Care after death: practical procedures
What to do after a
patient has died, out of the ward area
in hospital
The site co-ordinator and mortuary can be contacted for advice. It may be more appropriate and dignified for the deceased person to be transferred directly to the mortuary viewing room to perform personal cares.
Personal cares after death
The most up-to-date flow chart to guide practice is available in the blue ‘Care after Death’ box on every adult ward or on the intranet under Palliative and End of Life Care: nww.htft.nhs.uk/trust-wide/palliative-and-end-of-life-care
No treatments should be stopped until the person has been verified by a doctor or competently trained registered nurse / advanced clinical practitioner.
STANDARD OPERATING PROCEDURE FOR PERSONAL CARE AFTER DEATH IN HOSPITAL SETTING
It is best practice to do this with two people, one of whom needs to be a registered nurse or a suitably trained person. If the patient has been referred to the Coroner please leave all devices insitu e.g. catheters, drains, cannulas, syringe driver, NG tube etc.
PPE REQUIREMENTS: FOLLOW HDFT INFECTION PREVENTION POLICY
Lay the deceased person on their back
Straighten their limbs with their arms lying by their sides
Remove pillows
Close the eyes by applying light pressure for 30 seconds
* If fails, explain to family/carers a funeral director will resolve the issue*
*If donating cornea or eye close eyes with gauze soaked in normal saline*
Clean mouth to remove debris and secretions
Clean and replace dentures as soon as possible after death
*If cannot replace send to mortuary with the body in labelled receptacle*
Support the jaw by placing pillow or rolled up towel underneath
*remove it before family/carers view*
*Do not bind with bandages*
Tidy hair
*In preferred style if known to guide funeral director*
*Do not shave*
Remove syringe driver and Saf-T-Intima (if applicable)
Remove urinary catheter (if applicable)
Cover stoma with clean bag (if applicable)
Remove drains (if applicable)
*dress wound and seal with occlusive dressing*
Disconnect IV line and remove cannula (if applicable)
Suction excess fluid from oral cavity or tracheostomy site
Disconnect feed and remove NG tube (if applicable)
Cover leaking wounds with a clean, absorbent dressing, secure with an occlusive dressing
*Leave stitches and clips intact*
Wash and dress the deceased person
Dress in nightdress/pyjamas/gown or clothes chosen by family
*The funeral director will dress them in their own clothes*
Remove jewellery – return to family or send to General Office / put in Safe
*If family request for jewellery to be left on – secure with tape*
For deceased patients with suspected / positive Covid-19: all other valuables must be cleaned with either Clinell wipes. Return these immediately to any family present or follow guidance on SOP Care after Death (Ward Care after death blue box)
The deceased person requires one name band on a wrist and one on an ankle
Complete Mortuary Transfer Checklist
*ALL wards must follow SOP Care after death Care of Property & Valuables (ward care after death box) and follow guidance regarding infection controls*
Request porter
Complete identification check with porter
*discuss any jewellery left on body*
Wrap body in sheet, tape lightly
*Use body bag if has notifiable disease or fluid leakage not managed by padding* Where the deceased was known or suspected to have been infected with COVID -19, there is no requirement for a body bag unless fluid leakage. Attach ‘high risk’ label and COVID 19 should be written on the mortuary transfer sheet.
Assist Porter to transfer the patient onto the trolley
PLEASE NOTE:
Personal care after death should, wherever be possible, be carried out respecting the wishes of the patient, if made known prior to death, or by the family after death.
Be aware of any religious or cultural requirements of the deceased person (ASK!)
Do not tie the penis
Do not send body to the mortuary naked
The body may turn purple or pink as blood pools
The body will cool after death
The body will go stiff (rigor mortis) between two to six hours after death
You may see muscle twitches or spasms after death
The sphincter relaxes causing incontinence of urine and faeces, you may also hear gas released
You may hear moaning or groaning noises as muscles relax (including vocal cords) and gas builds up
Awaiting further flow chart