NHS
East and North Hertfordshire NHS Trust
Staff Information Folder Following A Death provided by the Bereavement Office
Contents Bereavement office contact numbers...................................................................... 1 Useful contact numbers.................................................................................................................. 1 Introduction........................................................................................................................................................... 3 Section 1.................................................................................................................................................................... 3 What to tell the relatives of the deceased.................................................................. 3 Section 2.................................................................................................................................................................... 4 Important Information for All Ward Staff ...................................................................... 4 Section 3.................................................................................................................................................................... 5 Preparing The Deceased’s Body for the Mortuary........................................ 5 High Risk (of communicable infection) deceased patients............... 5 Completing the Mortuary Admission Form................................................................ 6 Section 4.................................................................................................................................................................... 7 Personal Property........................................................................................................................................... 7 Section 5.................................................................................................................................................................... 8 Viewings........................................................................................................................................................................ 8 Section 6.................................................................................................................................................................... 9 End of Life care Pathway.................................................................................................................... 9 Section 7.................................................................................................................................................................... 10 Spiritual & Pastoral Care (Chaplaincy)........................................................................... 10 Section 8.................................................................................................................................................................... 11 Faith Deaths Out of Hours ............................................................................................................... 11 Section 9.................................................................................................................................................................... 12 Organ and Tissue Donation............................................................................................................. 12 Body Donation to Medical Science....................................................................................... 13 Further Help and Support for the Bereaved............................................................ 14 References................................................................................................................................................................ 15
Bereavement Officer contact numbers: Caroline Green Bereavement & Medical Examiner Officer
Ext 4208
Clare Urbani Bereavement & Medical Examiner Officer
Ext 8463
Marian Simmons Admin Assistant
Ext 4634
Mortuary
Ext 5408
Useful contact numbers: Palliative Care Team
ext / bleep 4035
Butterfly Volunteer Co-ordinator butterfly.enh-tr@nhs.net
07825 072142
Chaplaincy
ext 5519
Where is the Bereavement Office located? On Level 3 by the service lifts (in the old Coding office)
IMPORTANT: PLEASE DO NOT TELL THE FAMILY TO WAIT FOR THE BEREAVEMENT OFFICE TO CALL THEM. We always wait for the family to make contact with us first when they are ready to talk and to receive the information we give to them 1
Good practice guidelines Care after death is…. •
Preparing the body for transfer to the mortuary (last offices/ care after death) as soon as possible after the death has occurred.
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Providing the family with practical, yet compassionate support and advice on the next steps.
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Offer family and carers who are present the opportunity to participate in care after death and supporting them to do so.
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Ensuring the privacy and dignity of the deceased person is maintained.
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Honouring the spiritual or cultural wishes of the deceased person and their family/carers
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Ensuring that the health and safety of everyone who comes into contact with the body is protected. It is important to adhere to infection prevention precautions and to highlight where there is a risk of communicable infection.
The nature of the death and the context in which it has occurred may affect the level of support needed by those who have been bereaved. For example, some deaths are expected or peaceful while others may be sudden or traumatic. As a result, families and carers are likely to have a range of responses and needs and each may also have differing views about how the person should be cared for after death.
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Care after death requires sensitive and skilled communication, addressing the needs of the family and carers and respecting the integrity of the person who has died. It is a very difficult time for those who have been bereaved and can be emotionally challenging for healthcare staff. There is only one opportunity to get this right. People may not remember what you said, however they will always remember how you made them feel.
Section 1 What to tell bereaved relatives •
Ask the family to telephone the Bereavement Office on the next working day for information on how to proceed. Do not tell the family that we will call them first. We ALWAYS wait for families to contact us when they are ready to do so.
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Give the family a copy of the “Following a Bereavement…” information pack. There should always be a supply of these on the ward. The Bereavement Office supplies these booklets so please call us whenever you require more supplies.
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Section 2 Important information for all ward staff •
Please inform the Bereavement Office of the death straight away. We need to be aware of this so that we have the information to hand when the family contact us.
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We contact the wards each morning to request the deceased’s hospital notes. The reason we need them as soon as possible is because the MEDICAL EXAMINER must scrutinise the notes of every patient who has died and talk to the attending doctor(s) before the death certificate can be issued. The notes must be correctly filed in line with Trust requirements.
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Please do not send the family directly to the Bereavement Office. Please give them a Bereavement pack and ask them to call us later that day or preferably the next working day.
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Do not tell families the certificate will be ready immediately. It can take time for the doctor to complete the medical certificate of cause of death & all the other required forms. The coroner may be involved which often creates a delay of 2– 3 working days
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If you are unsure of what to do next, please call us (ext 4208) or the Mortuary staff (ext 5408). We will be happy to help you and answer any queries you may have.
IMPORTANT: If you do not know the answer to a relative’s question about our service, please ask them to call us. We understand it can be difficult and you wish to help, but providing the wrong information to families at this time can be damaging.
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Section 3 Preparing the body for transfer to the mortuary (personal care after death/last offices) •
Close the mouth and eyes as soon as possible after death. To further assist with closing the mouth, a rolled up towel or sheet can be placed beneath the chin.
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Lines & drains: Leave cannulas, endotracheal (ET) tubes and lines in place. Spigot nasogastric tubes, remove catheter bags and clamp the urethral catheter. Removal of these can cause excessive leaking of bodily fluids.
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Affix identification tags around the wrist(s) and ankle(s) – not too tightly - always double-check the ID bands are correct!
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Dentures: If dentures cannot be put in, place them in a labelled denture pot and put next to the deceased. Do not put dentures in the patient’s property bag.
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Dress the deceased in a shroud or a hospital gown or the patient’s own nightwear (if requested by the family).
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Use a clean sheet to wrap around the deceased. Use a small amount of micropore tape to secure the sheet. Do not apply tape across the head as this can distort the facial features. Never tie the sheet with bandages.
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High risk/infection risk including Covid-19 infection: If the deceased is known to be high risk ie: blood borne/ airborne infection please place them in a body bag and write “HIGH RISK” on the body bag. Ensure the zip is at the head of the body bag so that mortuary staff can quickly identify the deceased.
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Use of body bags: If purging (leakage) does occur, place the deceased in a body bag. Each ward orders its own supply of body bags. 5
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Complete the mortuary admission form checklist - in full (SEE BELOW).
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DO NOT remove jewellery – it is safer left on the body and unless the family specifically request for you to remove it, there is no reason to do so.
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Document the valuable items which are left on the body on the mortuary admission form (see below).
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Section 4 Personal property •
If the family members are present at the time of death, it is advisable for them to take their relative’s personal belongings home with them.
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If property is to be brought to the Bereavement Office, this must be accompanied by the property book or a list documenting the items in the property bag(s). The Bereavement Office will not accept the property without the property book/list.
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If the property is SOILED with bodily fluids, DO NOT send it to the Bereavement Office.
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Personal property items should always be neatly packed with clothes folded.
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Valuable items (such as jewellery, loose cash, key etc) must be listed in the valuables property book and placed safely in a sealed, clearly labelled envelope. Do not leave them loose in the property bag amongst clothes and toiletries etc.
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Do not put the following items in the patients’ property bags: - Open packets of biscuits/confectionery/open bottles of drink - Cardboard receivers, urine bottles, vomit bowls - Perishable food (meat, dairy, fruit etc) - Dentures (these should be placed in a labelled container and placed with the deceased before they are transferred to the Mortuary.
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Property belonging to a patient who was Covid positive must be double-bagged, clearly labelled and ward staff must provide a full list of the property items to the Bereavement Office. Always consider how you’d wish to receive your loved one’s personal belongings under these circumstances 7
Section 5 Viewings Viewings are always by appointment only This is an additional service and cannot be extended to every family as we do not have the capacity for this. Very often, we advise families that it may be best to view their loved one at the funeral home. Sometimes people prefer to remember them as they were in life – it is a very personal choice and no one should feel obligated to do this if they are unsure. Never tell a family they can have a viewing “at any time” or “whenever they want”. We run an appointment system which is essential for the smooth running of the department to ensure families are given dedicated time to visit. Please bear in mind that we have ONE non-denominational viewing room: it is no longer referred to as the Chapel of Rest. We can provide a limited viewing service during office hours only (8am – 4pm Monday to Friday) The only exceptions to this are police identifications for sudden deaths and paediatric deaths, where the on call mortuary technician will attend on these occasions.
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Section 6 End of life integrated care pathway If the patient was on the End of Life (EOL) care pathway, please ensure the last page of the purple booklet is completed by the doctor verifying the death and by the nurse in attendance.
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Section 7 Spiritual & pastoral care - chaplaincy The Spiritual and Pastoral Care Team is there for everyone (patients, families and staff) whatever their beliefs and needs. They provide care for all those living with caring, dying, death and grief. They offer empathy, compassion, a listening ear and support for all. “We respond with sensitivity to the needs of the individual, recognising that spirituality is unique for each person. So the support we offer is person-led, and may or may not involve religious beliefs. We can help people to be in touch with their own sources of strength, comfort and peace. If requested we can offer rituals and prayers of a religious nature, or humanist words of committal for the person who has died. We are a team from a range of faith and belief communities, including Christian, Muslim, Hindu, Buddhist, Sikh, Jewish and Humanist (non-religious) – and we can put people in touch with their own faith leaders if these are not represented within our team” Telephone: 01438 285519 / Lister ext 5519 Email: spiritualcare.enh-tr@nhs.net
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Section 8 Faith deaths out of hours If a faith death occurs out of usual daytime working hours and the family requires urgent registration of death and removal of the deceased for burial, contact the duty matron who will initiate the Out Of Hours Faith Death Procedure (See Trust SOP BO 18) on the Knowledge Centre. If it is expected that there may be a faith death out of hours, please alert the Bereavement Office (by 4pm) and we can provide advice and support to family and staff. The next of kin can contact the Hertfordshire Registration Service at the weekend on 0300 123 4045 to arrange an urgent death registration: Urgent death registration out of hours can only take place by appointment between: 09:00 - 12:30pm on Saturdays 09:00 - 11:00am on Sundays
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Section 9 Organ and Tissue Donation Organ Donation Donation of organs from the body can only be considered before death occurs and is only possible when a patient is in certain hospital areas such as the intensive care or critical care unit. Tissue Donation When a relative or friend dies at home or in hospital, it may be possible for them to donate tissues for transplant or research. Donated tissues such as skin, bones, tendons and heart valves can dramatically improve people’s lives and eye donation can restore sight. Most people can be considered for tissue donation after death. There are some age limitations for some tissues and there are some medical exclusions. Donation must usually happen within 24 hours of death (sometimes up to 48 hours) and this is sometimes subject to Coroner’s consent. Check with the Mortuary and Bereavement Office first. The NHS Blood and Transplant Tissue Donation service can be contacted on 0800 432 0559/0300 123 23 23
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Body Donations (To Medical Science) Under the Human Tissue Act (HTA) written consent must be given before death. Consent cannot be given by anyone else after their death. There are a number of establishments across the UK who accept body donations for medical science (see hta.gov.uk for the full list). The family are responsible for contacting the agreed medical school to inform them of the patient’s death as soon as possible so that the arrangements can be made to transfer the body. It is important you inform the Bereavement Office immediately of proposed body donations because there are strict time pressures from the medical school for the body to be accepted. The family will still need to obtain the death certificate and register the death in the normal way beforehand.
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Further help & support for the bereaved CRUSE Bereavement Care Adult 01707 278389 Helpline (Herts area) Children & Young People (Herts area) 01707 264293 Cruse National Helpline 0808 808 1677 www.cruse.org.uk WAY Widowed and Young www.widowedandyoung.org.uk Age UK 0800 169 6565 www.ageuk.org.uk Samaritans 116 123 Citizens Advice Bureau www.citizensadvice.org.uk
03444 111 444
Childhood Bereavement Network 020 7843 6309 www.childhoodbereavementnetwork.org.uk The Compassionate Friends 0345 123 2304 www.tcf.org.uk Grief Encounter 0808 802 0111 www.griefencounter.org.uk (Supporting bereaved children and their families)
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Stand by Me Bereavement Support www.standby.me CHUMS (Bedfordshire) 01525 863924 www.chums.uk.com Mental Health & Emotional Wellbeing Service for Children and Young People
References Trust Policy, Personal Care after Death CP 230 – visit the Knowledge Centre Documents and Policies page and enter in the search section: CARE AFTER DEATH Out of Hours Death Registration SOP (Standard Operating Procedure) – available on the Knowledge Centre in the Documents & Policies section EOL Integrated Care Pathway Booklet – available to view on the Knowledge Centre, search in Documents & Policies
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