Care of the Body after Death

Deliver care services using a palliative approach

CHCPA301B

What happens when a person dies

• Hospitals and Aged Care facilities must follow the regulations set out by the NSW Department of Health.

• These are:– NSW Health Policy Directive PD2012_036, Death-

Extinction of Life and the Certification of Death - Assessment

What happens when a person dies

– The Coroners Act 1980 & Amendments 2004,

Section 12A

– The NSW Health Circular 99/57, Infection Control Policy – 15.3.1 Post-mortem care

Assessment of the extinction of life

• This is a clinical assessment process undertaken to establish that life is extinct

• By evaluating cardiac output, neurological signs and respiratory status, a registered medical practitioner or registered nurse can generally establish that life is extinct.

Assessment of the extinction of life

• The medical officer, if not present, must be contacted and asked to attend the facility to certify that the client has died and document the circumstances of the death

• Once the medical officer has assessed the client, a death certificate or cremation certificate is issued.

Notification of client’s demise

• Relatives or the N.O.K. (next of kin) should be notified of the client’s demise

• The funeral parlour must then be notified of the client’s demise and arrangements made with them to attend the facility and remove the body

Notification of client’s demise

• Prior to the funeral parlour arriving the ‘Body Removal Book’ must be completed by the staff ensuring that all client’s valuables, dentures, hearing aids and any other items that need to be transferred with the body are documented

• This book must be signed by both the staff member entering the information and the representative of the funeral parlour

Notification of client’s demise

The cremation or death certificate must also be given to the funeral parlour representative as without this certificate they will not be able to remove the body

A Coroners Case• A death certificate is not issued if the person dies

under the following circumstances:

– A violent or unnatural death

– Sudden death of unknown cause

– Suspicious or unusual circumstances

– The person hasn’t seen a doctor for 3 months

A Coroner’s Case

– Within 24 hours after an anaesthetic

– Within a year and a day after an accident/operation

– If the person dies in a mental health facility

– If the person dies in a facility for person’s with a disability

Nursing Care - Last Offices

Wash and groom the client

Close the eyes using wet cotton wool if required to keep eyes closed

Close the mouth. A rolled up towel can be used to support the jaw in the closed position

Nursing Care - Last Offices Dress in a shroud or clothing of choice

Make the bed with clean linen

Straighten the body and place arms by their side

Remove all equipment, feeding tubes, catheters etc. & tidy the room

Nursing Care - Last Offices

If there is any drainage of urine, faeces or wound exudate an incontinence pad can be used

Ensure privacy & dignity is maintained at all times through out the procedure

Pack the clients belongings in a bag for the relatives to collect

Nursing Care – Last Offices

The wet cotton wool and the roll towel should be removed before viewing by the relatives/N.O.K.

Two identification labels are place on the body – one on the ankle and one on the wrist

The deceased is placed in a body bag, which is also labelled with their name

Nursing Care – Last Offices

If the deceased was known to have an infectious disease then a label stating this must be firmly attached to the outside of the body bag to alert staff as well as funeral parlour personnel

The deceased can then be transferred to the mortuary or left in their room if appropriate

Religious Practices

Vary greatly in some instances and must always be strictly adhered to, as this is showing respect to the deceased and their family/N.O.K.

Standard Precautions

All blood and body fluids are considered contaminated

Wear gloves and protective clothing at all times

The Nurses Responsibility to Family and Next of Kin

Maintain a quiet and respectful attitude at all times

Provide support and privacy for the family/ N.O.K. to grieve

Allow family/ N.O.K. to express their grief

The Nurses Responsibility to Family and Next of Kin

Allow family/ N.O.K. time with the deceased

Allow family/ N.O.K. to assist with care of the deceased if desired

Allow family/ N.O.K. to discuss feelings

What to do in a Coroners Case

The police are notified and will attend rather than the medical officer

NOTHING

All tubes, drains, airways, feeding tubes, catheters etc. are left institu

What to do in a Coroner’s Case

All sharps are left firmly taped and secured to reduce the risk of injury or leakage

The body is not washed, but is left in the position it was found in - e.g. sitting in a chair

Statements will be taken by the police from every staff member on duty in the section at the time of death

Nurses Responsibility to Other Client’s

Close all doors when the funeral parlour arrives and leave closed until the body has been removed

Provide support and sharing of feelings

Allow them to move out of the immediate vicinity if they wish

Nurses Responsibility to Other Staff

Guard your comments

Support other staff in what ever way possible:

- Allow time out for staff who were involved with

the deceased

- Allow staff to express their feelings

- Encourage staff to seek counselling if required