Dying big

 

The death care industry and related services have had to adapt to the increased weight of Americans and others around the world. As Allen Steadham, executive director of the International Size-Acceptance Association, puts it, ''People are living larger and they're dying larger, and industries have to adapt to that situation.'' Here are a few of the ways they have accommodated the obese deceased:

• Ambulances: Emergency services are retrofitting their rescue vehicles, replacing them with models that can “kneel’’ (lowering 2"-3") and including bariatric vehicles in their fleet equipped with oversize stretchers and hydraulic lifts capable of transporting patients weighing as much as 1,600lbs. “Is this totally, 100% foolproof? Absolutely not. We’ve still got to get them out of the house,’’ admits Boston EMS Captain Phil McGovern.
• Caskets: Manufacturers including Goliath Caskets, Inc. offer oversize caskets in widths ranging from 29" to 52" (1st image). Owner Keith Davis reveals, "When we first started in 1990, 36" was the widest casket out there. Now we're up to 52" wide, which can hold someone who weighs 800 to 1,000 pounds. We sold 11 that first year, and we fluctuate from 6 to 12 of the biggest ones each year." 
• Cemetery plots: Cemeteries are necessarily increasing the size of their burial plots or burying oversize caskets at the ends of other rows where they won't encroach on other plots. The size of the vaults must also be increased, and the deceased may have outgrown the plot which they prepurchased. According to the New York Times, "even the standardized scoop on the front-end loaders that cemeteries use for grave-digging (it is called a ''grave bucket'') is based on outdated estimates about individual size."
• Crematories: The additional body fat causes an obese body to burn for a longer time and to give off more heat, so in addition to offering a large enough chamber, the operator of a crematorium takes advantage of certain safeguards - like cremating the obese first, so that the retort is not already hot - to avoid overheating.
• Crypts: Cemeteries like Cedar Memorial in Cedar Rapids, Iowa, U.S., are adding oversize burial crypts in their mausoleums to fit the larger caskets.
• Hearses: Cadillac and other car companies are redesigning their vehicles to transport larger, heavier bodies.
• Morgue tables: Medical examiners offices like that of Snohomish County, Washington, have had to invest in equipment to manipulate and support the weight of larger bodies without causing them damage, including wider reinforced cots and examining tables (2nd image). "It's not unusual to encounter 300-pound people now, which used to be the exception rather than the rule," says Jim Noel, executive director of the Washington State Funeral Directors Association.
• Body Donation programs: Medical schools, which typically reserve the right to refuse bodies that have been embalmed or autopsied, now have to occasionally decline the donation of the bodies of the obese. The adipose tissue makes dissection difficult and time-consuming, the anatomy laboratories do not have the equipment to handle cadavers of that size, and the medical students are unable to reposition the bodies as is often necessary during their training. "We make every effort to accept a body, if we can. I wouldn't want people to get the idea that it's a common problem," says Richard Drake, director of anatomy and the body donation program at Cleveland Clinic.

Enhancements like lifts in the ambulance and the mortuary, and power hoists in the medical examiner's office, protect the employees from back injuries, but oversize products spare larger customers their dignity. "[T]he last thing we need is a lid that will not close when the time comes," says Davis of Goliath Caskets.