Information about practical and emotional bereavement support
Powys Teaching Health Board would like to offer you and your family our deepest sympathy at this time.
This booklet aims to guide you through the formalities to which you must attend following the death of someone close to you.
People close to you may offer valuable practical support and talking to them can help you process the emotions of grief. However, many people need additional support during this difficult time. Details of support services are outlined in this booklet.
Reference: Powys Teaching Health Board Bereavement Booklet
Bereavement, grief and loss can cause many different symptoms and they affect people in different ways. There is no right or wrong way to feel.
As well as bereavement, there are other types of loss such as the end of a relationship or losing a job or home.
Some of the most common symptoms include:
• shock and numbness – this is usually the first reaction to loss, and people often talk about "being in a daze"
• overwhelming sadness, with lots of crying, tiredness or exhaustion
• anger – towards the person you've lost or the reason for your loss
• guilt – for example, guilt about feeling angry, about something you said or did not say, or not being able to stop your loved one dying
These feelings may not be there all the time and powerful feelings may appear unexpectedly. It's not always easy to recognise when bereavement, grief or loss are the reason you're acting or feeling differently.
Direct to Director
If your relative/friend dies in hospital your chosen funeral director will collect their body from the ward where they died. The funeral director will store the body on your behalf.
If a funeral director has not been chosen, then the Health Board will choose an undertaker from the agreed stand-by list until you are able to confirm your chosen funeral director.
If you wish to pay your respects, your funeral director will be able to arrange for you to see your loved one at the funeral home’s chapel.
The Role of the Medical Examiner
In line with government requirements, Powys Teaching Health Board is working closely with the Medical Examiner Service.
The medical examiner is a senior doctor not involved in the care of the patient, who provides an independent scrutiny of each death. This service allows the cause of death to be more accurately identified, and the circumstances surrounding the death to be more objectively assessed.
The medical examiner has a team of medical examiner officers, who will contact you in the days following the death of your loved one.
They will discuss with you the cause of death, and listen to your views on the care provided. They can answer any questions you may have about the cause of death and the circumstances of the death.
Typically the Medical Examiner’s scrutiny process will take between 24 and 72 hours but it will not delay registration beyond any legal requirements (currently 5 calendar days) and will not delay the release of a body where religious or cultural beliefs require it.
In a small minority of cases it may not be possible to meet this timeframe but every effort will be made to ensure that any delay is kept as short as possible and that the requirements of the faith and the bereaved are met.
Once this discussion has taken place, the medical examiner will liaise with the doctor to issue the Medical Certificate of Cause of Death to the registrar, and you will be able to make an appointment to register the death.
The Role of the Coroner
The coroner is an independent officer with the statutory responsibility for the legal investigation of some categories of deaths. The coroner is either a doctor or a lawyer by background, and is supported by a team of coroner’s officers, who investigate any deaths which are referred to the coroner’s office.
The coroner is usually involved with any deaths that are:
• Sudden or unexpected deaths, without regard to age;
• Where death involved violence, trauma, physical injury or was caused by an accident;
• Where the cause of death is unknown, and the doctor is not able to issue a Medical Certificate of Cause of Death;
• Where death has occurred during or after surgery, treatment or medical procedure;
This list is not exhaustive, and there are also many other reasons why a doctor/medical examiner may refer a death to the coroner.
Once the coroner has received the referral, one of the coroner’s officers will contact you within a day or two to discuss the referral and listen to any views you may have.
If the coroner is satisfied that there is no investigation needed into your loved one’s death, they will advise the doctor/medical examiner to proceed with writing the Medical Certificate of Cause of Death. This means you can proceed with registration once the certificate has been completed.
Sometimes, the coroner may feel that further investigation is needed, and this investigation may include an inquest. When this happens, the doctor/medical examiner will no longer need to issue the Medical Certificate of Cause of Death and the Coroner’s Office will take over all aspects of paperwork relating to the death.
First Steps
If your relative/friend dies in a Powys Teaching Health Board Hospital, the Medical Certificate of Cause of Death is usually completed on the ward. Please speak to the ward team or the doctor and they will be able to advise on the progress of the paperwork.
If they die at home or in a residential/care home, their GP, depending on the circumstances, will complete the Medical Certificate of Cause of Death. If you know their GP, you may be able to contact them for more information.
If their death was sudden, unexpected or if your loved one has not been seen recently by their GP, the coroner’s office will be contacted for advice.
Their GP or the police (if in attendance) may be able to advise you on this.
Following the death of a loved one there are certain formalities to which you must attend, the most important things you need to consider first are:
• Registering the death
• Choosing a Funeral Director
• Deciding whether there is to be a burial or cremation
Registering a Death
The death must be registered at the Office of the Registrar of Birth and Deaths nearest to where the person died. As soon as you have been informed that a Medical Certificate of Cause of Death (MCCD) has been sent to the Registrar, arrangements can be made to register the death. A death must be registered within five working days following the death unless referred to the Coroner.
It is usually a relative that registers the death. If is not possible for a relative to register the death the Registrar can give you advice on who may register.
Before contacting the Registrar, it will be helpful to have the following ready:
1. The date and place of death
2. The full name of the deceased (maiden/former name if applicable)
3. The deceased’s date and place of birth
4. The deceased’s occupation and, in cases where the deceased is female, the name and occupation of her husband
5. The deceased’s usual address
6. Whether the deceased is in receipt of a pension or allowance from public funds
7. If the deceased was married, the date of birth of the surviving widow or widower
If you have them, it would be useful to take with you their Birth Certificate, Marriage or Civil Partnership Certificate and NHS Medical Card, or recent hospital letter with their NHS number.
You may also need to take with you your own identification documents if you have them, such as:
• Passport/Driving Licence/Birth Certificate
• Proof of Address (a utility bill or bank statement)
Once you have registered the death you will be issued with two certificates. These will be sent to you by first class post.
1. Death Certificate. The Registrar will issue you with as many death certificates as you require although all copies are chargeable. Photocopies are not usually acceptable for matters such as banking, insurance etc.
2. Certificate of registration of death (white certificate) – for social security purposes only. Complete the questions on the back of the form and send it to the relevant social security or pension office.
3. Green Form – Certificate of Burial/Cremation. This form needs to be given to the Funeral Director.
There is a fee for copies of the certificate and the Registrar will advise how many copies you need. You will not be given a death certificate as a matter of course by the registrar. If you require one you can purchase as many as you need.
All offices are appointment only. Please contact the Registration Service on 01597 827468 or registrar@powys.gov.uk to arrange an appointment
Items that may need returning
Following the death of an individual, certain items will need to be returned to the issuer. These may include passport, National Insurance card, library cards, season tickets, driving licence, NHS loaned equipment, order books/giro cheques and pension books. When doing this please remember to make a note of any identifiable numbers for future reference. Unused medication should be returned to a pharmacy, and should not be flushed down the sink or toilet.
Stop Mail
If someone 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 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.
Financial help
Financial help may be required and it is possible that you may qualify for help from the state.
For further information see www.gov.uk/funeral-payments
Tell Us Once Service
Tell Us Once is a service run by the Department for Work and Pensions (DWP) and is a service that lets you report a death to most government organisations in one go. This includes the DVLA, Passport Office, all Local Authority services, all DWP services, such as State Pensions or Income Support, and any HMRC (His Majesty’s Revenue & Customs) services.
At the time of the registration, the registrar can provide you with a unique reference number which will be used to notify various government and local authority departments of the death. More information will be given to you by the registrar at your appointment.
You can either phone the ‘Tell Us Once’ service or complete a form online, but this must be done within 28 days of getting your unique reference number from the registrar.
To use this service, you will need on hand:
• the deceased’s National Insurance number
• details of any benefits or services they may have been receiving
• their driving licence
• their passport
Information and contact details for the ‘Tell Us Once’ service are included in this pack.
After the funeral
Settling the deceased person’s estate can be confusing, time consuming and distressing. If you have been named as executor in a Will it is your responsibility to see that the person’s wishes, as you understand them, are carried out. This will include payment of funeral expenses, debts and taxes, as well as the disposal of their possessions and other assets.
If someone dies without leaving a valid Will it is known as dying intestate. It is necessary to obtain a ‘Grant of letters of administration’ from the Probate Registry in order to administer the estate. The Probate registry of Wales can be contact on:
Further advice and information can be obtained through the Citizens Advice Bureau www.citizensadvice.org.uk
Grieving and Support
Death can be very distressing and grieving is a normal human response to loss or death. Grief can affect people in many different ways, and people feel many different things. It is a unique and personal experience and there is no right or wrong way to feel when you are grieving.
This can often seem overwhelming at times while you are grieving, or at its opposite you may find that your grief may not fully ‘hit’ you until after all the practicalities are done.
Emotions tied to grief often change over time. But if you find there’s little or no change, and these feelings affect your daily life, you might be experiencing complicated grief.
If these feelings continue for over 6 months, seeking advice from a healthcare professional or bereavement counsellor may be beneficial.
Whether you need support early on in your bereavement or later down the line, you will find organisations that can support you listed on the next few pages under the ‘Further Support’ pages.
Further Support
Age UK
Offering information and advice on money, care, health and housing. Tel: 0800 678 1602
Age Cymru
Tel: 02920 431555
Website: www.ageuk.org.uk
Citizens Advice Line
Offering a range of advice on benefits, debt, money, housing and family.
Cruse Bereavement Care
Offering support, advice to adults, children, and young people when someone dies.
Tel: 0808 808 1677 (National Helpline)
Website: www.cruse.org.uk
Email: helpline@cruse.org.uk
Government Information
Helpful information can be found on the government website. Website: www.gov.uk
Marie Curie
Information and support relating to terminal illness and when someone dies.
Works to support anyone affected by the death of a baby.
Tel: 0808 164 3332
Email: helpline@sands.org.uk
Support After Suicide Partnership
Website: www.supportaftersuicide.org.uk/
Survivors of Bereavement by Suicide
Tel: 0300 111 5065
Email: support@uksobs.org
Terrence Higgins Trust (HIV Services & Support)
Tel: 0808 802 1221
Website: www.tht.org.uk
The Compassionate Friends
Offering support to bereaved parents and families after the death of a child of any age from any cause.
Tel: 0345 120 3785
Email: info@tcf.org.uk
The DPJ Foundation
Website: www.thedpjfoundation.co.uk
Victim Support (help after crime)
Tel: 0808 168 9111
Website:www.victimsupport.org.uk
Winston’s Wish
Charity offering support and advice for bereaved children.
Tel: 0808 802 0021
Website: www.winstonswish.org.uk
2Wish
Provides bereavement support for families who have died suddenly and traumatically lost a child or young adult aged 25 years and under.
Tel: 01443 853125
It helps to talk
We need to express our pain and grief for us to heal. You may find you need to talk about the events leading up to your loved one’s death, and about the death itself, many times. This is quite natural, and one of the ways we gradually make sense of what has happened. It is good to talk to family.
Avoid rushing into things
In the early months of grief our emotions may fluctuate widely. Nothings seems important, decision-making may be very difficult. It is not a good idea to rush into big decisions such as the disposing of our loved one’s possessions, the sale of one’s home, a change of career direction etc., until the feelings of grief and loss are less intense. If you give yourself time you are less likely to make a decision you may later regret.
Returning to work
When you go back to work. Try to find ways of supporting yourself. You may like a colleague to accompany you into work on the first day. Let people know whether or not you would like them to talk about what has happened. You can always change your mind once you have been back a while. If possible, return to work gradually, perhaps doing shorter hours or just a few days for the first couple of weeks.
Remember you will not yet be able to work to your usual capacity. Be patient with yourself. And make sure that there are times built into the day when you can be away from your desk to have some peace or the opportunity for a few tears.
Providing feedback, raising concerns and/or making a complaint
Providing feedback: Included in your bereavement pack is a questionnaire. We would like to hear your thoughts about the care provided to your loved one. Receiving feedback from families helps us to understand the things we are doing right and need to continue; and the things we need to improve upon. Please complete the questionnaire and return to:
Bereavement Service
The Library
Bronllys Hospital
Brecon
Powys
LD3 0LU
Alternatively, please scan the QR code above which will take you to an online questionnaire.
Raising concerns: It is also very important to us that you feel able to ask any questions or raise any concerns regarding the care your loved one received. In the first instance, the team that cared for your loved one should be able to respond to these.
Making a complaint: We hope that we will be able to respond to any questions or concerns that you have, Additionally you can raise concerns as a complaint, at any point. If you do this we will ensure that we respond, in writing to the issues you have raised.
To raise a complaint, please email the Concerns inbox: Concerns.qualityandsafety.POW@wales.nhs.uk
Funeral Directors
T R Ellis & Sons
Glanrafon, Llanfyllin SY22 5HU 01691 648358
I Jackson & Sons
The Old Chapel, Narrow Street, Llanfyllin, Powys SY22 5BU 01691 648243
Aubrey Kirkham
The Elms, Domgay Road, Four Crosses, Meifod SY22 6SL 01691 839292
If you require any further assistance or information please contact the Bereavement Service’s email address
PTHB.BereavementService@wales.nhs.uk
“Grief can’t be shared. Everyone carries it alone; Their own burden in their own way.”
Anne Morrow Lindbergh
The Health Board 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 Health Board 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.
We understand how expensive funerals can be and we specialise in providing a valued service.
In recent years families have increasingly chosen more straightforward options. We can connect you with a local partner who can o er a simple and digni ed cremation from £990.00, as well as more traditional funerals where we can add personal touches to re ect your wishes.
