The world watched in December as a 72-year-old funeral director pushed the coffin of President George Bush into a polished Cadillac hearse in Houston. He had done the same before at services for Presidents Gerald R. Ford and Ronald Reagan, the first ladies Betty Ford and Nancy Reagan, and many other well-known figures.

He is Robert M. Boetticher Sr., the chief executive of a boutique death services firm that contracts with the federal government for state funerals.

For almost two decades, Mr. Boetticher has been privy to perhaps the most intimate, and delicate, conversations around a commander in chief’s death. The planning begins almost as soon as a president is elected.

“It doesn’t matter if it’s the first family or if it’s the barber down the street, they all react the same,” Mr. Boetticher said in an interview earlier this year. “They just lost somebody that they loved. You are the person that they trust, that they look up to, to help them through it.”