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Home vigil honors a mother's last wish

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Embracing a visitor
Georgia Ramin, the daughter of Anne Conley, embraced a visitor during Conley's three-day vigil at her home in St. Paul, Minn. April 21, 2012. Conley was diagnosed with breast cancer June, 2011 and died at her home less than a year later. Ramin discovered the three-day vigil felt natural and allowed her to fully say goodbye.
MPR Photo/Jeffrey Thompson

On a chilly Thursday morning in April, a hospice nurse told Anne Conley's family that she would likely die that evening. 

Friends dropped firewood off on the front porch of the cozy house on St. Paul's Ashland Avenue, where the family had been taking care of Anne.

The family fed logs into the fireplace. 

"We kept the fire going the whole time, all the way through the end of her life," Anne's daughter Georgia Ramin said. "That was one of her favorite things, and the smell of it I knew would be comforting to her." 

Anne was diagnosed with a very aggressive form of breast cancer the year before. After she called off chemo, the cancer had rapidly spread. 

First, Anne lost the use of her right arm. Then her legs wouldn't hold her up. Her skin grew ashen. By her final day, Anne couldn't speak or swallow food or water. 

Home death care
Members of the Minnesota Threshold Network sing to Anne Conley during Conley's final days of life at her home in St. Paul, Minn. April 17, 2012. Conley was diagnosed with breast cancer June, 2011 and died at her home less than a year later. Conley had chosen to hold a three-day vigil at her home rather than a traditional funeral, and received guidance from Minnesota Threshold Network members about home death care.
MPR Photo/Jeffrey Thompson

At 1:25 a.m. on Friday, as the fire burned, Anne took her last breath in the house she had lived in for 40 years. She was 65.  

"After she passed, before we called anybody, before anybody came, we just opened all the doors and let the wind blow through," Georgia said. "You really get this huge sense of relief, when the person you love and are taking care of was not in pain anymore." 

Like a growing number of baby boomers in Minnesota, Anne rejected traditional rituals like embalming and a mortuary service in favor of a more personalized experience: the home vigil. 

Anne left detailed instructions for her family to follow after her death.  

"'They'll wash my body and prepare it,'" Anne told her daughter Georgia. "'Then they'll pack all this dry ice around my body. And I want to stay at the house for three days. And during these three days, I never want to be alone.'" 

"VIVACIOUS AND OUTSPOKEN" 

Anne's graying hair was streaked with white, and offset by dark vintage glasses. She wore long necklaces and dressed in a flowy, funky style.  

"She had been exercising regularly for about five years, she was really into eating well," Georgia said. "She was overweight for sure, but other than that, living this healthy alternative lifestyle."

"I want to stay at the house for three days. And during these three days, I never want to be alone."

Friends describe Anne as vivacious and outspoken. 

"She was a very fiery type of person," Georgia said of her mother. "If you crossed her and you went too far, and you might not know where that might be, but you would find out when she cut you off."

After her divorce in the 1970s, Anne starting hanging out with her younger siblings, and absorbed their hippie values and lifestyle. She became a community organizer in the former Lexington-Hamline neighborhood. Then in her 50s, she went back to school to learn homeopathic medicine. 

Anne found out about her breast cancer on June 8, 2011. She responded with characteristic bravery, Georgia said. 

Anne underwent chemotherapy and radiation, and travelled to Ann Arbor, Mich. for homeopathic treatments.  In February of this year, after hearing that her cancer had spread, Anne told the doctor she planned to quit chemo. 

The doctors said she could be dead within two months. And Anne, who had so often before bucked conventional wisdom about everything from medicine to her personal life, started preparing to die. 

"THIS IS WHAT I WANT TO HAPPEN"

Anne approached Marianne Dietzel and Linda Bergh for help in planning what would happen when she died. The two women began working together after their daughters, who were best friends, were killed in a car accident in 1996. 

Dietzel and Bergh now help others cope with grief. They also help people plan how they want to die and how they want to be mourned through their group, the Minnesota Threshold Network. Anne enrolled in the group's death and dying class. 

"At the beginning, she was just sort of upset and anxious," Bergh said. "At the end, all of us experienced this person who was at peace, and was living in a kind of joy. She may be dying, but she looked better than she had when she was more well."

Home vigil
Visitors greet Georgia Ramin during a three-day vigil for Ramin's mother at her home in St. Paul, Minn. April 21, 2012. Ramin's mother, Anne Conley, died from breast cancer, and had chosen to hold a vigil at home rather than a traditional funeral.
MPR Photo/Jeffrey Thompson

The class helped Anne formulate her plans for her vigil. She worried about her family's reaction. But Anne believed her spirit would be transitioning from this world to the next during the days of the home vigil. 

"I thought it was horrible and disgusting," Georgia said. "That's horrible to me that your decomposing body would be, what, in the living room?" 

Georgia still had reservations, but she accepted Anne's wishes.

Dietzel said making these arrangements freed Anne from worries of what would happen after her death and how her family would cope. She had time to make the most of the rest of her life.

"She was totally enjoying being with her granddaughter, just living in the moment and doing what was important in that moment," Dietzel said. 

Anne also used the time to put other parts of her life in order, deeding her house to Georgia and even making sure it was freshly painted. 

Anne's process of planning for the shuttering of her life changed her. 

"The whole thing she was talking about, bringing our family together -- this was a huge thing that she showed us all how to do," Georgia said. "There are things she set into motion that I thought might fall apart after she died. If anything, some of them seem stronger." 

"RIGHT BACK IN THE 19TH CENTURY"

A 2010 Minnesota law allows a family to show a body at home without embalming. Some traditional mortuary directors have started to provide support for a variety of alternative funeral arrangements, from green burials to home vigils. Anecdotally, at least, these practices seem to be growing in popularity. 

What all these practices have in common is that they reject the sort of ritual that's been the norm in the United States for the last 50 years, where a body is preserved with chemicals, displayed at a mortuary, then buried, said John Troyer, deputy director of the Center for Death and Society at the University of Bath in England.

"This is sort of the irony in many ways of the home burial movement, which is that it's sort of the discovery of the old," Troyer said. "The idea of the revolution being dead bodies in the home, well, you're right back in the 19th century."

In 41 states, home funerals are legal, despite popular misconceptions to the contrary, said Joshua Slocum of the Funeral Consumers Alliance. 

"Because we're so separated and removed from death, most of what we we think we know is wrong," Slocum said. "There have always been private people and some religious groups that have cared privately for their dead." 

But a home funeral, where the body is viewed in the house instead of at a mortuary, is still an unusual experience for many Americans. There are no national statistics, but Troyer believes baby boomers are open to new views on death.

"You have a significant portion of the American population coming to grips with its own mortality now," Troyer said. "You're finding more and more individuals who want to be assertive, or want to be even aggressive in the death that they experience, both in end of life, as well as the funeral that takes place."

Troyer said the home vigil also seems to be a rejection of the alienation people sometimes feel about the modern funeral rituals, which is something Anne herself worried about. She told Georgia that she was traumatized as a child when she would hear that people she loved had died and they'd just disappear from her life.   

"SING HER OUT"

Within a few hours of Anne's death, Linda Bergh and a group of friends came over to wash and prepare her body. 

"They kept asking us if we wanted to help and I was like, 'No, we don't,'" Georgia said. 

"Because, honestly, we were so wound up at that point that I think if a burp or a fart or a sigh had escaped her, I think we would have all just screamed and lost it." 

Georgia was told later that Anne's eyes did fly open while the body was being prepared. But otherwise, Dietzel said, the preparation of the body was routine. They dressed Anne's body and packed dry ice around her body to slow its decay. They scented her with essential oils to mask any smells, but didn't put makeup on her face.

"All of her color came back. She looked like herself," Georgia recalled. "She had like a little rosy cheek and her pink lips, she really looked like herself. That was a surprise."

With Anne on her hospice bed in her former office, Georgia felt something she hadn't expected, like the physical ties between her and her mother were being "cut and broken."

"I think that probably just happens with your mom," Georgia said. "'I came out of that body,' was one of the things I thought when she was lying there." 

Every two hours over the three-day vigil, a different friend or family member had volunteered to either sit with Anne or hold her in their thoughts. 

The dry ice under Anne's body was changed every few hours. Friends visited and the family mourned. They found it was comforting to have Anne near, and to know that her body was never alone. 

By the time the cremation society came to get her body on the third day, the family felt ready to let Anne go.

A group of friends and family had gathered to "sing her out," as her son-in-law Travis described it. They sang "Will the Circle Be Unbroken" as her body was carried out of the house.

After it was all over, Anne's approach to death and the vigil seemed to make sense. 

"It really also continued her legacy, continued the type of person that she was in terms of how she liked to do things her own way," Georgia said. "It seemed very natural, it seemed like her. The whole process seemed like her."