Isabel Hospice Community Bereavement Booklet

Help for you following a bereavement at home

Our thoughts are with you at this difficult time. When someone close dies, we are all deeply affected. We experience grief and enter into a period of mourning. Grief is a normal reaction to loss of any kind and we all grieve in our own way and at our own pace.

Isabel Hospice recognise that dignity, privacy and respect of your loved one is of paramount importance and our care continues during this time of sadness and grief.

Immediately after a death, there are a lot of practical things to do, like registering their death and arranging the funeral. Hopefully, you will have family or friends around to help you. The following information may help you to think about some of the practical issues to address and highlights some of the emotional impact on carers and family when their loved one dies.

Isabel Hospice

Our Vision

“Outstanding palliative care for all”

Immediate information and advice following a death

When someone dies at home

It is important that the body of the person who has died is cared for in a culturally sensitive and dignified manner.

When an expected death occurs at home, you should call the family doctor to verify the death and arrange to obtain a death certificate. If an expected death occurs outside of normal GP hours, the national 111 service should be called, rather than the emergency ambulance service.

If the death was expected, the doctor will give you a certificate showing the cause of death. You’ll also be given a formal notice stating that they have signed the certificate and telling you how to get the death registered. If the person is to be cremated you will need two certificates signed by different doctors, but this can be done at some point before the cremation and is usually arranged by the undertaker.

Some people choose to help with the laying out of the body; others prefer this to be performed by the undertaker, Isabel Hospice or community nurse. They will ask what your preferences are and assist you with these. If a nurse is not present, you may wish to ring our 24 hour advice line on 01707 382575 for further support.

Medical certificate

In some cases, doctors need to liaise with the coroner’s office to gain authorisation to release the Medical Certificate of Cause of Death. This is the case if someone has not been seen within two weeks before death at home by GP, someone who has experienced falls recently, had recent invasive procedures or asbestos related illness, for example. The coroner’s officer may wish to discuss this with you, as the patient’s relatives. Authorisation to release the certificate may take 24-48 hours.

In some cases, it may not be possible for the doctor to issue the Medical Certificate showing the cause of death. This may happen if the death was sudden, unexpected or the doctor is uncertain for some reason about circumstances or cause of death. If this is the case he/ she is legally obliged to inform the coroner. In this case, the coroner’s officer will contact you and advise you on any next steps, and the certificate will be ultimately completed by the coroner in due course.

For more information about when a death is reported to a coroner, please visit www.gov.uk/after-a-death/when-a-death-is-reportedto-a-coroner

Organ and tissue donation

Whether your relative or friend has died in hospital or at home, tissues (mainly the cornea of the eyes) can be donated for transplantation or research. It may be possible for your relative or friend to donate tissue up to 24 hours following their death. Your relative or friend may already have made arrangements to donate organs or their body to medical science.

If you would like more information, please speak to your Clinical Nurse Specialist. You can also ring the Tissue Donation National Referral centre 24 hour service on 0800 432 0559 or visit their website at www.nhsbt.nhs.uk/tissuedonation

You can also ring the Organ Donor line on: 0300 1232323 or visit www.organdonation.nhs.uk

Funeral arrangements

An important thing to do as soon as you feel able, is to contact a Funeral Director of your choice. You do not have to wait until the Medical Certificate of Cause of Death is issued. The Funeral Director will take care of all the practical arrangements for you, from arranging the transfer of your loved one from home to a funeral home, to advising and guiding you through your chosen funeral in an expert way.

The cost for collection of the body may differ greatly if done within normal working hours or out of hours. If a person dies overnight, their body can be kept in the house until normal working hours, if the family or carer wish.

The funeral is your opportunity to say your goodbyes in a way that is appropriate both for you and the person who has died. A funeral can be a celebration of a life well lived and there are many ways in which you can remember that person. You may wish to choose who might lead the service (who may or may not be a Minister of Religion), certain music or readings and you or other relatives may wish to take part in the service. These are not always easy decisions, so take time to consider the possibilities.

For further information about possible help with funeral costs or any other bereavement benefits you may be entitled to, you can contact the Bereavement Service helpline on 0800 731 0469.

Funeral Directors

Please find detailed below a list of local Funeral Directors:

Registering the death

Once you have the Medical Certificate of Cause of Death, you can arrange to register the death, and in accordance with the law, this must be done within 5 working days. If the death has been referred to the coroner, you will not be able to register the death and the coroner’s office can advise you further as investigations proceed. For more information or to book an appointment to register a death, please visit www.hertfordshire.gov.uk/services/ births-deaths-marriages-and-citizenship/deaths/ register-a-death.aspx

Who can register a death?

You can register the death if you’re:

• a relative

• someone present at the death

• an administrator from the hospital

• the person making arrangements with the funeral directors

What you need to do

Take the Medical Certificate Cause of Death (signed by a doctor) with you.

If available (but don’t worry if not), also take the person’s:

• birth certificate

• Council Tax bill

• driving licence

• marriage or civil partnership certificate

• NHS medical card

• passport

• proof of address (e.g. utility bill)

You’ll need to tell the registrar:

• the person’s full name at the time of death

• any names previously used, e.g. maiden name

• the person’s date and place of birth

• their last address

• their occupation

• the full name, date of birth and occupation of a surviving or late spouse or civil partner

• whether they were getting a State Pension or any other benefits

You should also take supporting documents that show your name and address (e.g. a utility bill) but you can still register a death without them.

You will then be provided with a:

• A Certificate for Burial or Cremation (the ‘green form’) which gives permission for burial or an application for cremation.

• A Certificate of Registration of Death (form BD8) - you may need to fill this out and return it if the person was getting a State Pension or benefits (the form will come with a pre-paid envelope so you know where to send it)

What is the ‘Tell Us Once’ Service?

Following the registration of a death, several government departments and local council services will also need to be told. Hertfordshire County Council provide a service enabling the Registrar to collect the required information and issue to the informant a unique reference number with the option of contacting the Department for Work and Pensions online:

www.gov.uk/tell-us-once or by telephone

0800 083 7308.

There is a period of 28 days to use this service following the registration of the death.

In addition to the ‘Tell Us Once’ service, original copies of the death certificate may need to be obtained for banks, building societies or insurance companies. There is an additional cost for these and the registrar will be able to guide you on this matter.

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.

Registration Offices

The death has to be registered at a Registration Office for the district in which it took place. If the death occurred in Hertfordshire, the registration can be made at any of the Registration Offices within the county.

Registration Offices are listed below:

Bishop’s Stortford

Registration Office

Broxbourne

Registration Office

Hertford

Registration Office

Hertfordshire

Registration Office

Hemel Hempstead

Registration Office

Stevenage

Registration Office

St. Albans

Registration Office

Riverside House, 2 Hockerill Street, Bishop’s Stortford, CM23 2DL

Bishop’s College, Churchgate, Cheshunt, EN8 9XH

County Hall, Pegs Lane, Hertford, SG13 8DE

19b St Albans Road East, Hatfield, AL10 0NG

The Forum, Marlowes, Hemel Hempstead, HP1 1DN

Danesgate House, Danesgate, Stevenage, SG1 1WW

The Gatehouse, 1 Victoria Square, Victoria Street, St. Albans, AL1 3TF

Watford

Registration Office

Watford Registration Office, 31 Hempstead Road, Watford, WD17 3EY

Dealing with the estate of the deceased

Probate is the legal process of settling the estate of a deceased person.

If the person has made a valid Will, this will state what should happen to the deceased person’s estate and will be held by a bank, solicitor, Will-safe facility, the Principle Probate Registry or trusted friend or relative.

If there is no Will, the person is said to have died intestate and there are different rules for dealing with the estate.

Solicitors can help guide you through these matters.

A Will often outlines what a person wishes to happen to their physical belongings when they die, however this more commonly does not stretch to include their digital presence.

By this, we mean their social media accounts, including Facebook and Twitter, as well as their email address. Unless they have included details of their passwords in their Will for you to close down any active accounts, they have potential to be compromised, now that there is no one to manage it. It is worth being mindful of this in the coming weeks.

Most online accounts make it possible to work with a confirmed immediate family member to have the account deactivated. In most cases, including Gmail, Twitter and LinkedIn, simply:

1. Go to the ‘Help’ section on the organisation’s website (you do not have to log in for this).

2. Locate the button ‘Manage Account’.

3. Choose the option that discusses ‘Removing the account of a deceased person’.

1. Some organisations may ask you to complete a form, providing personal details, and often prove the death of the account holder with a death certificate.

2. Each account case will be reviewed and action taken accordingly.

This information is only required to ensure that users do not deactivate another active user’s account without their knowledge. On other platforms, the ‘Help Forums’ are very useful in providing information that you cannot find immediately.

With Facebook, you may wish to take up the ‘Memorial’ option for a loved one’s account. Facebook suggest that these pages become “a place for friends and family to gather and share memories after a person has passed away. Memorialising an account also helps keep it secure by preventing anyone from logging into it”.

If you need further help with this, please call us on 01707 382500 to speak to the team that look after our digital platforms.

What to do with any medication and equipment following the death of a person at home

If someone dies at home, it is the responsibility of the family to take the medicines to their local pharmacist for safe disposal. This should be done as soon as possible.

If you wish to return equipment, such as that listed below, to the Hertfordshire Equipment Services, please call 01707 292555 to organise collection.

• Bathing equipment

• Commodes and toileting equipment (please ensure these are clean. Please discard urine bottles)

• Hoists and other transferring equipment

• Rise and recline chair

• Hospital bed Hertfordshire Equipment Services: 01707 292555

If you have equipment on loan from Isabel Hospice, please return this to the Isabel Hospice In-Patient Unit. This includes:

• Wheelchairs on loan

• Walking aids

• TENS machines

• Nebuliser

• Please note due to infection control we do not accept commodes or toileting equipment

If you need to return a wheelchair that belongs to Hertfordshire Wheelchair Services please contact: 0333 2340303 or 01707 386860.

Practical help

Sometimes the person who has died is the very person you may have relied on for help and support with your day to day activities. Hertfordshire County Council (0300 123 4040) and Age UK (01707 323272) can assist in providing help, so you are able to manage in your own home.

Information about self-care and grief

Experiencing grief

Following the death you may find that your emotions are erratic and you may experience some of the following:

• Numbness and shock – unable to take it in

• Guilt

• Anger at your situation

• Depression – feeling hopeless

• Loneliness

• Difficulty in sleeping, having disturbing dreams

• Changes in eating habits, loss or increase in appetite

• Loss of concentration

• Emptiness – feeling like you’ve lost a part of yourself

• The need to make sense of it all

• Going over and over things

• Yearning

• Loss of self-confidence

• Fear of coping without your loved one

What may help during this time?

• Try to express your emotions

• Remember that you need time to think, rest and sleep

• Be gentle with yourself

• Try to accept that some things are beyond our control

• Don’t be afraid to ask for help

Often we get the help we need from family, friends and neighbours. Not everyone is lucky enough to have such a support system, or maybe the problems are more than family and friends can cope with. You may want to talk to someone outside that circle to help make some sense of the situation or you may want help supporting the children with difficult news.

Adult Bereavement Service

Our Bereavement Service is a confidential service concerned with helping the bereaved to cope with their feelings of loss and grief, in line with Hospice and National guidelines. All volunteers have regular training and support. We can offer:

• One-to-one sessions. We have a team of trained counsellors and support workers who can offer you a telephone session. We offer up to six sessions.

• We offer up to six sessions initially, lasting for 50 minutes with scope for re-assessment if required.

• This is an open service which can be accessed at any time after the death, even if it has been months or even years.

• Grief Encounters, a 6 week group sessions held in Welwyn Garden City and Bishops Stortford.

If you need bereavement support you can access it at any time by calling 01707 382563.

Our usual practice is:

During the month following the death, all family or friends for whom we have an address will be sent a leaflet about what bereavement support is currently available from us, and a letter asking if support is needed. If you would welcome further support, you can complete a form giving your consent to be contacted by phone.

If you give your consent to be contacted in this way, the bereavement team will call you in the third month following the death, as research suggests this can be a helpful time, when initial support from others close to you may have subsided a little. Around this time, we also call any relatives or friends for whom we haven’t had an address, to offer support if needed.

Children’s and Young People’s Bereavement Service

We know that all children and young people grieve. It is normal, and children’s grief is expressed differently to the adults around them. Each child is an individual and will face bereavement in their own special way. What we say about death to our children or when we say it, will depend upon their age, understanding and experiences and perhaps your family’s beliefs or culture.

You may see the following signs that your child is experiencing normal feelings of grief:

• Feelings of sadness, anger, guilt, anxiety, loneliness, tiredness, helplessness, confusion, shock, numbness, worry about the future.

• Regressing and becoming more dependent again

• Changes in sleep and eating pattern

• Loss of interest in friends or social activities

• Physical signs such as aches and pains or lack of energy

• Worries about school

• Forgetting that something awful has happened for a while or pretending that it hasn’t happened

How you can help:

• Keep talking, listening, comforting and involving your child as much as possible and as much as their age allows

• Sharing grief as a family can be helpful

• Answer their questions honestly and in a way in which you think they will understand. You may not have all the answers and it is ok to say this

• Avoid the use of words that can cause confusion e.g. ‘gone to sleep or went away’.

• Acknowledge their feelings and don’t be afraid to show yours

• Keep to normal family routines and activities if you are able

• Keep the boundaries of behaviour that your family are used to

• Keep the school informed

• Keep remembering the person who has died

• Remember your own needs

How we can help:

• Make suggestions about suitable children’s books and adult literature on childhood bereavement

• Talk to you about how to support your child

• Offer one:one counselling for children and young people if the family has been known to the Hospice

• Talk to you about attendance at one of our group work sessions

• Provide information for your child’s teacher, GP or any other professional that they may know. Bereavement support is available to any children and young people who have experienced a bereavement, and have a GP in East Herts (i.e. fall within our hospice catchment area).

Spiritual Care

After a bereavement, you may find yourself reflecting on your beliefs about the meaning and purpose of life. The Hospice Chaplaincy service is available to all bereaved families and carers of any or no faith, as well as for those who are unsure what they believe. Chaplaincy can offer pastoral and spiritual support which may include:

• A listening ear for you about your worries or concerns

• Space to talk about your life story and hear what is important to you at this time

• A quiet time of prayer or reflection at your request

• Support if you wish to practice your faith or spiritual tradition

Lights of Love

Lights of Love is a chance to get together with the wider ‘Isabel family’; people who have been touched by our work, or who simply want to gather with others to remember someone special, near or far.

It’s a wonderful, inclusive occasion with readings and carols, and a moment for reflection before we switch on the Lights of Love as a way of marking the light and warmth they brought to the world.

Lights of Love takes place across Eastern Hertfordshire annually in November and December.

Please visit our website at www.isabelhospice.org.uk/lightsoflove/ for more information.

Comments

We’re always pleased to receive suggestions (including any complaints) from you and your family, as these may help us to improve our services. You may speak with any member of staff looking after you about any aspect of your support, or visit the friends and family questionnaire on our website.

Service quality

Although Isabel Hospice is an independent charity, we are regulated by the Care Quality Commission, which inspects the Hospice on a regular basis to ensure we are providing high standards of care. You are welcome to send comments (good or bad) to:

www.cqc.org.uk/give-feedback-on-care

Telephone: 03000 616161

Reference: Isabel Hospice Community Bereavement Booklet

Publication date: January 2023

Review date: January 2025

The Hospice would like to thank RNS Publications for publishing this information and the following pages contain some features from local 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.

It is distressing to deal with a bereavement and unsolicited mail can be insensitive and destructive during a grieving process.

By scanning the below QR code on your phone or visiting www.stopmail.co.uk, we are able to securely share this information with mailing organisations and under the Data Protection Act the information will not be used for any other purpose.

Other benefits reduce the possibility of identity fraud, such as assumed identity and you will only have to supply the information once.