In my travels, visiting funeral homes, visiting with owners, and embalmers, I reluctantly say I think I have heard and seen it all. One of the common themes I have witnessed is poor embalming, poor presentation, and yes many other things that I believe directly contributes to the increase in direct disposition. Embalming is the one thing that we can offer to families that cannot be purchased on the internet. They cannot go to Walmart or Costco and purchase embalming. So let’s get back to the basics.
The importance of a complete case analysis on every case cannot be overemphasized. Why did this person die? How much time has elapsed between the actual time of death, and the time they came into your care? Were the remains refrigerated and if so how long? What is the size of the decedent? If the person died at home, what was the general environment of the home, was it clean and well- kept or was it less than desirable? This list can go on and on, but a good embalmer will attempt to answer all of these questions prior to beginning the embalming procedure, let alone before making a decision regarding choice of fluids for each and every case.
Feature setting is the key to all good embalming’s. If on a removal at a care facility or home and the nurse or family gives you dentures, gently ask how long it has been since Mr. Jones wore these? Often you will be surprised to learn that it has been a period of time. Many times the mouth has actually shrunken over time. The dentures will not fit properly, and the mouth will not look natural following embalming. Mouth Formers and Eye Caps must be trimmed to fit each individual. There is not one standard size of mouth or eye, so why would you just put in eye caps and a mouth former without adjusting their size by trimming the edges to fit the individual? The lips should gently meet and the expression should be peaceful, not smiling or frowning. The head should be slightly tilted to the right, no more than 15 degrees, not staring at the ceiling or worse the lid of the casket. At times you may have to tilt the entire body with the usage of body blocks to achieve this. The hands should look comfortable, fingers together, and in most areas left over right. I use a paper towel rolled up like a ball under the right hand to provide some form so the hands do not lie flat. I know of some embalmers who use a tennis ball to achieve the same thing. Shaving should be achieved before injection of chemicals. If in doubt contact the family before shaving. Ladies also need to be clean shaven to allow smoother cosmetic application. Never glue lips or eyes before embalming, as this will cause a lot of issues.
Before I go any further, please know that I am a gallon at a time embalmer. I believe that in order to achieve the results I want and require by only mixing one gallon at a time allows me to see if there are going to be complications that I did not anticipate, or if distribution and diffusion is occurring properly. I cannot stress the importance of pre-injection enough. Research has proven that if a body is pre-injected with a solution designed to prepare the vascular system for introduction of a preservative solution fewer embalming complications will occur. I inject one 16 ounce bottle of pre-injection to one half gallon of tap water with a closed vein.
When choosing an arterial fluid to use, I always start out with a 20-25 index fluid, 6-8 oz. per gallon, along with one 16 ounce bottle of drainage. Why do you start out with a weak solution many ask? Simply put, it is an absolute necessity that all tissues receive ample concentrations of preservative for full preservation to occur. If you start out with a more concentrated solution then you are taking a risk of what I call shell embalming occurring. The stronger arterial solution will actually wall off some of the smaller vessels and deep tissue preservation will not occur. When this happens, you may encounter external firmness and color, but in a couple of days the deep tissues will actually start to decompose and you may have issues of odor and other complications. You can always spike the solution, but it is hard to take away. I am not a believer in extremely high pressure embalming. Often times, the decedent’s vascular system may not be in great shape due to age or medications they were administered prior to death etc. Start out with 40-60 lbs. of pressure with a rate of flow of 8-12 oz. per minute and see what happens from there. Once again take your time, let the fluid do its job and increase the pressure as tolerated by the decedent. On the succeeding gallons either you can either increase or decrease your concentration of solution to achieve the results you wish to achieve. If needed and often times it is, raise vessels in areas that do not receive adequate amounts of solution. I think back to my early days when I was told by a great embalmer” if in doubt raise it”. Add additional dyes on the last gallon only. The reason for this is actually pretty simple, with the arterials we have today, there are many wetting agents and surfactants in each and every bottle. These act to cross cell membranes which allows the preservative solution to reach all areas. Additional dyes may actually attach to some of these agents and cause splotching. If you wait to the last part of the injection to add cosmetic dyes, the agents have already done their job and splotching is less likely to occur.
Aspiration can be done immediately at the end of the arterial injection or delayed for 12 hours or so in most cases. If swelling or other complications arise during the arterial embalming, then aspiration should occur immediately following. However, if no complications arose during the arterial injection, then I prefer to wait 12 hours to aspirate. I have many reasons why I feel strongly about this, but my number one reason is I want the preservative solution to continue to work following the injection. I want an intact vascular system to remain that way to insure complete saturation of all tissues has occurred. I do realize that some firms do not have the time nor the resources for this to occur. But in my 30 years of doing it both ways, I still prefer to wait. During aspiration take your time, insure that you have penetrated all solid and hollow organs, remove every bit of fluid that you can. Following aspiration inject a minimum of 16 ounces of a trusted cavity fluid. I usually use a 52 firmdex cavity fluid that gives me a firm solid cavity following treatment.
Bathe the remains with warm soapy bath, clean all blood and other body fluids, wash the hair, clean the fingernails, and comb the hair. Sounds simple but you would be surprised how many times not all of this occurs.
If I can impart one thought into everyone reading this article, it would be the words of a very trusted former employer who stated to his staff, “You make your money in the preparation room, not the selection room”. If a family has a positive memory picture of their loved one, in all likelihood they will remember that and never consider direct disposition. However if they have a negative memory picture then next time, fire up the tort as they do not want to remember their loved one looking that bad. It is up to each and every embalmer to learn from each other, and insure that families are given the positive memory picture that they deserve. FBA
Dana Goodell is director of sales for The Embalmers Supply Company. He is a 1988 graduate of Dallas Institute of Funeral Service and a licensed funeral director/embalmer since 1989. He has worked in firms of all sizes and still serves as a consultant for several firms. He and his wife Lorna live in Sioux City, Iowa. He may be contacted at [email protected] or by phone (712)389-0406.