Providing care after death
Please be aware - this information is for healthcare professionals
By continuing to provide high-quality care to the patient at the time of death, you can continue to show them respect and protect their dignity.
Being prepared will give you more confidence and help you provide appropriate care after death. Preparing in advance also means knowing what support you can access and how you might deal with your own emotions.
You should check the patient’s care plan and ask the family about the patient’s wishes and if there are any cultural, spiritual or religious customs or preferences that need to be observed.
There are also legal requirements when someone dies, and you need to be aware of your responsibilities in terms of who to call and how to care for the body. Legal requirements may differ depending on whether you are in England, Northern Ireland, Scotland or Wales. Your job role will also affect what you can do after someone dies. For example, health care assistants cannot verify a death.
How do I know that someone has died?
It’s not always clear when the exact moment of death occurs. The person will have lost consciousness and stopped breathing. They will have no pulse.
If family or friends are present, you should tell them sensitively and gently that the person has passed away.
If you think the patient has died, this must be legally verified by a doctor or nurse with the appropriate verification training. This formal verification is a necessary step, even if it is obvious that the person has died.
After the death has been verified, it needs to be certified. Only a doctor can certify death and issue a certificate, and it will usually be the person’s regular GP. They’ll complete a medical certificate of cause of death, if the death was expected and they’re sure it was from natural causes.
They’ll give the person’s family or friend a notice to informant, which will be attached to the medical certificate of cause of death. It explains how to register a death. Sometimes a GP will verify and certify the death at the same time.
If you are not qualified to verify the death, you should call a professional who has received the appropriate training to do so, such as the person’s GP or a district nurse. Calmly explain to any family or friends that this is a legal requirement, and that someone will come as soon as possible. This may take a little while as an expected death is not considered an emergency.
When you speak to the GP or district nurse, you should provide a handover and tell them:
- the time you think the death occurred
- whether you noticed anything unusual before or at the point of death
- how the patient’s relatives are and if they have any questions
You should also make a note of time you called the GP or district nurse.
Be aware that the family may want to have religious support, with a visit from their faith leader.
If an unexpected death occurs, for example following a fall or a suspected suicide, the police and coroner will need to be involved. The GP will determine whether this is necessary with input from the police if needed.
What should I do if I am on my own when the death occurs?
Your employer should have a policy on this, so make sure you know what this is. It should be in line with local NHS procedures. If in doubt, call the person’s GP or out of hours service and the doctor will come to the house as soon as possible.
Should I stay with the body?
You should stay with the body until you can hand over to another professional, such as the district nurse, unless the family asks you to leave. They may want to be alone with their loved one. If there is no carer or family present at the time of death, you must not leave the body alone. If you have another shift to attend, you should contact the person’s GP, district nurse or out of hours service and explain the situation. In the event that another healthcare professional is unable to arrive before you need to leave, you should contact the police using the non-emergency number 101.
Is it OK to touch the body?
This will depend on the family’s preference and your local policy. Some loved ones may find it comforting to wash and dress the body or change the bed themselves. Or they may prefer not to be in the room while this is done. You should follow standard precautions and observe COSSH regulations (eg hand hygiene, appropriate use of protective clothing, appropriate cleaning of the environment) when handling the body and encourage the family to do the same to minimise any risk of infection.
There may also be cultural or religious traditions that need to be followed. This should be in the care plan but make sure you are aware of the family’s wishes at the time.
It is best practice for two people to wash the body as it may feel much heavier after death has occurred. If you are working alone, you may need to ask for assistance from a colleague. A relative may also offer to help you. Always remember to work respectfully, considering the patient’s dignity and privacy.
It is not advisable to remove any equipment such as catheters or syringe drivers unless your local policy allows you to do this – it is best to check in advance. Again, be mindful of cultural or religious beliefs before proceeding.
There are some circumstances where the coroner (or the procurator fiscal in Scotland) needs to be informed of the death, such as a diagnosis of mesothelioma, asbestosis or when a GP has not visited for over two weeks. The GP, district nurse or paramedic verifying will deal with this.
Sometimes, the patient will have expressed a wish to donate their organs and/or tissue in their care plan, and you should tell the person verifying if this is the case. If the patient has expressed a wish to donate their corneas (the clear tissue at the front of the eye), they will need to be retrieved quickly to ensure a better transplant outcome for the person who receives them.
Do I close the eyes if they are open?
It might be possible to close the person's eyes but it's not always possible. You can try to close the eyes by pressing the eyelids downwards with your fingertips, for 30 seconds. If this does not work, you could ask another health or social care professional to help with this. If the family are using a funeral director, they might be able to help with this.
What should I do if the mouth is open?
Do not bind the jaw, as this could cause marks to appear on the body later on. Place one pillow under the head, and a rolled up towel under the jaw to help hold it closed. If this does not work, you could ask another health or social care professional to help with this. If the family are using a funeral director, they might be able to help with this.
How do I deal with leaking body fluids?
It is best to use continence pads placed carefully to manage any leaking.
How can I support family members at this time?
Your professional and caring manner can help loved ones through this difficult experience. Everyone is different and some family members or friends may wish to be there at the time of death. Once the death has been verified by a qualified person, such as the GP or district nurse, you can begin preparing the body (ie washing and dressing) if the family would like you to. Be prepared to take the lead for a while or stay in the background, depending on what the family wants at the time. Even simple tasks like making a cup of tea may help.
If the timing is appropriate, or if the family asks questions about what practical things they need to do next, you can tell them about our information on practical, legal and financial matters after death.
Should I call the funeral director (undertaker)?
You can do this if the family wants you to, after the death has been verified. Don’t recommend a particular funeral director and don’t make any agreements or negotiations with them, as this is a matter for the family. You might find helpful information in the person’s care plan, if these decisions were noted earlier. If there is no family involved, the district nurse or GP will have instructions on what to do. Occasionally people might not use a funeral director. They can contact their local council to talk about what to do next.
Points to remember
- Be prepared. Know what is in your patient’s care plan, and learn about your employer’s policies.
- After your patient has died, continue to show respect, protecting the dignity and privacy of your patient and their family.
- Observe the family’s cultural, spiritual and religious practices.
- Remain in the background, prompting and guiding rather taking over from the family.
- Acknowledge and support the family’s grieving process, by recognising that this may be a traumatic experience for them.
Print this page