Please click on the question below you are interested in to find the support you need.

When is resuscitation done or not done?
Can I see someone very soon after death?
How can I be certain the person has died?
How will the ward care for someone who has died?
How does the mortuary look after someone who has died?
How do I find out what to do after someone has died in hospital?
How can I arrange to see someone in the hospital after they have died?
We believe that someone should stay with the person who has died until the funeral – will this be possible?
We need to arrange the funeral very quickly – will the hospital understand and help?
Can we bring the person who has died away from the hospital immediately?

 

When is resuscitation done or not done?

If someone collapses suddenly and unexpectedly in hospital an emergency team will be called to help the department or ward staff and they will attempt to resuscitate the person. Some departments such as Accident & Emergency or Intensive Care may not call for help because their teams are already very skilled in resuscitation.

This will not happen if it has already been decided that the patient is too unwell or frail for resuscitation to have any chance of being successful (medical staff may use the term ‘futile’) or the patient has instructed that they do not want this done if their condition deteriorates. This type of decision must be recorded in the patient’s medical records and if at all possible should be discussed with the patient and their carers before the decision is recorded.

Resuscitation of someone you care for is hard to watch but the patient is unconscious and will not be feel any pain. Although breathing can be supported by a mechanical ventilator, if the medical team is unable to restart the patient’s heart within a certain period of time, the team will agree to stop all treatment and that time will be recorded as the time that the patient died.
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Can I see someone very soon after death?

If you are not already in the hospital, you will be contacted to inform you what has happened, whether the death was expected or sudden. If possible, you will usually be given the opportunity to visit while the person is still on the ward. You do not have to do this but some people find it helpful. If you live far away this may not be possible but you will still have opportunities to see the person who has died later, either in the hospital mortuary viewing room (often called the chapel of rest) or when they are with a funeral director.
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How can I be certain the person has died?

If no resuscitation was attempted, before any further care of a patient who has died can be carried out, the fact of death must be confirmed by a trained professional. This may be a doctor or a nurse who has had extra training in this procedure. They will ensure the patient is not breathing; the heart has stopped beating and that certain reflexes (automatic reactions by certain muscles) are absent. The date and time that death is verified will be entered in the medical records and this will be used as the official time of death.

If you have been with the patient when they died, verification may be delayed to allow you to spend more time with them until you are ready to leave.

Some people may describe this procedure as certifying the death, but certifying is when the document giving the cause of the death is written or when a coroner issues a document giving the cause of death. Any appropriately trained professional can verify the cause of death but only certain doctors can certify a death.
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How will the ward care for someone who has died?

The dignity of the patient remains very important after their death, and care is taken by professionals to maintain this.

Last Offices is the traditional title used by nurses for their care of a patient who has died. Another term is ‘laying out’ someone.

Usually nurses will ensure the patient is clean, their hair brushed, and clean shaven if this was normal for a man. They will be laid flat with just one pillow under the head. Because muscle tone is lost after death, the jaw will be supported to help keep the mouth closed, and if possible the eyes will be closed. A body does become stiff with rigor mortis after a while but this takes some time to develop and it will eventually wear off. Often people look remarkably peaceful after their death. However many relatives find the cold feel of the skin of someone who has died quite a shock.

Around half of all deaths in hospital are notified to the coroner to decide if further investigation is necessary. If this is probable, nurses will leave drips, catheters, and any tubes that helped the patient with breathing in place until a decision has been made by the coroner. This is in case any of this medical treatment has contributed to the death. Everything will be removed later by mortuary staff or a funeral director and there will be no effect on the final appearance of the person who has died.

If the death does not need to be referred to the coroner, the nurses may ask you if you want to assist with the final care of the patient on the ward. You can also ask for the patient to be dressed in their own nightwear or for a hospital gown to be used (sometimes called a shroud). These are often made from disposable paper like material.

One very important aspect of the final care of a patient on a ward is using purpose made labels to ensure the patient can be correctly identified.

Usually a sheet is wrapped around the patient and ward staff will call the portering staff to bring a special concealment trolley to move the person from the ward to the mortuary. Some hospitals also use a body bag for every patient who has died. More often body bags are used just when a patient had a condition which can pose a risk, especially of infection, to staff who may be involved in caring for the body or in just a few other specific circumstances.

Nurses are often reluctant to use the word mortuary when telling bereaved people that the deceased person will be moved from the ward. They may use the term ‘chapel of rest’. Use this link for more explanation.
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How does the mortuary look after someone who has died?

Many mortuary staff are highly trained as anatomical pathology technologists. They understand how important it is that a patient who has died is cared for with dignity in a professional manner.

Hospital mortuaries are equipped with refrigeration designed specifically to care for people who have died.

This keeps the person at the best temperature until you have decided whether you want to use a funeral director to look after your relative or that you will do this yourself. Hospital staff do not carry out any other preservation treatment of the body.

Most people want their relative or friend to remain in the hospital for as short a time as possible. However sometimes you know you will need longer to make funeral arrangements if, for example, someone has to travel from overseas. If the hospital has a bereavement office let the staff there know and they can advise what will be best for your circumstances.

You can also talk with the person in charge of the mortuary and they can advise whether it is best to transfer the deceased person to a funeral director for preservative treatment (sometimes called embalming) or whether it is best for the person to remain in the mortuary.

Some hospitals have freezers which can be used for looking after someone over a much longer period but this is only done rarely, usually when the nearest relative cannot be found or there is some other legal reason why the funeral cannot take place.
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How do I find out what to do after someone has died in hospital?

Many hospitals have a department called the Bereavement Office. In some places the office is called Patient Affairs. The ward staff will give you information about how to contact the Bereavement Office or what the arrangements will be if the hospital does not have a bereavement service.

The Bereavement Office exists to ensure all the correct legal processes are followed after the death by hospital staff and to care for bereaved families. This involves some or all of the following as exactly what service is provided varies between hospitals:

  • Issuing the doctor’s certificate of cause of death to the family if the coroner is not investigating the death
  • Sometimes issuing a ‘release’ form which you give to a funeral director authorising them to act on your behalf
  • Explaining all the necessary paperwork and what needs to be done with it
  • Ensuring bereaved people understand the involvement of the coroner if applicable
  • Assisting making appointments with the registrar of deaths or coroner’s officer if appropriate
  • Returning the deceased patient’s property to the bereaved family if this has not already been done by ward staff
  • Assisting medical staff to explain post-mortem examinations and the choices available to families if appropriate
  • Arranging visits to the mortuary viewing room and supporting bereaved families while they visit (may be done by mortuary staff in some hospitals)
  • Providing non-biased information about local funeral directors
  • Giving information on any bereavement follow-up services provided by the hospital
  • Providing information about national and local bereavement support services
  • Providing information about how to pursue any concerns or complaints the family may have about the care given to the deceased patient or themselves (some services actively support families in this process).
  • Most hospitals provide written information, often in a booklet, that will confirm what you are told about where to register or about contact with the coroner’s officer. There will often be other useful local information and information about the experience of bereavement and how to get more support.

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How can I arrange to see someone in the hospital after they have died?

If the hospital has a bereavement office or equivalent, they can usually arrange for you to visit the person who has died in a viewing room attached to the mortuary. Most hospital viewing rooms are tastefully and simply furnished and you can ask for any religious symbols to be removed if these are inappropriate for the person who has died. In most cases you will be allowed to be on your own with your relative or friend but hospital staff will be nearby to give you support if needed.

ADVICE: If you are not the closest relative or the person named as next of kin by the patient to the hospital, you will not be able to visit the person who has died without their permission. It is usually easier to wait until the deceased person has been transferred to the premises of the funeral director. However you will still need permission from the closest relative or the person arranging the funeral.


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We believe that someone should stay with the person who has died until the funeral – will this be possible?

It can be very difficult for a hospital to arrange this because it is rare for a hospital to have a private room that can be set aside for this purpose. The bodies of people who have died are kept in purpose built refrigerated storage in the mortuary. This will be an area accessible only to staff except for the viewing area in the mortuary. This needs to be available for other families to spend time with their loved ones who have died so cannot be set aside for just one family. The hospital will do everything they can to release your relative to your funeral director (or whoever you have nominated to collect them from the hospital) as quickly as possible.
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We need to arrange the funeral very quickly – will the hospital understand and help?

Hospital staff will understand if you have to make arrangements for registering and a funeral very quickly, perhaps because of the beliefs of the person who has died or perhaps because a relative has visited from overseas and must return home soon. However if the death has been referred to the coroner for any reason, the timings depend on the coroner and not the hospital. Usually a coroner only begins investigation at a weekend or bank holiday if the death is suspicious.

You must also register the death or at least obtain authority for a burial at the weekend from the registrar. Most hospitals and registrars have ‘out of hours’ procedures for families who need to make urgent arrangements but the registrars may only be available for a few hours. Contact the council switchboard if the person who has given you the doctor’s certificate does not know the details of what service is available.

A doctor’s certificate can only be issued by a doctor who was caring for the person when they were alive. In a hospital it is possible that the death was verified (confirmed) by a doctor who did not know the patient and they are not allowed, in law, to write the certificate and you will then have to wait until an appropriate doctor is back on duty.

If the person who has died has to be flown overseas (repatriated) the coroner has to give permission even if a doctor has been able to issue their certificate. The coroner may be available to give his or her permission in some parts of the country but not everywhere. Talk to your funeral director about this and they will probably be able to find out and deal with the paperwork.
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Can we bring the person who has died away from the hospital immediately?

This will only be possible if the doctor who needs to sign their certificate is available. The deceased person cannot be released before this document has been signed as until then, it will not be known by other staff whether the death has to be referred to the coroner. You will not be able to remove the deceased person if their death has been referred to the coroner, as the hospital will then keep the deceased person safe on behalf of the coroner.

You will also need suitable transport and enough people to be able to safely carry the person who has died unless you instruct a funeral director to work on your behalf.

Once the doctor has signed their certificate, you can arrange for the deceased person to be removed from the hospital. You will almost certainly be asked to sign a release form naming the person/company who you are authorising to carry out the removal. This release form may also include an indemnity clause. This means that you are taking responsibility for the deceased person legally once it has been taken from the hospital and will ensure that the person is correctly buried or cremated.

Some hospitals ask for proof that the death has been registered before agreeing to release the deceased person. The balance of legal opinion is that they cannot insist on this, but we believe this still occurs in quite a number of hospitals. Bear in mind as well that some mortuaries also have limited opening hours.

A hospital does have to keep legal records of people who die in their care and the key record is the mortuary register. It is for this reason and to maintain the dignity of the patient that people who have died are transferred to the mortuary in the special hospital concealment trolley. It can also be difficult for other patients and their families to see a funeral director coming to a hospital ward.

Advice : The exception to not directly removing someone who has died from a ward is for babies and children who are small enough to be carried in the arms of an adult. Some hospitals have a procedure to help parents take babies and children home after they have died. However the same restrictions about the doctor (or midwife) completing the necessary forms applies in case there is a possibility that the death must be referred to the coroner.


Please bear in mind that if you plan to arrange a cremation for the person who has died, there is an additional form that needs to be filled in addition to the certificate completed by the doctor who looked after the patient. These are usually completed within working hours and must be done by a senior doctor who was not connected with the care of your relative or friend. This doctor has to inspect the deceased patient as part of this legal procedure. Arranging for the deceased person to be removed from the hospital before the additional form has been completed may cause delays in making the funeral arrangements and may mean you are required to pay extra to the funeral director.


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