Tagged Videophones and Videoconferencing

Zoom Funeral Tips

How to Hold a Virtual Memorial Service

A virtual memorial offers several advantages: It’s easy for distant guests to attend, and you can record it.

Credit…Derek Abella

  • Jan. 14, 2021, 5:00 a.m. ET

When my 80-year-old father recently died, coronavirus restrictions meant that our family, like many others, could not safely gather for a funeral. My mother, brother and sister-in-law in New York, along with me in Berkeley, Calif., hastily organized a memorial service on Zoom.

What could have been a disaster or fodder for an episode of “Curb Your Enthusiasm” ended up being incredibly moving. Rather than diminishing the experience or getting in the way, videoconferencing facilitated an event filled with emotion, humor and love. During a difficult time for our family — in a devastating year for the entire world — that was an unexpected blessing.

Despite our fatigue with remote work meetings, we all were struck by how well-suited it turned out to be for a memorial.

Families who are opting for video memorials are probably doing so because of pandemic restrictions limiting the number of people who can attend an indoor gathering. Since you can join a virtual event from anywhere — and with minimal planning — more people are likely to attend than if they needed to travel to an in-person event.

In our case, the immediate family was on both coasts, one grandchild was in Scottsdale, Ariz., and the rabbi, Jeff Salkin of Temple Israel West Palm Beach, a longtime friend and former student of my dad, was in Florida.

With a videoconferencing service, you can style your memorial as you like. While we did not include photos, videos or music, nothing prevents you from doing so. In addition, a virtual memorial costs much less than an in-person event, where you’d have to pay for the brick-and-mortar venue and perhaps catered food. And you can easily record the event to share and save for posterity.

A virtual memorial also might accommodate more speakers than an in-person event. Ours began with moving eulogies by Rabbi Salkin, followed by my brother and me, then morphed into an impromptu shiva, as numerous guests offered wonderful remembrances and reflections about my dad. The event lasted two and a half hours; many people remained the entire time.

My father’s was not Rabbi Salkin’s first Zoom memorial service. He was skeptical before he led a Zoom gathering after his stepmother died of Covid-19 in April.

“I feared that such funerals would be alienating,” he said. “I was wrong. Wi-Fi carries the love quite effectively. In person, you can hold people’s hands and embrace them. On Zoom, it’s more about holding people’s eyes and simply being with them, in every way that matters.”

At the beginning of lockdown, Zoom ran into security issues. As the technology writer Brian X. Chen detailed in a column in April, weak privacy protections resulted in uninvited “Zoombombers” crashing meetings in embarrassing fashion.

That happened when my kids’ school district started distance learning: A nude man entered a virtual class and used racial slurs. It was a lesson for our family to be sure our event was password protected.

Even Jonathan Leitschuh, a software engineer and security researcher who identified flaws in Zoom’s security protocols that allowed hackers to take over Mac users’ webcams in 2019, turned to Zoom to plan a funeral for his mother who died in April.

“I went in terrified about a Zoombombing,” Mr. Leitschuh said. “I’d seen the same media coverage everyone else did.” But he said: “For this use case, I wasn’t aware of a better platform.”

There are several alternatives to Zoom, including Google Meet, Skype and GoTo Meeting, which may offer enhanced security protections and come with their own inherent trade-offs.

Funeral homes are also offering livestreamed services, in conjunction with limited in-person memorials. Chris Robinson, a fourth-generation funeral director in Easley, S.C., and spokesman for the National Funeral Directors Association, said his funeral home has been livestreaming services via its website, allowing anyone to attend without the need to download software or register for a videoconferencing platform.

“It’s important to go ahead and put together a virtual service,” he said, “rather than wait until the pandemic is over, because it could be a long time, and delaying indefinitely can be an ongoing trauma.”

In my family’s case, we were truly impressed by how videoconferencing, which can be so enervating in our daily work lives, enabled us to celebrate my dad’s full life in a beautiful and moving way.

If you have to arrange a memorial service on a video platform, here are some tips.

Go Pro

We purchased a one-month subscription to Zoom Pro (right now it’s $14.99 a month and you can cancel at any time). It allows for up to 100 participants (other plans allow for more, at additional cost), with unlimited meeting time, and stores a recording in the cloud. We’re glad we did. If we had had to limit the time of the event, we would have missed many moving contributions from participants.

Identify Someone to Handle Logistics

Because I created the account, I was the de facto meeting host. In hindsight I wish I had handed the role to my 17-year-old daughter, a digital native. Responsibilities include admitting people from the waiting room; muting all mics as appropriate; unmuting the officiant or other speakers; troubleshooting technical issues; providing assistance to guests; and passing messages along to family members in the chat box. Introduce the tech host at the beginning of the service, so people know whom to contact for help.

Familiarize Yourself With Platform Settings

The back end of video platforms have settings that can be tricky if you are new to them, especially if it is an emotional event. The host can go through the “toggle” switches in advance to figure out how to mute people upon entry or enable the waiting room, a security feature that keeps guests in a queue until the host admits them.

Who Will Lead?

Our virtual memorial succeeded, in part, because the rabbi wasn’t thrown off by the difficulties inexperienced Zoomers had muting themselves at the start. When the service segued into the shiva, my mother moderated — greeting people and making sure everyone who wanted to offer a remembrance had the chance to do so.

Plan a Dry Run to Anticipate Issues

Schedule one or more short practice sessions to work out kinks and make sure you’re on the same page about various roles. Some participants at our event were complete Zoom novices, fearful of missing the eulogy, and self-conscious about holding up the program as they attempted to mute as requested. We recommend offering tips to guests about logging on and off; muting and unmuting; switching screen views; and using the chat function — either along with the invitation, or on request ahead of the event. Don’t assume that everyone will be joining with up-to-date devices.

Invitations

We sent an email to notify friends and relatives of my dad’s death and of the Zoom event, including a link and password. Each of our family members compiled and distributed our own lists. You can also use Zoom to send email invitations.

You’re on TV (Sort of)

Without being obsessive, think about your on-screen appearance, makeup, lighting, camera height and angle and backdrop.

Beware of Tech Gremlins

While we were spared technical disruptions, the specter lurked in our minds. Many parts of the country experienced power outages this summer, and we’ve all had our internet connections go down or struggled with microphones and screens that freeze at just the wrong time. Although impossible to predict, be mindful of what could go wrong and how you’d handle it.

Ultimately, you want to make sure the virtual event accomplishes the same things an in-person funeral or memorial service would, honoring the life of the deceased and comforting the survivors. As it turned out, many more of my parents’ circle — friends and family in their 70s and 80s — were able to attend the funeral than would have been able to, even without Covid restrictions. Likewise, more people spoke than would have stepped to the lectern at an in-person funeral service. And the video we have is a blessing, which will enable my family to keep my father’s memory alive and hold on to vivid memories of those who so loved him.

Steven Birenbaum is senior communications officer at the California Health Care Foundation in Oakland, Calif.


Play These Games Digitally

Enhance Your Family Zoom Calls With an Online Game

The best way to digitally bond may be to beat the pants off your father-in-law.

Credit…Rose Wong

  • Dec. 26, 2020, 10:21 p.m. ET

At their best, good video calls are a mediocre substitute for real interaction. And when they’re bad? They can be really bad. If your Thanksgiving family Zoom devolved into melting down toddlers and bored teenagers, maybe it’s time to consider adding a little friendly competition to the mix.

Online games allow those near and far to engage over a common goal, which in turn sparks a feeling of togetherness — a feeling that everyone wants to have these days.

Here’s a selection of digital games and apps that players of all ages can enjoy.

Caribu

“A boring video call is even more boring for kids,” said Max Tuchman, the chief executive and co-founder of Caribu, a video-call app specifically built for children. During the call, kids and adults can interact on-screen with games like tic-tac-toe, word searches, memory-matching cards and math challenges. Caribu also has a library of books that will open on your screen, and adults and kids can read together. The unlimited offer ($9.99 a month) is a family plan, which means far-flung cousins and grandparents can interact on a single membership.

Bunch

If your family already has a deep lineup of online games, consider downloading Bunch, too. This free app overlays video-chat windows onto existing games, so you can talk trash as you play Uno, Minecraft or Scrabble.

Jackbox Party Packs

If some of your crew have gaming consoles and others use computers, consider a Jackbox Party Pack, which allows play between eight players on a range of devices. Only one family member needs to purchase the party pack, which ranges from $13.99 to $23.99. Packs have five games that you can play an unlimited number of times.

For The Culture and For La Cultura

While playing trivia games with his family, Teddy Phillips realized most had a severe lack of representation. “All the classic BET movies, none of them were ever in those categories,” he said. So, Mr. Phillips, 32, who lives in Seattle and works as a cybersecurity engineer, made the For The Culture game, highlighting Black culture and history. It’s built to be played in person, but also works well over video chat.

Mr. Phillips also recently released For La Cultura, which showcases Latinx culture and history. Because the culture is so diverse, Mr. Phillips brought in help from Puerto Rican, Mexican and Central American friends to ensure the game showcased everyone’s history. Both For The Culture and For La Cultura are free, with in-app purchases.

Hosted Zoom Games

For families that are not particularly computer savvy, a hosted Zoom game, where a game-master leads and officiates, can be a good option.

Since March, Michael Wade, a recent M.B.A. graduate based in Richmond. Va., has been building and hosting Trivia Throwdown Online, a Zoom-based trivia game that breaks families into teams for a “Family Feud” meets “Jeopardy”-style match. “It’s built based on the idea of, how do we get people to engage with each other and work together,” he said.

Mr. Wade writes questions specific to age ranges, which means Grandma and your tween niece will both have an equal chance at getting a pop-culture question right. Rates differ for families, nonprofit and corporate events, but the average event with up to 30 people costs around $300.

Matt Hendricks, a game expert who owns Philadelphia’s Thirsty Dice game store and cafe has taken his game-hosting business online too, charging around $270 (depending on group size). Recently, an art-based game called Duplik has been especially popular. The game relies on cooperation between small groups, which “makes people feel like they’re together,” he said. That’s the key to making everyone feel like a winner.

A Shifting View on Telemedicine

In March 2019, a robot entered a patient’s room in California and a doctor on its screen told him and his granddaughter that he was dying.

This experience, posted to the granddaughter’s Facebook page, was treated as a scandal. Newscasters questioned the humanity of a health care system that would do such a thing. Words like callous, heartless and cold were used to describe this apparent lack of compassion and care.

Bad news, it seemed, should be delivered only by compassionate individuals, with good communication skills, who are actually in the room with the patient. Not at a distance over a screen.

Just a year later, Covid-19 changed all that.

We had a highly contagious virus devouring hospital resources, a combination of factors that made hospitals inhospitable to families. Almost overnight, most American hospitals strictly limited visitation.

In the early days of the pandemic, some staff members could not ignore the human toll of isolation they were witnessing, and started using their own cellphones to connect patients with their families, if only for a few moments. This would never have happened pre-Covid, when fears of HIPAA violations and a mandate for personal privacy had always kept personal phones in pockets.

These virtual reunions were powerful and almost always positive — not only for the patient and family, but for staff. They brought humanity to days filled with stress and sadness.

And for the patient, alone in the hospital, the iPad on a stick represented not a cold robot but a portal to their loved ones. Where just last year, communication through a screen felt crass, all of a sudden, it became the only compassionate thing to do. Hospital teams expected families to be resistant, but we discovered receptivity and profound appreciation for the ability to connect, by whatever means available.

Before we all realized it, we had entered the era of tele-health — where instead of an iPad representing coldhearted indifference, it now symbolizes our human desire to connect and communicate. Just as we have found creative ways to continue to connect socially through life-cycle events — video cocktail hours, Netflix parties, Zoom weddings and funerals — we have realized that technology can provide so much more to the care of patients than we thought it could.

At the beginning of the pandemic, when I knew I would have to start interacting with families virtually, I was apprehensive. The hallmark of a palliative care team’s work has always been in-person, human connection. As facilitators of arguably the most difficult conversation topic of all — death — we literally lean into emotions that most people would run from. Unlike most medical interactions, we are not transactional, extracting a vial of blood, a signature on a consent form. Our service is to witness, reflect, and be truly present. We have been trained to provide a certain physicality, pulling up a chair, making eye contact, holding a hand. Could we really do that on a screen?

But our team had no choice, and having no choice can be clarifying. It was clear we needed to bring in the technology and at least try it. We received an emergency grant from the San Francisco-based Stupski Foundation and got to work, deploying 30 new iPads to various teams in the hospital so they would be able to access our services more readily.

The choreography of this experience varied, depending on the technology and staff available. The set up could sometimes feel like we were on a film set, the med student encased in PPE playing the role of camera operator, minus the professional training, holding the iPad shakily over the patient’s face as the Zoom panel looked on. Sometimes I was the person “bringing” others — family members, our chaplain, or our social worker — into the patient’s room on the rolling iPad. Other times I was “rolled” into the room, the virtual consultant, sitting on my couch, my poodle curled next to me.

I was working offsite for our first virtual encounter. The patient had Covid pneumonia and had been in the intensive care unit on a ventilator for weeks. The intern who consulted us warned us that his family was frantic, angry, calling incessantly in search of information. We arranged for all six siblings to join us in our “Zoom room” to meet with us, get a medical update, and see their father, intubated in the I.C.U.

I was surprised by how nervous I was, nervous that I didn’t know what I was doing, that I would be perceived as a fraud. “You’re not even with my father, right now?” I imagined his irate daughter saying to me as I fumbled with the technology.

Before the meeting started, I joined our chaplain and social worker in the “Zoom room” to strategize our approach to this uncharted virtual territory. Having worked together for a decade, we are adept at reading each other’s body language in person, but we knew this would be different, all of us facing forward in a grim Hollywood Squares. We anticipated it could so easily get out of control — family members grieving alone in their homes, anger brewing, even a Zoom-bomber, which I’d been hearing about. We devised a subtle hand signal so that we would be less likely to trip over each other during the video visit. “Ready?” I asked, before holding my breath and pressing “admit.”

To our surprise, it turned out to be less challenging than we expected, as did all the ones that followed. Any initial doubts I had about this medium were erased by the relief of families connecting in this desolate time. True, they didn’t have much of a choice, having been shut out of the hospitals. But their heartfelt appreciation of a physician’s presence was a striking contrast to the national sentiment expressed just 12 months earlier, where an iPad on a stick was seen as a cold robot. Now, it was perceived as a lifeline. One patient said to me as I hovered from home in one of the Zoom squares, “I don’t know who you are, but thank you for bringing my family here to be with me.”

Over the next few months we learned how to better translate our in-person presence to an online format. Where I would normally hug or touch a patient on their shoulder, now I put my hands over my heart. Instead of looking directly into their eyes, I made sure to always look directly into the green light of my computer’s video camera. I stayed quiet as the families wept and spoke to their unresponsive loved ones.

I discovered that I can be compassionate on and off the screen, which made me wonder: Is the most important factor for delivering excellent care physical proximity? Or is it depth of focus, and quality of communication? Is it dependent on technology or the person using the technology?

In this work I have discovered that telehealth is not merely a pale substitute for in-person care but rather a viable alternative, even offering some distinct advantages. It allows patients to see their loved ones from all over the world. It reduces the risk of exposure to Covid or other hospital-borne infections. It also allows us to preserve precious PPE for the primary teams who need it.

Telehealth has been in the background of health care for a while, primarily in rural communities where distance limits access. Now that Covid has pushed it into the mainstream, many more of us have seen and felt its benefits. Health care teams are grateful to have it available, and patients and families are not shocked when an iPad is rolled into a room or they are invited to a Zoom call. While I look forward to a time when face-to-face interactions are the norm again, I am grateful for the wide acceptance of this new tool that will continue to help us support patients and families everywhere.

We’ve learned that it’s not about the medium, it’s about the message, and the way it’s delivered.


Jessica Nutik Zitter (@JessicaZitter), a palliative medicine and critical care doctor in Northern California, is the author of “Extreme Measures: Finding a Better Path to the End of Life.”

A.A. to Zoom, Substance Abuse Treatment Goes Online

Until the coronavirus pandemic, their meetings took place quietly, every day, discreet gatherings in the basements of churches, a spare room at the YMCA, the back of a cafe. But members of Alcoholics Anonymous and other groups of recovering substance abusers found the doors quickly shut this spring, to prevent the spread of Covid-19.

What happened next is one of those creative cascades the virus has indirectly set off. Rehabilitation moved online, almost overnight, with zeal. Not only are thousands of A.A. meetings taking place on Zoom and other digital hangouts, but other major players in the rehabilitation industry have leapt in, transforming a daily ritual that many credit with saving their lives.

“A.A. members I speak to are well beyond the initial fascination with the idea that they are looking at a screen of Hollywood squares,” said Dr. Lynn Hankes, 84, who has been in recovery for 43 years and is a retired physician in Florida with three decades of experience treating addiction. “They thank Zoom for their very survival.”

Though online rehab rose as an emergency stopgap measure, people in the field say it is likely to become a permanent part of the way substance abuse is treated. Being able to find a meeting to log into 24/7 has welcome advantages for people who lack transportation, are ill, juggling parenting or work challenges that make an in-person meeting tough on a given day and may help keep them more seamlessly connected to a support network. Online meetings can also be a good steppingstone for people just starting rehab.

“There are so many positives — people don’t need to travel. It saves time,” said Dr. Andrew Saxon, an addiction expert and professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine. “The potential for people who wouldn’t have access to treatment easily to get it is a big bonus.”

Participants of the combined virtual and in-person therapy group at Ottagan. While the convenience and ease of telehealth is undeniable, some say they crave the intensity of physical presence.
Participants of the combined virtual and in-person therapy group at Ottagan. While the convenience and ease of telehealth is undeniable, some say they crave the intensity of physical presence.Credit…Emily Rose Bennett for The New York Times

Todd Holland lives in northern Utah, and he marvels at the availability of virtual meetings of Narcotics Anonymous around the clock. He recently checked out one in Pakistan that he heard had a good speaker, but had trouble with some delay in the video and in understanding the speaker’s accent.

Some participants say the online experience can have a surprisingly intimate feel to it.

“You get more a feel for total strangers, like when a cat jumps on their lap or a kid might run around in the background,” said a 58-year-old A.A. member in early recovery in Portland, Ore., who declined to give his name, citing the organization’s recommendations not to seek personal publicity. Plus, he added, there are no physical logistics to attending online. “You don’t go into a stinky basement and walk past smokers and don’t have to drive.”

At the same time, he and others say they crave the raw intensity of physical presence.

“I really miss hugging people,” he said. “The first time I can go back to the church on the corner for a meeting, I will, but I’ll still do meetings online.”

Mr. Holland, who for decades abused drugs until Narcotics Anonymous helped him stay sober for eight years, said the online meetings can “lack the feeling of emotion and the way the spirits and principles get expressed.”

It is too early for data on the effectiveness of online rehabilitation compared to in-person sessions. There has been some recent research validating the use of the technology for related areas of treatment, like PTSD and depression that suggests hope for the approach, some experts in the field said.

Even those people who say in-person therapy will remain superior also said the development has proved a huge benefit for many who would otherwise have otherwise faced one of the biggest threats to recovery: isolation.

The implications extend well beyond the pandemic. That’s because the entire system of rehabilitation has been grappling for years with practices some see as both dogmatic and insufficiently effective given high rates of relapse.

A worksheet to help patients clarify their thoughts and behaviors during the Ottagan group session.Credit…Emily Rose Bennett for The New York Times

“It’s both challenging our preconceived concerns about what is necessary for treatment and recovery but also validating the need for connection with a peer group and the need for immediate access,” said Samantha Pauley, national director of virtual services for the Hazelden Betty Ford Foundation, an addiction treatment and advocacy organization, with clinics around the country.

In 2019, Hazelden Betty Ford first tried online group therapy with patients in San Diego attending intensive outpatient sessions (three-to-four hours a day, three -to-four hours a week). When the pandemic hit, the organization rolled out the concept in seven states, California, Washington, Minnesota, Florida, New York, Illinois and Oregon — where Ms. Pauley works — and has since expanded to New Jersey, Missouri, Colorado and Wisconsin.

Ms. Pauley said 4,300 people have participated in such intensive therapy — which entails logging into group or individual sessions using a platform called Mend that is like Zoom. Preliminary results, she said, show the treatment is as effective as in-person meetings at reducing cravings and other symptoms. An additional 2,500 people have participated in support groups for family members.

If not for Covid, Ms. Pauley said, the “creative exploration” of online meetings would still have happened but much more slowly.

One hurdle to intensive online rehab involves drug testing of patients, who would ordinarily give saliva or urine samples under in-person supervision. A handful of alternatives have emerged, including one in which people spit into a testing cup while being observed onscreen by a provider who verifies the person’s identity. The sample then gets dropped at a clinic or mailed in, though the risk of trickery always remains. In other cases, patients can visit a lab for a drug test.

Kim Villanueva, of Muskegon, Mich., shared a story during the group therapy session at Ottagan.Credit…Emily Rose Bennett for The New York Times

Additionally, some clinical signs of duress can’t be as easily diagnosed over a screen.

“You can’t see the perspiration that might indicate the person suffering mild withdrawal. There are limitations,” said Dr. Christopher Bundy, president of the Federation of State Physician Health Programs, a group representing 48 state physician health programs that serve doctors in recovery. He said that hundreds of physicians in these programs are attending regular virtual professionally monitoring meetings in which they meet with a handful of specialists for peer support and to assess their progress.

“This sort of thing has challenged our assumptions,” he said of the pandemic and the use of the internet for these therapies. “There’s a sense it’s not the same, but it’s close enough.”

Other participants in drug rehab and leaders in the field say that while online has been a good stopgap measure, they also hope that in-person meetings will return soon.

“It’s been a mixed blessing,” said David Teater, who wears two hats: he’s in recovery himself since the 1980s, and he’s executive director of Ottagan Addictions Recovery, a residential and outpatient treatment center serving low-income patients in western Michigan whose therapy typical gets paid through Medicaid.

In that capacity, he said online tools have been a godsend because, simply, they allowed service to continue. Through $25,000 in grants, the center got new computers and other technology that allowed it to do telemedicine, and set up a “Zoom room.” It includes a 55-inch monitor so that people who are Zooming in can see the counselor as well as the people who feel comfortable enough to come in-person and sit at a social distance wearing masks.

“We think it works equally well, we really do,” Mr. Teater said.