The death of a loved one can be a very stressful, emotional and confusing time. To try and make this difficult time easier we have created this guide, to explain the processes that occur and what to expect, after a loved one dies.
If the patient has been previously fit and well, and the doctor was not expecting the patient to die, the death would be described as unexpected.
In these circumstances the police and ambulance must be called.
They will take information from those present and those that know the patient. The body of the patient will then be taken to the mortuary (our local mortuary is at Leighton Hospital, however if there is no room there, then sometimes the body will be taken to an alternative mortuary).
The coroner will contact the patients doctor and family the next working day to gather more information and if there is no immediate reason why the patient may have died, they will perform a post-mortem.
A post-mortem is an examination of the body: internal and external, including blood tests and toxin tests that will try to determine the cause of death.The coroner will issue the death certificate once the post-mortem is completed.
If a patient has had deteriorating health for sometime and the doctor feels that no further treatment will resolve the ill health; the doctor may discuss with patient (and if appropriate their family) their declining health and explain that the patient is approaching the end of their life.
In these circumstances a DNAR (do not resuscitate) order will be signed by the doctor. The doctor will leave a purple DNAR with the patient (or care home).
The Out of Hours (OOH) and ambulance service will be informed by the GP of the DNAR. When the patient dies with a DNAR in place (unless there are any suspicious circumstances) this would be described as an ‘expected death.’
When a patient dies of an expected death, before moving the deceased, the death will need to be
confirmed. This is often done by a GP (either the patient’s GP or an out of hours GP, depending on availability). However it can be done by anybody trained to confirm death, it does not legally have to be a doctor; a carer/nurse in a home or a district nurse, if trained, can do this.
Normally who will confirm death will have been discussed with the family in advance of a death.
If you are not sure what to do please ring 01606 544555 in working hours or 111 out of hours.
Once death is confirmed the patient’s body can then be moved to a funeral directors of the family’s choice. (Please see below.)
A death certificate (a medical certificate with cause of death) will be produced either by the deceased’s usual GP or the coroner (if there has been a post mortem).
In the case of an expected death the family should contact the Danebridge secretary’s on 01606 544580 who will discuss with the deceased’s GP and arrange the Death Certificate.
Occasionally the GP may need to discuss the death with the coroner first, this may create a slight delay in the preparation of the death certificate.
Registering a death:Deaths should be registered by a family member (though see link below for other people that can register the death) within 5 days of the patient dying, however if the coroner is involved this may take longer.
More information is available at www.cheshirewestandchester.gov.uk/residents/births-deathsand-marriage/register-a-death.aspx
The local register is located at:The Northwich Customer Services, 1 The Arcade, Northwich. Tel No: 0300 123 8123. Currently deaths can be registered on Wednesday and Thursday by appointment only.
Burial or Cremation:The funeral director should discuss with you, your wishes for the funeral of the deceased including if the deceased is for a burial or cremation. If a cremation is planned then the GP or Coroner who issued the death certificate will need to complete a cremation form. A second doctor will also need to complete the second part of the cremation form. This is a legal requirement to ensure there are no suspicious circumstances surrounding the death prior to cremation. To elicit this, the doctors may need to talk to the carers or family to ensure there are no concerns surrounding your loved one’s death.
Before completing the cremation form it is a legal requirement that the doctors view the deceased’s body. If the body has been taken to a funeral directors out of the GP Practices area it is usual practice to have the funeral director bring the deceased’s body to a local funeral directors for the completion of the cremation form. Please be aware the expense of this maybe passed from the funeral director to the family.
Getting help with bereavement:We know that losing a loved one is incredible upsetting and stressful. Often the family may find it very difficult to cope in the immediate days, weeks and months following the death. Your GP can support you in times of bereavement, with time off work if needed or supporting you with distress of grief.
We have included some websites below for further advice and support but please contact us if you need any more assistance.
Government Website: After Death: www.gov.uk/after-a-death
Bereavement Register- to stop unwanted mail after death: www.thebereavementregister.org.uk/
National Association of Funeral Directors – www.naftd.org.uk
National Society of Allied and Independent Funeral Directors: – www.saif.ork.uk
The Samaritans – www.samaritans.org
Sue Ryder Online Community – terminal illness and bereavement support forum – https://support.sueryder.org/community
Cruse Bereavement Services – www.crusebereavementcare.org.uk
Cruse Bereavement Services for young people – www.rd4u.org.uk
Child Bereavement UK – www.childbereavement.org.uk
The Child Death helpline – www.childdeathhelpline.org.uk
Winston’s Wish – www.winstonswish.org.uk