Lancashire Hospice
East Lancashire Hospice
East Lancashire Hospice is a charity providing specialist palliative care to the population of Blackburn, Darwen, Hyndburn and the Ribble Valley. It is important to us that we provide care that is safe, effective, caring, responsive and well led.
Palliative care focuses not on cure, but on providing patients with relief from the symptoms, pain and stress of a serious life limiting illness. Our aim is to improve quality of life for both the patient and their family and we care for people with serious and chronic illnesses such as cancer, cardiac disease and motor neurone disease.
This booklet provides information for bereaved relatives and friends on what to do when someone dies and who can help
This is a very difficult and confusing time. This booklet aims to provide some useful help and advice as you cope with the death of someone you were close to.
There are a number of practical issues that need to be dealt with after someone dies. This booklet gives information on:
• The issuing of the Medical Certificate of the Cause of Death (Death Certificate) by a doctor who looked after your loved one during their last illness
• The registering of the death with the registrar of births, deaths and marriages
• Who can help you with arranging the funeral of your loved one
• A little about some of the emotion you might experience after the death of someone you were close to
Medical Certificate of the Cause of Death (Death Certificate)
The Medical Certificate of Cause of Death can be issued by a doctor who has seen your loved one at any point in their lifetime. If your loved one died at home you should contact your own GP as soon as possible to inform them. The doctor completes the certificate and this will be sent electronically to the medical examiner’s office, who will then forward this on to the registrar’s office for the death to be registered. The registrar will then give you the person’s official Death Certificate (see page 13).
Until the death has been registered your loved one’s body cannot be moved out of the area, although it may be possible to move their body to a preferred place of rest. You can speak to any of the team about this.
In some cases it may not be possible for the doctor to issue the Medical Certificate of Cause of Death.
This may happen if the death was sudden, unexpected, if the cause of death is linked to the person’s work, e.g. asbestos exposure, or the doctor is uncertain for some reason about circumstances around the death or the cause of death. If this is the case he/she is legally obliged to inform the coroner (see page 16).
Medical examiners service
Who are medical examiners and medical examiner officers?
Since 2019 senior NHS doctors have had the opportunity to receive specialist training and spend some of their time working as medical examiners. In the immediate period before a death is registered (five days) medical examiners independently scrutinise the causes of death given by the attending practitioner. Alongside other specially trained staff, their job is to give independent advice into causes of deaths, except for deaths which have to be reviewed by a coroner.
Medical examiners and their officers offer families and carers an opportunity to raise questions or concerns about the cause of death of a loved one or about the care they received beforehand. This will usually be done over a telephone call. They can help explain medical language to make it easier to understand. Medical examiners also look at the relevant medical records and discuss the causes of death with the doctor filling in the official form - this is called the Medical Certificate of Cause of Death.
Coroners
Some deaths must legally be notified to the coroner, and the medical examiner service will explain to the family, if this is required.
When the coroner starts an investigation, he or she will investigate the death independently - although the medical examiner may still provide expert medical advice to the coroner.
What questions will I be asked?
The medical examiner or their staff will explain what is written on the Medical Certificate of Cause of Death, they will provide further clarity if required, and will ask if you have any questions or concerns about the care the person received before their death. This is the best time for you to raise questions and speak about anything that concerns you. They will also pass on praise or compliments to the appropriate teams/ individuals.
Why am I being asked if I have any concerns?
A discussion with an independent medical examiner provides you with an opportunity to have an open and honest conversation and address any worries or concerns, with someone who was not involved in providing care to the person who died. Medical examiners and their staff will discuss your thoughts, questions and concerns and if they find issues with care that need further investigation, will refer these on to someone who can investigate further.
It could be as simple as helping you to understand more about the treatment and cause/s of death or to understand the medical language used. There may be something about the care which you think did not feel right. As well as answering your questions this can help us to provide better care for patients, their families and carers by recognising ways in which care can be improved in the future.
Can I nominate someone else to talk if it’s too difficult for me?
Yes, the medical examiner or the bereavement team may contact you to ask who you would like us to talk to instead, or, you can let the medical team know if you would rather appoint someone else as a first point of contact. We understand this is a difficult time for many people and so speaking to the medical examiner is completely your choice.
What will happen if something was not right?
The medical examiner and their staff are here to listen to your questions and concerns, provide answers if possible and, if necessary, pass them on to someone who can investigate further.
Medical examiners will not investigate further themselves, as they must complete their work within set time limits for the death certification process, but they will make sure that the correct process relevant to your concerns is commenced.
Will funeral plans or release of the body take longer?
We make every effort to avoid any delays and work with families to meet the legal requirements for registering deaths. We try to be flexible, for example where relatives need release of the body quickly.
How can I contact the medical examiner office?
You can contact the medical examiner office either by phone or email:
Telephone: 01254 735673
Email: medicalexaminer@elht.nhs.uk
The opening hours are 8:30am to 4:30pm Monday to Friday. You can also ask the bereavement service to contact the medical examiner office on your behalf.
Funeral arrangements
Contact a funeral director
You do not need to use a funeral director (undertaker) to organise a funeral – your local council will guide you through the regulations involved. If you choose to use the services of a funeral director they will take care of this for you at what is a distressing and confusing time for many.
You do not have to wait until the Medical Certificate of Cause of Death has been issued to make contact with a funeral director. You should take time before making a decision about using a funeral director, comparing services offered and likely costs. A list of local firms and addresses can be found in the telephone directory or online. Your loved one may have decided on a funeral director as part of an advance care plan or may have a prepaid funeral plan.
The funeral director of your choice will advise you of the options and discuss with you the arrangements you wish to make. The funeral is your opportunity to say your goodbyes in a way that is appropriate both for you and the person who has died. You may wish to choose who might lead the service (not necessarily a Minister of Religion), certain music or readings, and you or other relatives or friends may wish to take part in the service. You will also need to decide if your loved one’s body is to be buried or cremated. These are not always easy decisions, so take time to consider the possibilities.
Viewing your loved one’s body
It is completely up to you whether you would like to see your loved one again after they have died. Some find it helpful to spend some time with their loved one after death. It can also be helpful for family members who might not have been able to see the person who has died before their death.
If your relative has died in the East Lancashire Hospice viewing is possible at the hospice (usually for up to four to six hours after death) or at the funeral director’s chapel of rest. Please ask the staff at the hospice.
If your loved one died at the East Lancashire Hospice our staff will make arrangements with you for the collection of your loved one’s belongings including any personal equipment they brought to the hospice with them to use during their stay with us.
Tissue donation
Whether or not organs can be transplanted depends on how and where your loved one died. It may also depend on the cause of death, treatment received and whether they had any underlying medical conditions. The donation of internal organs such as the heart or kidneys may be possible if they died in hospital whilst on a ventilator to support breathing, but not if they died at home or elsewhere. It may, however, be possible to donate tissue such as corneas, heart valves, tendons, skin and bone, but this must be done within 48 hours of the death. Your loved one may have talked to you or our team about their preferences on this.
Please speak to a member of the medical staff or nursing team if you need more information. You can also ring the Organ Donor line on: 0300 123 23 23 or see www.organdonation.nhs.uk.
Registering the death
This is a legal responsibility and should usually be done within five days of the death unless the coroner is investigating the circumstances around the death. The Medical Certificate of Cause of Death will be issued by the hospice and sent to the registry office electronically by the medical examiner’s office (see page 3).
Who can register a death?
• A relative of the deceased
• A person present at the death
• The occupier of the premises where the death occurred if she/he knew of it happening
• The person arranging a funeral – this does not have to be a funeral director, but may be
What will the registrar ask me?
The registrar will ask you a number of questions in a private room. These will include:
• The date and place of death
• The full name and surname, and maiden surname if the person who has died was married
• The date and place of birth of the deceased
• The occupation of the deceased and if the deceased person was a married woman or widow, the full name and occupation of the spouse and if retired
• The usual address of the deceased
• If the person who has died was married, the date of birth of the surviving spouse
• Whether the person who has died was receiving a pension from public funds
It will be helpful if you have the person’s birth certificate, marriage certificate, medical card etc. with you at that meeting.
The registrar will enter all these details into a computer and will give you an opportunity to check that they are correct. This is a legal record and you should be sure you are happy with the information entered as mistakes discovered later can be very difficult to correct. The information will then be saved onto the electronic register and you will be given a copy of the entry. This is the official Death Certificate. Further signed copies can be requested for a small fee. It can be a good idea to get extra copies as they will be needed by banks, insurance companies etc.
At the same time you will be given a “green form” which enables you to arrange the funeral (if the coroner is involved different procedures may apply). You will also receive a form to complete around benefits.
Deaths to be registered in Blackburn
Deaths in the East Lancashire Hospice must be registered in Blackburn (see map on page 14).
Deaths at home in Blackburn (if you pay Council Tax to Blackburn Council) must be registered in Blackburn.
Deaths in Royal Blackburn Hospital must be registered in Blackburn.
Blackburn registrar’s office:
The Register Office Town Hall
Opening times: Monday - Friday 9.00am - 4.30pm BY APPOINTMENT ONLY
Tel: 01254 588 660
Blackburn Registrar’s office:
The Register Office Town Hall
Blackburn BB1 7DY
Tel: 01254 588 660
At time of printing, all appointments are by telephone.
THE REGISTER OFFICE, Town Hall, Blackburn. BB1 7DY
’Tell Us Once’ service
To use ‘Tell Us Once’ the death must already have been registered. This can be done by contacting the Register Office. The registrar will give you information about the service when you go to register the death.
You can also find further information from the registrar or at www.gov.uk/tell-us-once
Tell Us Once brings together several organisations (see the list below) so that people do not need to notify them individually of the death.
Tell Us Once links information between:
• Department for Work and Pensions (DWP)
• HM Revenue and Customs (HMRC)
• Local Authorities
• Driving and Vehicle Licensing Agency (DVLA)
• Identity and Passport Service (IPS)
Other people you may need to inform
o Royal Mail
o Utilities
o TV Licensing
o Library cards/season tickets
o Insurance companies
o Rental companies
o Bank/Building Society
o Credit Cards
o Social Security/DWP
o Dentist
A coroner’s authorisation
If it is not clear about the cause of death, or where there is concern about the potential of a work related disease being involved, a doctor cannot issue a Medical Certificate of Cause of Death without consulting the coroner.
If a death is referred to the coroner, a police officer working for the coroner will need to contact you to prepare a report relating to your loved one’s medical history. This is standard procedure and should not cause you any alarm. They may make contact with you by phone or visit you at home to talk through what had been happening to your loved one before they died.
In certain circumstances the coroner may authorise the doctor to issue a Medical Certificate of Cause of Death with written clearance from the coroner without the need for any other investigations.
A death may not be registered until the registrar has received written clearance from the coroner. It is the coroner’s duty to ensure that there is a clear understanding around the cause of death. If there is any doubt, a coroner may decide that a post mortem (examination of the dead body) is required to establish the cause of death.
Please do not hesitate to ask the hospice team about anything that is unclear.
A coroner’s post mortem
The coroner may decide that a post mortem is required to establish the cause of death. If this is the case your consent is not needed. You will be informed of the decision but cannot stop the post mortem being conducted.
Once the post mortem has been completed, you will receive a letter asking you to register the death. The coroner will send the Death Certificate directly to the registrar. This process usually takes a few days.
A hospital post mortem
The doctor who has written the Medical Certificate of Cause of Death may ask your permission for a post mortem examination to assist in medical knowledge and teaching.
Whether you grant permission is your decision. You will be given further information and, if you do decide to permit it, you will be asked to sign a consent form.
If at any stage you are unclear about what is happening, or would like further information, please ask. We appreciate that at such a difficult time it is sometimes hard to understand or remember information.
Financial assistance to help with funeral arrangements
Leaflets are available from the registrar’s office.
Benefit advice about Funeral Grants (payable to the responsible person if in receipt of qualifying benefit) may be obtained from The Social Fund. For advice on Bereavement Benefit (may be payable to the widow(er)/civil partner if the deceased was under 60), please use the Bereavement Service Helpline Tel: 0800 731 0469.
Pension/allowance arrangements
Any queries regarding pensions and allowances can be directed to the Pension Service – telephone 0800 731 0469.
If the deceased was in receipt of a war pension, you need to telephone the Veterans Agency on freephone 0808 802 1212. You will need the pension information and National Insurance number of the deceased and next of kin.
NHS equipment
If your loved one was registered with a Blackburn GP then any NHS beds must be returned. Please contact the district nurses at your surgery to organise this. Other equipment used during your loved one’s illness is their property and you are free to dispose of it as you feel appropriate.
If your loved one was registered with a North Lancashire GP the equipment may have been issued via Medequip. Please telephone 01772 286573 to arrange collection.
Alternatively, equipment prescribed for your loved one via the retail model (small items of equipment) remains their property and you are free to dispose of it as you feel appropriate.
Wheelchairs issued by Preston Specialist Mobility Rehabilitation Centre (SMRC) need to be returned to them. Please telephone 01772 716921 to arrange collection.
If you are not sure about what to do with any piece of equipment please ask at your GP surgery or a member of the hospice staff.
Stopping Junk Mail to the recently deceased
If someone you know has died, the amount of unwanted marketing post being sent to them can be greatly reduced which helps to stop painful daily reminders.
By registering with the free service www.stopmail. co.uk the names and addresses of the deceased are removed from mailing lists, stopping most advertising mail within as little as six weeks. If you cannot access the internet you can call 0808 168 9607, where you will be asked for very simple information that will take only a few minutes to complete. Alternatively, ask the bereavement team for a leaflet that can be returned in the post.
This free of charge service provided by the Bereavement Support Network will actively reduce the unwanted marketing mail but also can help reduce the likelihood of identity theft following the death of someone close. The information is not used for any other purpose and you only have to complete this once. Additionally to Stop Mail a comparable service can also be accessed from the Bereavement Register or Deceased Preference Service if you would prefer to use them.
Social media
It would be fair to assume that the social media account of the person who has died would be automatically closed after a period of inactivity, but sadly this isn’t always the case. Given the number of social media accounts that a person may have, if you have to close them, it’s important to understand the procedures and requirements, as it’s slightly different from one provider to another.
This simple overview is designed to help you with the next steps. If you have access to their login details, it will make the process simpler, but they are not essential to close or alter them. Often a copy of the death certificate and a few other documents are required for these companies to action your requests, but please note this may change in time.
X (Formerly Twitter) will automatically close after six months of inactivity; it can be refreshed if someone were to gain access at a later date. X provides the options of official deactivation or the deletion of the account.
Facebook has two options. The account can either be closed permanently or you can choose to have the page memorialised so family and friends can still share memories after the person has passed away. Some users of Facebook may have already nominated a ‘Legacy contact’ to administer their account in the event of a death.
Instagram has two options. The account can either be closed permanently or you can choose to have the page memorialised.
Linked In, if the account is premium it will first have to be downgraded before it can be closed.
These are just a selection of social media companies. Others may include; Pinterest, Gmail, I-Tunes, Microsoft outlook, Flickr, Tumblr, YouTube, WhatsApp, Skype, Snapchat and Tiktok. There may be smaller interest groups such as sports and hobbies that may need looking into.
On any of the social media platforms, visit their webpage scroll to the bottom and click ‘Help’ and use the search term ‘deceased’, they will direct you from there on the next stages.
Grief: When someone dies
The death of someone you love can be a devastating experience, often causing stronger emotions than most people have ever felt before.
Feelings
Even if you knew your loved one was dying, there is still a sense of shock when the death occurs. You may feel cold, numb, empty and unreal for a time. Following this you may experience such emotions as anger, panic, guilt and sadness. This may also be accompanied by periods of restlessness, especially at night when it may be difficult for you to sleep. You may also react by becoming irritable or critical of yourself and others, or by feeling unable to attend to routine matters or to think straight, which can lead to feelings of despair. All these are natural reactions to bereavement and are not a sign that you cannot cope any more.
Grief is a very individual process and we each react differently. What is important is that you allow yourself time to grieve and to come to terms with your loss in the way that is right for you.
Support
Our bereavement support provision is available to those who have experienced loss within the last three years, are registered with a GP in Blackburn, Darwen, Hyndburn or the Ribble Valley and are aged 18 or over, irrespective of cause of death or relationship to the person who has died. There is no requirement to have had previous contact with the hospice services.
You can ask any member of staff about the bereavement support provision or alternatively information is available on the hospice website or telephone 01254 916983 or 01254 965864. You may also want to consider the help of relatives or a close friend. Often they want to help share the burden but are waiting for you to ask them.
During this time you may need extra support. Do not be afraid to speak about your feelings to someone. Other people may be afraid to speak about your loved one for fear of upsetting you. You may need to let them know when you want to talk. Tears are a natural way of releasing emotions; do not be embarrassed by them.
Grief takes time and effort. You may already be very drained physically and emotionally if your loved one had been ill for a time. If you feel unwell, or are concerned about physical symptoms, go to see your GP.
There are also various organisations locally who can offer further support and counselling for you. Some of these are listed at the end of the booklet. If you are not sure please speak to a professional about what is happening to you.
You will have good days and bad days but, in time, the pain will ease and you will find yourself able to remember your loved one without becoming distressed. You never ‘get over’ a bereavement but you gradually adjust to the loss and start to live anew.
Some people may feel unable to grieve after a death; perhaps because they are caring for someone else and feel that they ‘have to be strong’. The grief may then be released when a subsequent loss or event occurs, which may even be relatively minor, but is the trigger for emotions to be expressed. Sometimes this can be many years after the original loss.
When two bereavements occur relatively close to each other, the grief may be compounded and the feelings more extreme. Grief does take time; it needs to be allowed to happen. If, however, you are concerned about a grief reaction in yourself or in someone close to you, please seek further support from the organisations listed in this booklet.
Staff at the East Lancashire Hospice are more than willing to spend time with you and will try and support you. We can also arrange for a member of our hospice Family Support Service to see you.
Talking to children about death
Adults often feel the need to protect children from death. They may feel children will not understand or that they will be too upset. However, we can often underestimate a child’s resources and ability to cope. Children often find it harder if they are not told what is happening because they may be frightened by imagined events. Children should be told the facts in a simple manner using appropriate words e.g. ‘dead’, ‘death’ rather than ‘lost’ or ‘asleep’. Give them time to ask questions (which may be very direct) and offer plenty of reassurance.
It is helpful for adults to share feelings with children; such as feelings of sadness. By doing this they learn that it is natural to feel sad when someone dies. Children may like to draw pictures as part of their way of saying goodbye. We have resources on the Inpatient Unit that may help, e.g. story books.
Children’s support
National organisations in relation to children
Child Bereavement UK
Helpline: 0800 028 8840 www.childbereavementuk.org
Child Bereavement Network
For children and young people’s bereavement support services in your area. Telephone: 020 7843 6309 www.childhoodbereavementnetwork.org.uk
The Child Death Helpline
For anyone affected by the death of a child. Telephone: 0800 282986 www.childdeathhelpline.org.uk
The Compassionate Friends
Bereaved parents offering friendship and understanding to other bereaved parents. Telephone: 0345 123 2304 www.tcf.org.uk
Grief Encounter Project
For bereaved children and their families. Telephone: 0808 802 0111 www.griefencounter.org.uk
Partnership for Children
Good mental health for children, helping your child to cope with bereavement.
Telephone: 020 8974 6004
www.partnershipforchildren.org.uk
SIBS
For brothers and sisters of disabled children and adults, with any disability, long term illness or life limiting conditions.
www.sibs.org.uk
Winston’s Wish
Winston’s Wish helps bereaved children and young people rebuild their lives after a family death.
They also offer support and guidance to families, professionals and to anyone concerned about a grieving child.
Freephone Helpline: 08088 020 021 www.winstonswish.org
Young Minds
The voice for young people’s mental health and wellbeing.
Parents Helpline: 0808 802 5544
After the funeral
Settling the deceased person’s estate can be confusing, time consuming and distressing. If your loved one made a valid Will, at least one executor will be named. It is the executor’s responsibility to carry out the person’s wishes. This will include ensuring that further expenses, debts and taxes are paid from the deceased person’s estate. It will also mean arranging that possessions and other assets are disposed of appropriately and in accordance with the deceased person’s Will.
When a person dies without leaving a valid Will, their property (the estate) must be shared out according to certain rules. These are called rules of intestacy. A person who dies without leaving a Will is called an intestate person. Only married or civil partners and some other close relatives can inherit under the rules of intestacy. If someone makes a Will but it is not legally valid, the rules of intestacy decide what will happen to the estate and this may be different to the wishes expressed in a Will that is not legally valid. Further advice can be obtained from the Citizens Advice Bureau.
It is wise to avoid making hasty decisions about the future. The length of time will vary for each individual, but gradually you will realise that you are more able to cope with your bereavement. Then will be the time for thinking about plans for the future.
Remembering your loved one
East Lancashire Hospice hosts an annual Light Up A Life service in December – an opportunity for bereaved families and friends to pay tribute to their loved one. Lights can be dedicated in their memory. The name of the person you are remembering can be included on the hospice website Light Up A Life page. You will also receive a card bearing their name and be invited to the service.
For more information see the East Lancashire Hospice website: www.eastlancshospice.org.uk
Creating a lasting legacy
East Lancashire Hospice is a registered charity and relies on the generosity of its communities to provide care and support to our patients.
The care we provide is completely free, and you are not obliged to make a donation in any form, but should you so wish, there are a number of ways to get involved and help to ensure we can continue to provide care for years to come.
Any additional memorial events are shared via our website.
For more information, please visit the website: www.eastlancshospice.org.uk or call the fundraising office on 01254 965877 for further information or to register to receive a newsletter to keep you updated with hospice news and events.
Useful telephone numbers
Age UK
0800 678 1602 (freephone)
Bereavement Support Network National Helpline
0808 168 9607 (freephone)
Bereavement Care Services (Royal Blackburn Hospital)
01254 734500 or
01254 732861
Cruse Bereavement Care National Helpline
0808 808 1677
Compassionate Friends National Helpline
0345 123 2304
Citizens Advice Bureau (Blackburn)
0808 278 7880
Citizens Advice Bureau (Burnley)
0808 278 7975
Child Bereavement UK
0800 028 8840
Coroners Officer’s Office (Blackburn) 01254 734116
Coroners Officer’s Office (Burnley) 01282 804508
Department of Work and Pensions (Bereavement Service)
0800 731 0469
East Lancashire Hospice
01254 965830
Medical Examiner 01254 735673
Mortuary 01254 732067
Samaritans National Helpline (freephone) 116 123 (24 hours)
FREE Furniture Collection
Furniture to Donate? - FREE and Fast Collection available!
We are o ering a FREE, fast furniture collection service for items donated to East Lancashire Hospice for sale via our Furniture Warehouse. This service is provided through our logistics partner, Boxmove.
How does it work?
Visit our website to book your slot eastlancshospice.org.uk/hospice-charity-shops-furniture-collection
Alternatively you can call our Furniture Warehouse on: (01254) 680520
We aim to collect your items as soon as possible. You’ll receive a text message with a timeslot the night before.
Please note that drivers will reject any items that aren’t suitable for donationcheck in store or online to see what we can accept.
Volunteering opportunities at East Lancashire Hospice
We are very fortunate to be supported by a wonderful team of volunteers both in the hospice and in our communities. The contribution of their time and talents enhances and supports the work of all hospice departments. People decide they would like to spend time volunteering with us for many reasons and this can also be after the death of a loved one when the time is right for them.
Our volunteers are a valued and essential part of the hospice team, they commit to support us in delivering services to provide a special way of caring to people with a life limiting illness and their families. We value volunteers, providing training, support and guidance to use their experience and learn new skills. It’s a great way to meet new people, gain experience and most importantly, to help our patients make the most of each day.
If at any point in the future this is something you, your family or friends want to talk to us about you can find the latest volunteer vacancies on our website at www.eastlancshospice.org.uk/volunteering
Reference: East Lancashire Hospice Bereavement Booklet
Publication Date: October 2024
Review Date: October 2026
The Hospice would like to thank RNS Publications for publishing this information and the following pages contain some features from services o ering their help at this time.
Whilst the Hospice is grateful of their support it does not endorse or recommend any of the services that they provide.
You may need help, support or advice on what to do when someone dies in relation to probate.
We offer free guidance and advice on the legal and financial aspects of bereavement including your responsibilities and whether probate is required. Calls are
