Page 13 Arranging a funeral without a funeral director
Page 14 Grieving
Page 15 Some helpful grieving advice
Page 16 Stopping junk mail to the recently deceased
Page 17 Children
Page 20 Further support and useful contacts
INTRODUCTION
When someone dies there are many decisions and arrangements that have to be made. If you were the one who was closest to the deceased patient, a lot of responsibility may fall to you. This can be overwhelming, especially when you may be dealing with many emotions at the same time. Some people appreciate having lots of practical tasks to do when they are bereaved whilst others find that they just cannot cope in the immediate period after losing a loved one. Ask family and friends for help and do not try to cope with everything on your own. Whilst it is impossible to cover every detail, we have tried to provide help and advice in this booklet on the main issues to be faced when arranging a funeral. This booklet has been prepared to include help and advice to overcome the immediate and long term effects of dealing with grief, as well as being an aid to the practicalities associated with the loss of a loved one, particularly if the death should occur in hospital.
Information in this booklet may need some explanation. Bereavement advisors will be happy to help you. We would like to offer you our sympathy and condolences at this sad time. If we can be of any further assistance, please do not hesitate to contact us.
POINTS OF CONTACT
Telephone numbers
James Paget University Hospital
Switchboard: 01493 452452
Hospital Chaplain: 01493 452408
Mortuary: 01493 452396
Bereavement Office: 01493 453327/452389
Medical Examiner’s Office: 01493 452177
Coroner’s Office
Norfolk: 01603 774773
Suffolk: 0345 607 2040
Great Yarmouth Registry office: 0344 800 8020
Lowestoft Registry office: 0345 607 2070/2050
Bereavement Office Opening Hours
Monday to Thursday 08.30 – 16.30. Friday 08.00 – 16.00
The Bereavement Office is closed at weekends and during public holidays.
Mortuary Opening Hours
Monday to Thursday 08.00 - 16.30.
Friday 08.00 - 16.00.
Out of hours - the on call staff can be contacted through hospital switchboard.
WHEN A PATIENT DIES IN HOSPITAL
• When a death occurs in hospital, the Bereavement Coordinator will contact the person named as next of kin by the deceased in their medical records.
• The Bereavement Coordinator will contact the treating Doctors to complete the Medical Certificate of Cause of Death.
• The Medical Examiner will scrutinise the deceased patient’s records and speak with the doctor who has issued the MCCD or the consultant responsible for the patient.
• The Medical Examiner will sign and send the MCCD to the central registration office.
• The Bereavement Coordinator will then contact the Next of Kin to make an appointment to register the death.
THE MEDICAL EXAMINER (ME)
Medical Examiners are senior Doctors independent of the treating medical team. Supported by Medical Examiner Officers (MEO), they review every death that occurs within the hospital and community.
The role of the ME Service is to:
• Provide the bereaved families with the opportunity to raise any concerns about the care of their loved one in their final illness.
• Explain and ensure accuracy of the MCCD.
• Ensure that those deaths which are required by law to be notified to the Coroner, are appropriately referred.
A ME or MEO will contact you or a designated family member by telephone to discuss these matters. This is a routine call for all who have lost a loved one and will normally take just a few minutes.
The team will often be able to reassure you about matters of concern and explain medical issues (such as technical terms on the MCCD).
The ME Service can also escalate matters that may need further review and signpost you to other services to support you.
REGISTERING THE DEATH
The Death Certificate
This is a certified copy of the entry in the register of deaths at the registry office. You may wish to discuss with the Registrar how many certificates you require as banks, building societies and insurance companies require original copies only. There is a fee for each Death Certificate you require.
The death must be registered within 5 working days of the MCCD being received by the central registration office, or up to 14 days with the Registrar’s consent unless it has been referred to the Coroner. In this situation the procedure is slightly different, but you will be advised accordingly.
• Deaths must be registered in person in the district in which they occurred. Once the MCCD has been sent to the Registration service the Bereavement Office will ask you to contact them to make an appointment to register the death.
The Registrar cannot register the death until the doctor has completed a Medical Certificate of Cause of Death and it has been sent electronically from the Medical Examiner’s Office.
WHEN YOU REGISTER
The death should be registered by one of the following (in order of priority):
• A relative of the deceased
• An owner or occupier of the building where the death took place and who was aware of the death
• The person instructing the funeral director, but not the funeral directors themselves.
The Registrar will also need to know the following information. It may help to tick these off before your appointment:
The date and place of death
The date and place of birth
The deceased’s usual address
The deceased’s full name and maiden name if appropriate
The deceased’s occupation and name and occupation of the spouse or registered civil partner if applicable
The deceased’s marital status and date of birth of the surviving spouse or registered civil partner
The Registrar will give you:
• The Death Certificate. There is a cost for every certificate.
• Tell Us Once. The registrar will give you a unique code to inform the DWP and any other Government organisations of the death. You can do this on tell-us-someone-died.dwp.gov.uk
VIEWING
Viewing your loved one after death may help with the grieving process. This can easily be arranged by yourself or someone else on your behalf. Our Chapel of Rest comprises of the viewing room, a separate seated side room and a garden. It is situated adjacent to the mortuary and is suitable and open to all religions and denominations.
Viewings are available in working hours by appointment only. You can also arrange to make arrangements to view with your nominated Funeral Director.
Please contact the mortuary or the Bereavement Office directly and we will endeavour to arrange a convenient time for you.
If there is Coroners involvement, permission to view must be obtained from the Coroner by the mortuary/bereavement staff prior to an appointment being made.
TISSUE DONATION
If at this difficult time you feel able to consider donation please contact the Bereavement Office or the mortuary. They will be able to put you in contact with NHSBT (NHS Blood and Transplant) to discuss this further.
Alternatively, you can contact NHSBT directly on 0800 4320 559.
The decision of donation is a very personal one. We must stress it is only an option, it is not expected of you and your preference will be respected either way.
Many people can be considered for tissue donation after death. Most donors would have expressed this wish with family or friends during their lifetime and may have carried an organ donor card. Every year hundreds of lives are saved with the help of donated tissue and organs.
You may not realise that donated tissue such as eyes (corneas), skin, bone and heart valves can dramatically improve the quality of life for recipients, and even save lives as well. However the majority of these must be taken within 24 hours following death. A family member may consent on behalf of the deceased, even if they were not previously registered as a donor or carried a card.
CHAPLAINCY AND RELIGIOUS INVOLVEMENT
The JPUH have a Chaplaincy team who can be contacted via the hospital switchboard. They have contacts with most faith groups and can usually contact an appropriate representative for you. If you feel the need, the Chaplaincy team can offer support and advice. You do not have to be a member of any particular faith group to ask for help.
During office hours there is usually a member of the Chaplaincy team available in the hospital to attend to spiritual needs of relatives.
A 24 hour service is operated and is available via the hospital switchboard.
CORONER’S INVOLVEMENT
Under certain circumstances the involvement of the Coroner may be necessary. Some examples are:
• All sudden and unexplained deaths
• Where the cause of death is unknown and a doctor cannot issue a certificate
• Any deaths through unnatural or suspicious causes. Examples of these would cover accidents, suicides, violence, poisoning etc.
• If the death occurred whilst the patient was undergoing a medical operation or was under the effect of anaesthetic
• A custodial death whilst under arrest, detained in prison or under the Mental Health Act
• If the death was caused by an industrial disease i.e. Asbestosis or Mesothelioma.
Coroners are independent judicial officers who inquire into deaths and the Coroner’s Officers are independent representatives who work for the Coroner. They will be the people contacted in any of the above circumstances and may decide one of two things from the information they are given:
• The Doctor will issue a Medical Certificate of Cause of Death meaning that NO post mortem is necessary
• A post mortem examination will have to be undertaken to ascertain the cause of death.
• Relatives will be informed if a post mortem is necessary. The Coroner is legally empowered to request this, irrespective of religious beliefs, consent is therefore not required. If you have any concerns you can discuss these with the Coroner’s Officer.
• A post mortem is usually carried out at the James Paget University Hospital. It is a surgical examination to find out more accurately the cause of death.
• Following the outcome, the Coroner’s Officer will be in touch and will inform you of the result. They may ask which funeral directors you intend using and whether a burial or cremation is to be arranged.
INQUEST
If the death is by unnatural causes and a post mortem is required or there is need for further investigations. The Coroner’s Officer may open an inquest into the medical cause and circumstances surrounding the death.
The Coroner’s Officer will explain the details to you at the time, specific to the case, but the inquest will usually be adjourned and re-opened at a later date. In this situation an Interim Certificate of Fact of Death will be issued to the next of kin.
The Coroner’s Officer will issue an Order of Burial Form or Certificate of Cremation Form E so that the funeral can take place. In some circumstances the body may be required to have a further examination, but if not the funeral can take place before the inquest.
After the inquest the Coroner will send the Medical Certificate of Cause of Death to the Registrar to supersede the temporary interim one, then the next of kin can register the death.
HOSPITAL POST MORTEM
Although the Coroner may not require a post mortem examination, a hospital doctor may, in some cases ask your permission to perform a post mortem. By consenting to this examination, you are still able to collect the Medical Certificate of Cause of Death, register the death and make the funeral arrangements.
A hospital post mortem can help doctors to understand any underlying factors that may have attributed to the death. The findings may also help in the study and potential treatment of familial disease in your family as well as treatment of other patients in the future.
A member of the medical staff will approach the next of kin for permission to do this and they will be asked to sign a hospital post mortem consent form. The doctor and/or the Bereavement Service staff will explain the form and take you through the process. The consent form offers you complete control as to how in depth the post mortem can be.
You are within your rights to refuse consent to this request.
You can contact a Funeral Director of your choice as soon as you feel able to following the death. They will advise and discuss the funeral arrangements with you. Contact details of our sponsors are provided within this booklet. However, you are under no obligation to choose from the small selection provided.
A Will may have been made by the deceased. This may include requests about their wishes for funeral arrangements and names of executors to deal with the deceased’s estate. In these circumstances contact the Solicitor for assistance.
Funeral Directors
The hospital is not able to recommend a particular Funeral Directors. There are no universal standards that apply to Funeral Directors; however some are members of professional organisations, which operate a code of conduct. The National Association of Funeral Directors (NAFD) and the Society of Allied and Independent Funeral Directors (SAIF) are examples of these.
A Funeral Director should give you a full, written estimate of charges at the time of taking the instructions. This includes an estimate for a standard funeral, as well as any additional services that you may require. Do not be afraid to discuss these extras or possible ways of reducing the costs quoted.
Help with funeral costs
If you are receiving Income Support, Family Credit or Housing Benefit, you may be able to get assistance from the Social Fund to help pay for the funeral. For advice please contact www.gov.co.uk/funeral-payments
You may be entitled to help with funeral costs if you receive certain benefits; help and advice can be gained from any Benefits Agency or Citizens Advice Bureau.
FUNERALS ABROAD
Moving a deceased person to any county within England and Wales requires no additional documentation. If, however, repatriation to another country (including Scotland and Ireland) is requested, the Funeral Director acting on your behalf will arrange the documentation from the relevant authorities.
ARRANGING A FUNERAL WITHOUT A FUNERAL DIRECTOR
It is possible to do this please contact the Bereavement Office for more information.
Alternatively, more information can be found at www.goodfuneralguide.co.uk
GRIEVING
Bereavement is a distressing experience that all of us encounter at some time, yet it is something that is talked about very little in our everyday lives.
Grieving is a natural process that can take place after any kind of loss. When a loved one dies this can be a very overpowering emotion that has to run its course.
Although it may be distressing to attend the funeral or to see the body, it is important to say goodbye to the ones we loved. It is often the case for people who did not do this to experience a great feeling of regret for years to come.
Generally, simply spending time with the person who has been bereaved can help them as being close to others can be a great source of comfort. It is not always necessary to say anything, just being there is enough.
It is important that a bereaved person is able to talk and cry without being told to pull themselves together.
It can also be difficult for people to understand why the bereaved keep covering the same ground, talking and apparently becoming distressed about the same things over and over again. This is an important part of the healing process and should really be encouraged.
Not mentioning the name of the person who has died for fear of upsetting them can indeed lead to a sense of isolation and can add to the grief of the bereaved.
Another difficult time when friends and relatives can be of help is festive occasions and anniversaries, which can be particularly painful for years to come. Practical help with domestic chores and looking after children can all lead to easing the difficulties facing the bereaved.
Elderly bereaved parents may need more practical help than most, particularly with financial arrangements - paying bills etc. If you feel you would like to speak to someone, you can contact one of the bereavement organisations listed on pages 20 to 22.
SOME HELPFUL GRIEVING ADVICE:
Try not to:
~ Hide your feelings
~ Rush into having the funeral unless it is your cultural practice
~ Make any major life changes whilst grieving, give yourself time
~ Neglect yourself. Try to eat and rest well
~ Enter any legal or financial arrangement unless you fully understand it
~ Hurry yourself to overcome your grief, there is no timescale for this
~ Let others rush you into anything before you are ready
~ Turn to drugs, smoking or alcohol to stop the pain or grief
Try to:
~ Express your feelings as much as possible
~ Talk through what has happened with someone you trust
~ Contact one of the hospital organisations or voluntary services if you wish to talk to an anonymous person. Some helpful contacts are within this booklet
~ Take good care of yourself. Get lots of rest, eat well and give yourself plenty of time to grieve
~ Choose a funeral director you like and trust
~ Contact the doctor if you feel unwell or would like a doctor to refer you to someone to talk to
~ Begin to make longer term plans for the future so you will have something to look forward to
~ Keep in touch with friends and family. It may be difficult, but it will help and many people feel honoured to be asked and trusted.
STOPPING
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.
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 a comparable service can also be accessed from the Bereavement Register or Deceased Preference Service.
CHILDREN
Try to tell children of all ages what has happened as honestly as you can. Be prepared to answer their questions simply and truthfully. No child is too young to notice when an important person in their life is no longer there. Frequently adults, knowing how painful bereavement can be or having difficulty in accepting the death themselves, attempt to shield the children from the pain by telling them little or nothing about what has happened.
However, children always sense when something is wrong from the behaviour of those who are caring for them and from the changes which inevitably occur as a result of the death.
On their own, many children are not able to understand the reality of death, and the feelings which they are experiencing. They may be confused and even feel rejected or abandoned at a time when they most need comforting, understanding and security. Adults, struggling to cope with their own reactions to death, may feel inadequate or totally helpless in dealing with grieving children.
Children frequently show their grief in ways which adults do not expect. They may possibly express themselves physically rather than verbally. They tend to grieve in spurts and may go through periods of time seeming to be unaffected by events.
We hope the following information will be helpful to bereaved parents or other people who are in the position to reach out to a grieving child.
How children grieve
Children and young people of any age may respond with any or all of the following reactions:
Denial - a way of coping with something which is not understood or accepted. They may fantasise about the dead person, talk about them in the present tense or continue to ask for the person despite being told that they are never coming back.
Guilt - may be the result of needing to find a reason for the death. Some children feel responsible for the death or feel guilty for being alive themselves. Sometimes, the behaviour of other family members causes children to feel guilty.
Anger - may be directed at peers who have suffered a loss, at the dead person for dying or at surviving parents, brothers, sisters or other close relatives.
Panic - children may fear losing more people who are close to them or might even fear that they themselves may die. They invariably feel insecure and worry about who will take care of them.
Idealisation - children may often idealise the dead person and even begin to imitate their mannerisms.
Physical complaints - children may lose their appetite, have nightmares, seem to be tired for much of the time, complain of upset tummies or of having headaches. Some children may even complain of having the same symptoms as those which were shown by the dead person during the final phase of their illness.
How can you as a parent, teacher or friend help a grieving child?
1. Reassure them that they are still loved and will be taken care of.
2. Maintain as much stability, security and order in their lives as possible.
3. Answer their questions honestly and in a way which they can understand. You may have to do this repeatedly.
4. Talk with them about the dead person whenever they wish to do so.
5. Allow them to share in making decisions about their role in attending the funeral and visiting the grave. Prepare them in advance for what they will see.
6. Be certain that they are receiving attention, love and care; they need time to be with their parents as well as with other caring adults.
7. Encourage them to share their feelings with you and help them to understand and express those feelings appropriately.
8. Share grief with them. Allow them to comfort you when they wish to do so. Do not hide your tears from them - they need to know that crying is an appropriate and acceptable reaction.
Support and help that is available
Sometimes it helps to talk to someone who is not directly involved with you or your family’s grief.
In this booklet, please find a list of some organisations who may be able to give you the support you need. Your GP may also be able to give you more support and information.
Wellbeing Norfolk and Waveney Bereavement support
www.wellbeingnands.co.uk
If you feel you would benefit from support to manage your grief and find other ways of coping with the loss - the wellbeing service may be able to help. They offer a free service throughout Norfolk and Waveney for anyone over the age of 16.
They offer regular online ‘Coping with Bereavement’ workshops and can also put you in contact with a wellbeing advisor who will signpost you to the most appropriate support available.
You can arrange an individual appointment by calling 0300 123 1503 or by completing a self-referral form online.
Cruse Bereavement Care - provides nationwide bereavement counselling advice, information and social contact.
www.cruse.org.uk
0808 8081677
Samaritans - 24 hour helpline for help and support on any matter. www.samaritans.org 116 123
Citizens Advice Bureau
www.ncab.org.uk www.nesuffolkcab.org.uk
Great Yarmouth: 03444 111 444
Age UK
www.ageuk.org.uk
0800 1692081
Norfolk: 0300 5001217
The Natural Death Centre - independent funeral advice. www.naturaldeath.org.uk
The Compassionate Friends - supporting bereaved parents and their families after the death of a child. www.tcf.org.uk 0345 1232304
Time Norfolk - support with pregnancy loss and stillbirth. www.timenorfolk.org.uk 01603 927487
Tommys - advice for parents on miscarriage and stillbirth. www.tommys.org 0207 3983400
Nelson’s Journey- Norfolk based charity helping bereaved children.
SSAFA - national charity for helping serving and ex-serving men, women and their families in need. www.ssafa.org.uk 0800 260 6767 Norfolk: 01603 403322
Road Peace - national charity supporting those bereaved or injured in a road crash. www.roadpeace.org 0845 4500355
The Sudden Death Support Association - organisation helping relatives and close friends of people who die suddenly. www.suddendeath.org
SOBS - Survivors of Bereavement by Suicide www.uksobs.org
The Terrence Higgins Trust - charity providing practical support, help, counselling and advice for anyone concerned about. AIDS/HIV.
www.tht.org.uk 0808 802 1221
Other people may also be able to offer some support and information.
For example:
Your local church. You do not need to be a regular church attendee to ask for their support. Your local Citizens Advice Centre. Your General Practitioner doctor.
Please do not hesitate to contact us if you have any further questions or concerns.
Whilst every effort has been made to ensure the accuracy of advertisements contained in this publication, James Paget University Hospitals NHS Foundation Trust cannot accept liability for errors and omissions. The Trust cannot accept responsibility for claims made by advertisers and their inclusion in James Paget University Hospital Bereavement Booklet should not be taken as an endorsement by the Trust.
Reference: James Paget University Hospital Bereavement Booklet
Publication date: August 2024
Review date: August 2026
The Hospital 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 Hospital is grateful of their support it does not endorse or recommend any of the services that they provide.
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stopping mail
STOPPING JUNK MAIL
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.
