the person’s life and information about the upcoming funeral. In most cases, a funeral home will handle writing and delivering obituaries.  You may choose to write your own.

Organ donation:  http://donatelifenewengland.org

Palliative care:  Palliative care focuses on providing relief from the symptoms and stress of a serious illness. The goal is to improve quality of life for both the patient and the family.  You do not need to be in hospice care to receive palliative care, but palliative care is often given to those in hospice.  Palliative care may include surgery, drugs, radiation, with the aim at reducing symptoms. https://en.wikipedia.org/wiki/Palliative_care

Post Mortem Care – Preparing the patient for viewing by the family (bathing, grooming, dressing, arranging); Ensuring proper identification of the patient prior to transport to the morgue or funeral home, and providing appropriate disposition of the patient’s belongings (if not at home).

Post Mortem Vigil: See Vigil

Postmortem photography (also known as memorial portraiture or a mourning portrait) is the practice of photographing the recently deceased. These photographs of deceased loved ones were a normal part of American and European culture in the nineteenth and early twentieth centuries. It is done occasionally nowadays for infants. 

Power of Attorney – POA is a written authorization to represent or act on another’s behalf in private affairs, business, or some other legal matter.

Probate  https://en.wikipedia.org/wiki/Probate  is the judicial process whereby a will is "proved" in a court of law and accepted as a valid public document.

PROD – Preliminary Report of Death

Psychedelics - Psychedelics, like Psilocybin (derived from fungi), have been used to temper the existential crises often seen as one approaches death. They have also been used as therapy for depression. The use of Psychedelics as a form of therapy is legal in a few states. Do an internet search.
https://www.hopkinsmedicine.org/news/newsroom/news-releases/2022/08/psychedelics-may-lessen-fear-of-death-and-dying-similar-to-feelings-reported-by-those-whove-had-near-death-experiences

Review: See Viewing

Rigor Mortis: The body stiffens after death.  https://en.wikipedia.org/wiki/Rigor_mortis 

RN, Registered Nurse. RN's Provide general nursing skills such as recognizing symptoms, administering medicines and treatments, and collaborating with families and doctors to optimize patient care. RN's often specialize in their fields and require more education than LPNs and LNAs. Laws vary by state regarding scope of practice for licensed medical professionals, and in Vermont an RN may pronounce death. (LPNs, and LNAs and Personal Assistants may not unless doctor’s orders state differently.).

Scattering of ashes – locally regulated. Funeral directors and death doulas may also help with permits and ceremonies.

SIDS – Sudden Infant Death Syndrome. https://www.mayoclinic.org/diseases-conditions/sudden-infant-death-syndrome/symptoms-causes/syc-20352800

Sky Burial, or Celestia Burials:  Sky burial is a funeral practice in which a human corpse is placed outdoors to decompose while exposed to the elements or to be eaten by scavenging animals, especially carrion birds.  It is practiced in areas of China and Mongolia, Tibet, Bhutan, Nepal.  The locations of   sky burial are understood in the Vajrayana Buddhist traditions as charnal grounds.  Sky burials are not done in the United States. State and town laws vary, regarding burial practices. Check with your town clerk regarding any non-conventional burial practices you may wish.

Stages of Grief – dabda. Denial, anger, bargaining, depression, acceptance, as designated by Elisabeth Kubler-Ross.  See link: https://en.wikipedia.org/wiki/Kübler-Ross_model 

Traditional Funeral - This usually includes a viewing or and formal funeral service; also the use of a hearse to transport the body to the funeral site and cemetery, and burial, entombment, or cremation of the remains.

TOD - Transfer On Death -- In Vermont, a Transfer on Death (TOD) provision allows an individual to transfer certain types of assets to a named beneficiary upon their death without going through the probate process. This applies to assets such as bank accounts, brokerage accounts, and securities.

Vermont Act 39  (Death with Dignity) – (Vermont Act 39 aka Death with Dignity; aka Right to Die; aka End of Life Bill, aka physician-aided suicide.  Basic info – Legalized in Vermont May 20, 2013.  A person who is 18 or over, of sound mind, and terminally ill, may request that a doctor prescribe a lethal dose of medication. Doctors, family and friends are immune from prosecution if present. The law requires a 15-day wait period from the time the patient first requests both orally and with a witnessed written request. Doctors must wait 48 hours before issuing the medication. See: http://www.leg.state.vt.us/docs/2014/Acts/ACT039.pdf 

Vermont Advance Directive downloads. Long forms and short forms. Create and register your Vermont Advance Directive to let your health care providers and others know your wishes regarding medical care.  http://www.healthvermont.gov/health-professionals-systems/advance-directives/create-and-register-advance-directive 

Vermont: DNR/COLST  (DO NOT RESUSCITATE ORDER/CLINICIAN ORDERS FOR LIFE SUSTAINING TREATMENT).  This is a doctor-signed order so that health care workers have clarity on life sustaining treatments.  Medical professionals should be informed if their clients have a DNR /COLST order. https://vtethicsnetwork.org/2022-vt-dnr-colst-form

Vermont Good Samaritan Act: This Act details the liability for healthcare professionals in an emergency situation. https://howardcenter.org/wp-content/uploads/2021/04/Good-Samaritan-Law-Press-Release.pdf

Viewing: A viewing is sometimes referred to as calling hours, review, funeral visitation or a wake in the United States and Canada. Family and friends may see the deceased after they have been prepared by a funeral home.  A viewing may take place at the funeral parlor, in a family home or at a church or chapel prior to the actual funeral service.  

Vigil: A vigil, from the Latin vigilia meaning wakefulness, is a period of purposeful sleeplessness.  It is a time for devotional watching, or an observance.   A death vigil may include the time prior to death, and time after death, known as a “Post Mortem Vigil.”

Wake: See “Viewing” 

Water Burial  (“Burial at sea”) Burial at sea is the disposal of human remains in the ocean, normally from a ship or boat. It is regularly performed by navies, and is done by private citizens in many countries.  

Will: A will is a legal document, drawn up by a lawyer, that in indicates how a person wants his or her estate (money and property) to be distributed after death.  Wills must be signed, dated and include the signatures of at least two witnesses.  https://www.merriam-webster.com/dictionary/will.  

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Exit Interview Vermont

Written and illustrated by Marcie Vallette   

info@exitinterviewvt.com