NHS Dartford and Gravesham NHS Trust
What happens following a sudden death? Information for Bereaved Relatives
EMERGENCY ROOM
Introduction Please accept our sincere condolences to you at this very difficult time.
We do understand that making arrangements following a death can be sad and a little confusing. We would like to do all we can to make things a bit easier for you at this time.
This leaflet is designed to give you all the information you will require to make the necessary arrangements and to access further support if you find you need it.
Contents: Practicalities...............................................................................................................................................1 Medical Certificate of Cause of Death...............................................1 The Coroner’s involvement................................................................................1 Personal possessions.................................................................................................................2 Tissue and Organ donation.................................................................................................3 Before you leave the hospital..........................................................................................4 Hospital Chaplaincy........................................................................................................................5 Viewing arrangements................................................................................................................6 Registering the death...................................................................................................................7 Tell Us Once..............................................................................................................................................9 Arranging the funeral....................................................................................................................10 Reactions to an unexpected death..........................................................................11 Helping children cope with sudden death. ......................................13 Who can help you................................................................................................................ 14 Funeral arrangements for children...........................................................................15 Who to inform of the death..................................................................................................16 Organisations that offer help and advice........................................................17 Notes....................................................................................................................................................................18 Friendship group.................................................................................................................................19 Donate in Memory............................................................................................................................21
Practicalities Hospital telephone: 01322 428100 Medical Certificate of Cause of Death You need a “Medical Certificate of Cause of Death” (MCCD) to be able to register the death of your loved one - in the case of a sudden death the cause may not always be known. In most cases of sudden death, the matter will be handled by the Coroner and the MCCD will not be issued by the hospital. The Coroner’s involvement Where the cause of death is uncertain or there are unusual circumstances, the Coroner will need to be informed. We will automatically contact the Coroner’s Office for you to minimise any delays at this difficult time for you. The Coroner’s Officer will need a little background information from you for the Coroner so we will need to confirm your contact details to help in this process. Even if it is possible for your family doctor or the hospital doctor to issue a certificate stating the medical cause of death we will still need to inform the Coroner’s Office, especially if your loved one’s time in hospital was short or if they have had recent surgery. It does not necessarily mean that there are suspicious circumstances involved in the death of your loved one but occasionally the Coroner may order a post mortem to identify the cause of death. If a post mortem is requested by the Coroner, this is a legal matter and must be complied with. The Coroner’s Officer will inform you if a post mortem will be necessary. The post-mortem will usually be carried out within this hospital. The Coroner’s Officer will contact you when the relevant paperwork is available and advise you of what to do next. Occasionally, the Police may be involved in the investigation - this is routine under certain circumstances. 1
It is helpful for the Coroner’s Officer to know which funeral directors you will be appointing and whether you are arranging a burial or cremation. The necessary paperwork can then be prepared for the Funeral Directors. The Coroner’s Officer should normally get in touch with you to deal with the issues relating to your loss within 24 hours. If you have not heard from them or you wish to discuss anything regarding the circumstances of the death of your loved one please feel free to contact them. Their telephone numbers are 03000 410502. If picking up the Medical Certificate of Cause of Death from the hospital or if you need information from the hospital, please call the Bereavement Services department after midday Monday to Friday, closed weekends and Bank Holidays) telephone: 01322 428165 / 428168. Please note than the MCCD can take up to 3 working days to complete after the coroner has given permission for us to issue it.
Personal possessions When someone dies the ward staff will invite you to take home any property that your relative had at their bedside. The ward will also arrange for the medical notes and any personal belongings that have not been collected to be sent to the Bereavement Office. Any valuable items handed in for safe keeping will be returned to the next-of-kin or named representative by the Bereavement Office at your appointment with them. Unfortunately it is not possible to store property after 30 days and arrangements should be made for collection prior to this time.
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Tissue and Organ donation Many families find donation of organs or tissue a source of comfort as something positive that can come out of something so sad. One donor can save the life of several people, restore the sight of two others and improve the quality of life of many more. Transplants are the most miraculous achievement of modern medicine, however they depend entirely on the generosity of the donor and their families, who are willing to make life saving or life enhancing gift to others. During this difficult and painful time you may wish to consider helping others through the donation of organs or tissues. Organ donation The donation of organs to help those who are awaiting a transplant. Organs include the heart, lungs, liver, kidney and pancreas. Tissue donation Tissue donors can help people who require corneal transplants, skin grafts and heart valves. It may also be possible to donate bone and tendons. Tissues can be donated up to 24 hours after death. Families need to consent in order for tissue donation to take place and if you do agree we can assure you that your loved one will be treated with respect and dignity throughout. Being a donor does not cause delay to the funeral arrangements. If you wish to discuss the possibility of donation, please ask a member of staff or you can contact a nurse from the National Referral Centre 0800 432 0559 (freephone).
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Before you leave the hospital If you have any religious beliefs or customs that need to be considered then please inform the staff before you leave and we will do everything possible to ensure your wishes are complied with. We will look after your loved one in the Mortuary once you leave the hospital. You are able to see your loved one, if you wish, once you have left the hospital in the Chapel of Rest. You can also see your loved one at the funeral directors if you wish.
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Hospital Chaplaincy The hospital has a Chaplaincy Service which is managed by a Free Church (Baptist) Chaplain who ensures that someone is available at all times to assist families who are bereaved whatever their faith background or none. There is also a Roman Catholic Chaplain available to those who require a Catholic Priest. The Chaplaincy has contacts with most faith groups and can usually contact an appropriate representative as needed. You don’t have to be a member of any particular faith group to ask for a Chaplain. Chaplains are available both to administer appropriate rites of passage, to support family members following a bereavement or when coming to view a deceased relative. For those who have been recently bereaved the Chaplain can help in contacting a local minister or you may request for the Chaplain to preside at a funeral service particularly if you have no connection with a local Church (subject to the Chaplains availability). Babies born in the Delivery Suite can have a blessing performed by the Hospital Chaplain, or a member of their team, or alternatively by their religious leader. This can be arranged at the time of delivery and the midwife will discuss this with you. During normal office hours there is usually a member of the Chaplaincy team available in the hospital to attend the spiritual needs of patients and their relatives. A 24-hour emergency service is available via switchboard, telephone 01322 428100. Messages can be left for the Chaplain on Hospital extension 4640. For services in the chapel/multi faith prayer room please see notice boards. 5
Viewing arrangements While we fully appreciate that some families wish to see their loved one as soon as possible after death, it is not always possible to facilitate this. If we are waiting for a decision from the coroner as to whether a post mortem is required , the body has to remain as it was at the point of death, which may mean that there are tubes still attached to the deceased, which can be distressing to see. Once a case has been referred to the corner, you will only be able to view your loved one from behind glass. If you should wish to view the deceased in the Chapel of Rest. The team will do all they can to make you as comfortable as possible during this time, and we ask that you do not attend the hospital without making prior arrangements for viewing. Please note that the mortuary team require the permission from the deceased’s next of kin for other family members or friends to attend a viewing. To arrange an appointment please call the following number between 10am and 3pm: Strictly by appointment only tel: 01322 428428. If the Police have been involved we may need to arrange for a Police Officer to accompany you for the viewing, again this is part of the legal requirements involved. If the Coroner’s Officer has given you a reference number regarding the death of your loved one it would be helpful if you could have that to hand when you call.
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Registering the death Once you have received the cause of death certificate please phone the number below to make an appointment with the office of your choice to register the death. The death must be registered within 5 working days. Sometimes this is not possible, but as long as an appointment has been made, this is acceptable. Details of the local Registration District offices are as follows:Gravesend Register Office (In Library) Windmill Street Gravesend, Kent DA12 1BE Swanley Register Office In Library Next to ASDA Swanley Kent BR8 7AE Parking is available in the Asda car park Dartford Register Office In Library Central Park Dartford DA1 1EU Bexley Register Office Danson House Danson Park Bexleyheath Kent DA6 8HL Parking is available at the office Note: Strictly by appointment only tel: 03000 415151 * You are now able to register at any office in Kent, but not the Medway Towns. 7
* If you are unable to get to the right Register Office, you can go to a registrar in a more convenient place in England or Wales but they will not register the death. The details will be passed onto the registrar in the area in which your relative died and the certificates will be sent to you by post a few days later. This may cause delays in organising the funeral. The person who is to register (The Informant) should take the cause of death certificate and if possible the Medical Card of the deceased with them, and be prepared to give the following information to the Registrar. 1. The date and place of Birth and Death. 2. The full name of the deceased. 3. The home address of the deceased. 4. The marital status of the deceased. 5. The occupation (if any) of the deceased. 6. If the deceased is female, her maiden name and her husband’s full name and occupation. The Registrar will issue a Green Certificate for Burial or Cremation which should be handed to the Funeral Director as soon as possible. Copies of the Entry of Death (Death Certificate) may be obtained from the Registrar on payment of the appropriate fee. • A certificate of registration of death which should be sent, together with any pension or state benefit books to the Department of Social Security. Read the information on the back of the certificate and, if any of it applies, fill it in before sending or taking it to your local DSS office.
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• The death certificate is a certified copy of the entry in the death register and you will have to pay a fee to obtain one. You will need them for probate, pension claims, insurance policies, banks etc. so you may wish to ask for several copies straight away as the price increases if you need one later on. If you have any further questions the bereavement services officer at the hospital, or the registrar will be able to advise you.
Tell Us Once service Kent County Council’s Registration Service provides the National Tell Us Once Service when you register the death of a person that has died in Kent. The Tell Us Once service notifies a number of different organisations, including central and local government, on your behalf (see list of examples below), providing information and advice about the services. The service is offered at the Registrar’s Office or online. The Registrar will give you a unique reference number before you leave, for you to log in or telephone.
Who it notifies Tell Us Once notifies the following organisations that the person has died. The list below is a guide only. Local Authority • • • • • •
Council Housing Housing Benefit Council Tax Council Tax Benefit Library Services Electoral Services
• Adult Services • Children’s Services • Authority owned equipment • Blue badges • Concessionary travel 9
Arranging the funeral You do not have to use a funeral director but most people are reassured by the wealth of experience that they have. It is advisable that you wait until after your bereavement services appointment before you begin to make funeral arrangements, however many funeral directors will be happy to discuss plans with you before this time either by telephone or in person. Once you have registered the death at the registrar’s, you will be given the burial or cremation order (green form). This should be taken to the funeral director of your choice. As prices vary considerably it is in order to contact more than one funeral director for a written quote for their services. The funeral director will advise and help you arrange the funeral of your choice. It may be that the deceased has given instructions, either in a will or to someone personally, as to their last wishes. The choice of burial or cremation may also depend on cost or whether there is a family grave. Should you wish to transport the body of the person who has died to another part of the country for the funeral, or to another country, they will arrange this. You may wish to seek help/advice from your religious leader, minister or priest with regard to conducting the service or the funeral director can arrange this for you. Alternatively, a nonreligious service may be planned by family and friends. Funerals can be expensive. If you are on income support, family credit or housing benefit, you may be able to get payment from the social fund to help pay for the funeral. Advice can be obtained from the Department of Social Security. If you do not wish to use a funeral director you might find the following website helpful: www.naturaldeath.org.uk 10
Understanding what happened As a family member, partner, friend or carer of someone who has died you may have comments, questions or concerns about the care and treatment they received. You may also want to understand more about the reasons for their death. There may be things you didn’t really understand or feel uncertain about, or you may be unhappy about the way your loved one was treated or cared for. We will always try to answer your concerns and you can always register a complaint with the trust if we fail to do this. We would like to think if we have provided care below the standard we would have told you this already and involve you in any investigation into why this happened. In addition we look at a number of deaths in detail where no concern was raised by anyone to ensure we are delivering a high standard of care, including care to patients bearing the end of natural life. However, please do not worry if you are not ready to ask these questions straight away, or if you think of questions later - you will still have the opportunity to raise these with us when you are ready. It is also important for us to know if you don’t understand any of the information we provide. Please contact the PALS team if we can be of any help regarding these or other issues. They can be contacted on 01322 428382 or via email: dgn-tr.PALS@nhs.net
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Some families have found that counselling or having someone else to talk to can be very beneficial. You may want to discuss this with your GP, who can refer you to local support. Alternatively, there may be other local or voluntary organisations that provide counselling support that you would prefer to access. Some examples of organisations that may be able to help you are included later in this leaflet. The Gov.uk website: www.gov.uk/after-a-death also provides practical information on what to do following a death.
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Helping children cope with sudden death Children are always affected by sudden death, they can react in different ways: frightened, naughty, reserved or withdrawn. They may have problems with sleep, nightmares or wetting the bed. It can be difficult for adults to know how to reassure and comfort children, especially when they are suffering. Children will cope more successfully if they are told in a simple and honest way about what happened. Encourage the child to talk about their feelings and to ask questions. It is however important to remember that children will take what you say literally, so telling them that your loved one ‘has gone to sleep’ can be very frightening leading them to believe that it will be risky for either themselves or their loved ones to fall asleep. Try to give time to listen to children, allow them to deal with their grief at their own pace. Reassurance is important particularly if they felt the death was somehow their fault. Include the children in what is happening telling them the truth. Allow them to see you upset. All children will find it difficult if they are shut out from important aspects of family life even when distressing.
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Who can help you Your main form of support will be family members and close friends. This is very helpful as there will be plenty of opportunity to talk about the person who has died and share memories. For some this may prove to be too difficult, and talking to someone less emotionally involved would be more of a help. Whilst other friends or strangers may bring an understanding, perhaps from their own experiences. Your local church or religious community may be able to offer help and support; don’t be afraid to contact them even if you are not a practicing member. Visiting your GP may prove to be helpful. In time most people find they are able to move forward living their lives again. There will be good as well as bad days. Often something quite small will trigger a renewal of grief, but it is very important to build on the good days and try to prepare for occasions which are going to be difficult. Everyone finds their own way of coping, other people can be helpful, try to allow others to lend their support. If the grief becomes persistent there are other people and organisations which may help, talking to your family doctor may give you some useful suggestions.
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Funeral arrangements for children Children one year and above All children of one year and above are subject to normal funeral arrangements. Infants under one year If parents wish, the Trust is able to make funeral arrangements for them. Parents are able to make their own arrangements for their baby if they prefer. Most funeral companies do not charge for this service. Newborns Stillborn babies of 24 weeks and above are required to have their death registered. Under 24 weeks if babies are born with no signs of life their death does not have to be registered. A bereavement services officer will explain the arrangements to you and answer any queries you may have. Babies can have a funeral arranged by the hospital, or parents can arrange their own, this can be discussed with bereavement services.
Reference: Dartford and Gravesham NHS Trust A&E Bereavement Book Review Date: September 2021 Publication Date: September 2019
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The following services may need to know about the death Done Date Solicitor Bank, Building Society, Insurance Company etc Social Services (if they are providing any services) Inland Revenue & Benefits Offices Employers and Trade Unions Schools, College, University attended Any hospital the person was attending Local Gas / Electric / Telephone / TV Licence / Water Companies (the relevant office should be informed) Local Council (e.g. Council Tax) Professional Organisations
Please note, some organisations may request the National Insurance No. of your loved one.
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Organisations that offer help and advice You may find help and support from some of the following national and local organisations. Ring the national number for details of local branches if they are not listed here or look in the Yellow Pages. Cruse Bereavement Care Bexley Branch:
0208 304 5245
The Compassionate Friends: (for bereaved parents)
0345 123 2304
The Ellenor Lions Hospice:
01322 221315
National Association of Funeral Directors: 0121 711 1343 The Samaritans: Bexleyheath & Dartford: Gravesend, Medway & Swale:
0208 301 1010 01634 730981
The Terence Higgins Trust: Switchboard: Enquiries
0207 812 1600 0808 802 1221
SANDS (The Stillbirth & Neonatal Death Society) Mon - Fri 9.30 am - 5.30 pm Tues and Thurs 6.00 pm - 10.00 pm
0207 436 5881
Email: helpline@sands.uk.org TCF (The Compassionate Friends for The Bereaved Parents)
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01322 272957 Annie Wellard
Friendship Group The Darent Valley Hospital Friendship Group, with the help and support of the Voluntary Services, was set up in January 2005. It was the brainchild of two widows, who felt there was a need, on Sunday for people to be able to meet up for a couple of hours. The Friendship Group meets on the 1st & 3rd Sunday between 1pm and 3pm in the Blue CafÊ Restaurant at Darent Valley Hospital, Level 1. The aim was just a meeting place to have a chat. It has developed into a social club. We have regular theatre trips, usually in groups of 4 to 6 people. During the summer months there are at least 2 trips arranged. So far we have visited the London Eye, Buckingham Palace, Houses of Parliament, Windsor and last year’s trip was by coach to Herne Bay with a fish and chip lunch. The list goes on. On the Sundays that we do not meet, we arrange a pub lunch; this has become the casualty of our success. Our group which has grown to over 50 members; too many to organise for little country pub lunches, however small groups do arrange meals out between themselves. Friendships have been formed and many meet up during the week and go off to all sorts of places. Even groups teaming up and enjoying a holiday together, with a New Year holiday in the process of being organised. The good thing is that they still all come along to the Sunday Group for a chat, which of course, was the reason for setting up the Friendship Group. Everyone is welcome so just please come along - nothing formal. If you would like to come along to the group, please ring 01322 428392 and arrangements will be made for Joan to meet you in the reception area. Joan Warwick 19
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