The cost of dying in San Diego

S1: Well , welcome in San Diego. It's Jade Hindman on today's show. The cost of living is high , but a recent KPBS report explores the cost of dying in San Diego. This is KPBS Midday Edition. Connecting our communities through conversation. On this show , we often talk about San Diego's high cost of living. But what about the cost of dying? Well , it turns out the burial process can reach well into five figures. It's a huge burden for families who are already navigating impossible grief. KPBS health reporter Heidi DeMarco has the story. She joins me now. Heidi , welcome. Hi.

S2: Hi. Welcome. Thanks for having me.

S1: Glad to have you here. Tell me. I mean , what made you want to work on this particular story?

S2: Well , it came about from , you know , one story that I worked on about death doulas or trying to work on , actually , it led me into this whole world of death and dying. And I just started meeting different people , and I started learning about the different options at the end of life. And I thought it was fascinating. I had not heard of a lot of them , so I thought it would be of interest for people to know that they have options at the end of life.

S1: You spoke with Penny Waugh , who is a death doula here in San Diego. Tell me about her and how she describes her work.

S2: Well , I met her at one of these death cafes , and , you know , she has a personal connection. She saw what her mother went through during , you know , her end of life journey. And she said , I think I can make a difference in this space. So she created the Death Network , and it's just this hub where you can learn about different options , kind of learn how to start the conversation about end of life. And she decided to become a death doula , and she worked in a funeral home for a little while and just kind of wanted to branch out. And now she counsels people at the end of life.

S1: Well , here's some of what Penny had to say.

S3: What I learned was that we are so uneducated on what death and dying can look like here in the US , and people are just making rash , urgent decisions.

S1: Well , so , you know , for many families , this conversation around death and money is one that happens after the loss of a loved one. What does that look like?

S2: Uh , you know , unfortunately that's that's the the norm , right? I think death usually is unexpected. And so people are not prepared for that. So the way that it's been described to me by all these different people is that they're kind of faced with these decisions in the moment of , you know , being very vulnerable. And there's a little bit of a sticker shock there , right? They're not prepared for it. And they just kind of go with the flow , right? Like they they make decisions in the heat of the moment. And , you know , at the end they don't know all their options. So it's very unfortunate. She also mentioned that a lot of the times what was heartbreaking was that she would see , you know , children who had no idea what their parents wanted for their end of life. So she is a big advocate for having those conversations before the crisis. Yeah.

S1: Yeah. I mean , tell me , what does it look like to work with a death doula? Heidi , I mean , what how does that how does that work out?

S2: Well , you know , you can start early on. You don't have to be in hospice care or anything like that. You can , you know , work with them way before just to plan things out , to take care of those documents that , you know , people really don't have. Right. There's a really low percentage of people that have advanced directives. And so just to kind of get your affairs in order so that when the time comes , your loved ones don't have to guess and maybe make decisions that you didn't want or , you know , maybe are not within budget. You know , we make a lot of decisions because we love them so much that we want to , you know , get this and get that. But the way she describes it is that they can just , you know , go and plan things ahead of time or you can come , you know , you can work with a death doula when you know it is that time and you kind of want to , um , have that , you know , hand-holding and just kind of guide you through that process. And there's a lot of things that , you know , they offer in terms of just , you know , maybe having , you know , a living funeral , something that , you know , the loved one who is , um , on hospice can participate in it , uh , you know , kind of enjoy that moment. And I've seen a little bit of that in some stories that I did where people are gather , you know , while the person is still alive and just kind of share that moment. And there are so many other things , right? Maybe like having a viewing in your home versus at a funeral home. So there's a lot of options that they can kind of help guide you through.

S1: So that's interesting. You learned , um , about the cost behind all kinds of of options for burial as well , starting with the most familiar options traditional burial and flame cremation starting though with traditional burials. What's the price tag there.

S2: For a traditional burial? It's about , I was told , 12 to $1300. And you know that it just doesn't include like the land , but it's also labor. It's the upkeep. It's the burial vault. So a lot of , you know , goes into it , maybe the memorial or , you know , placard , things like that. But we are here in San Diego , about $2,000 more than the national average.

S1: And there's additional expenses that come with a funeral home , too.

S2: Right , right. I mean , you know , if you. Well , I mean , you have the cemetery and then you have the funeral home , and the funeral home takes care of the body so that , you know , includes the embalming , you know , taking care of the body , preparing it for viewing , maybe having some sort of , you know , a ceremony. Um , so , you know , a lot of things kind of can add up , which I had no clue about , which is maybe if they have to pick up the body after hours , you know , that's that's an extra charge. You know , if it's on a weekend , you know , little things like that that maybe you were not aware of. And then it kind of just starts adding up.

S1: And a death doula would , would come in and prepare you for all of these things.

S2: Right , right. And , and you know , and be there with you. Right. It's , it's when you think of like a birth doula right there helping you in that moment. Um , just.

S1: Coming up to it. Right.

S2: Right. And just being your advocate. Really. Right. And so it's just kind of being there for you and supporting you and guiding you so that you don't make these , you know , rash decisions at the end. Man.

S1: Man. What is the cost breakdown for a flame cremation?

S2: So a flame cremation is usually what you know people will go for nowadays because it is significantly lower. Um , an average here in San Diego is about. Excuse me , $1,500. Excuse me. And you know , that includes , you know , the flame cremation , the urn. But it's very simple , right? So it's it's the most simple and cost effective right now. So it's a very popular choice.

S1: But there's also new options gaining popularity , like water cremation , for example. Uh , you visited White Rosa Aqua cremation in Escondido. Here's executive director Kayla Flores describing the process. Escondido.

S2: Escondido.

S4: It's basically returning your body to its natural state , which is amino acids , peptides , sugars , protein and water.

S5: And five nautical mile markers.

S2: Then there's burial at sea. Wow.

S1: Wow. So that's that's very interesting. So there are all of these different options. Um , and obviously something that a doula would be familiar with. Tell me , what did you learn about the water options here? Right.

S2: Right. I mean , fascinating it was fascinating. The water cremation. Right. She gave me a tour of of these this like chamber where the body is going. It's kind of like she said , returning the body to its natural state. There's , you know , it. The water and the pH balance kind of , you know , helps the body , um , dissolve and just , you know , you come , you're left with more ashes , actually , than a flame cremation , she told me. And it's just , you know , it is it's very fascinating. And in terms of like price , it is a little more expensive. Um , but a lot of that has to do. She told me because of the process , it's an all electric process. And inflation , you know , has hit every industry , including this one. And so since electricity has gone up , you know , so it's hard , you know , it's a little harder. Um , but the average right now would be about $3,800.

S1: What about burial at sea?

S2: Burial at sea? It can range , right? I mean , it's very beautiful to have gone out there with them to see what they do. It's just , you know , you know , it's you can have it be unattended , which means that you can view it from maybe a dock and they will do it for you. Maybe they film it for you and , you know , um , they'll send you that. They have to go far out enough to be able to do , like scatter your ashes. They put it in this beautiful , biodegradable , you know , basket with flowers , and then they just let it go. And you see , you know , the flowers and roses and just scatter into the sea. And then they also have something where you can have your family come , right? Or you can have loved ones come and they get on the boat and they go out there and , you know , they're they're part of the process. You know , the way he describes it with music and maybe the person's favorite cocktail. You know , it's kind of an event. And and then you have something where it's like a full body burial where you have the full body. They have to go out a little further , you know , into the ocean for that. And , you know , the body is shrouded and , you know , let you know , let go into the ocean. And it's just , you know , it's fascinating to to know that these options are available. Interesting.

S1: Interesting. So next year California will add another option human composting. Can you describe that process. Right.

S2: Right. This is you know , um , the way they incorporate I think it's like all the , like the material , the fleshy material , your bones , everything goes into this , um , you know , composting , you know , process. It's about three months , I believe. And it , you know , you go , they take it out , you put it back in. So it's a back and forth , and then you're left with , you know , um , a lot of , of compost material that you can use to plant , you know , in your garden to plant , you know , flowers , you know , whatever you like and just kind of have your loved one with you , or you can give them , you know , give a little bit out to each family member. But it's something that it's more , you know , very green. A lot of a lot of these options like the water cremation , the water burial , they're all it's it's they're leaning more towards green options. And um , that's also gaining popularity.

S1: How much would something like that cost?

S2: Um , I think right now it is about 8000. And once it becomes available in California , it'll be the same. Right now it's available out of state. So if you wanted to do that , you still could do that. But it's an extra cost to fly the remains out to a different state and then bring them back.

S1: You know , experts say the most important decision may be , you know , to have the conversation before they're forced to make one. Make a decision. Rather , what is their advice for starting the conversation around this? When do you know? Like , hey , I should reach out to a death doula , right?

S2: I mean , I think it's something that we all kind of will have different ways to do it. I think that's why they're trying to to make these death cafes more popular and just kind of do them in different ways so that people so that the conversations so it could be more , um , comfortable. And , you know , a lot goes into it. It depends on the family's religion or culture or background. And so they just , you know , just getting it started beforehand. I think if you are dealing with , you know , older parents or , you know , you kind of have that conversation , you know , way before someone has to go into assisted living or a hospice. So I think they're trying to be more out in the community. A lot of these death doulas and folks like from the all the people that I met for this story , just go out into community events and they try to , you know , spread the word about the options and just kind of try to normalize the conversation around death and dying. Mhm.

S1: Mhm. You know , what is your approach to telling these stories in a compassionate way like you do.

S2: Well , well I feel like I think it's it starts with one story right. It'll start with , you know , the first story I did with this , it just came out of nowhere actually. And it's word of mouth , honestly. Like once you produce one story and they see your work , and then I ask , oh , hey , I'm trying to find out about this , and they will introduce me to other people. And I really I really just see it as I'm very fortunate and I feel very honored to be able to tell these stories. And , you know , I try to do them with as much respect and dignity. And , you know , as a health reporter , it's , you know , always dealing with people at the most vulnerable of times. But this in particular , I mean is , is even. It's even more so. Right? So just to try and make sure that , um , I'm doing the best I can to represent , you know , the folks that I'm interviewing and , and , you know , and so that the audience can also get that connection.

S1: And it's great. I've been speaking with Heidi DeMarco. She's health reporter for KPBS. Heidi , thank you so very much for your reporting.

S2: Thank you for having me.

S1: That's our show for today. I'm your host , Jade Hindman.

S6: Thanks for tuning in to Midday Edition. Be sure to have a great day on purpose , everyone.