What do you do when someone dies at home?

by Ruth Nichol / 27 February, 2019
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When the death of a friend or family member is imminent, a little planning will limit the potential panic of the situation.

When Barbara McCulloch’s mother, Margaret, died 10 days before Christmas, she and her siblings knew what they had to do next.

They’d looked it up online when it became clear that Margaret, who was 85 and living with McCulloch’s sister, had only a short time to live. Soon after their mother died – peacefully and at home, as they had hoped – they called her GP, who arrived at the house a short time later and issued what’s known as a medical certificate of cause of death.

They also contacted the funeral director they’d chosen earlier, who promised someone would come and collect their mother’s body before they went to bed that night – even though it was a Saturday. They didn’t want their sister, who had been sharing a bedroom with their mother to provide the level of care she needed, waking up with their mother’s body still in her room.

“Everyone will have a different comfort level about that, but I know I couldn’t deal with it,” says McCulloch. “You only find out how you feel when you’re put in that position.”

It’s a position fewer and fewer people find themselves in. Although most elderly people say they want to see out their time at home, they are much more likely to die in hospital or in rest-home care. That means the practical steps that have to be taken after someone dies – getting a death certificate and arranging for the body to be removed – are dealt with by professionals.

Figures collated by Joanna Broad and her colleagues at the University of Auckland’s department of geriatric medicine show that slightly more than a fifth of over-65-year-olds died at home in 2015, down from more than a quarter in 1998. According to a report published by the Palliative Care Council in 2014, that figure is even lower for over-85s, of whom 13.4% died in a private residence between 2000 and 2010.

The longer we live, the more likely we are to spend our final days in care. That means the proportion of people who die at home will keep falling.

“With life expectancy continuing to rise, a greater proportion of deaths will be of the very old, so I’d expect this trend to continue for a few decades yet,” says Broad.

As Gary Taylor, president of the Funeral Directors Association of New Zealand, points out, dying at home used to be the norm. “We were much more familiar with death because it happened around us, rather than at arm’s length and almost sanitised.”

These days, many people have never seen a dead body before, and they may feel frightened by the thought of having one in their house. However, Taylor says, spending time at home with the deceased can be very therapeutic.

“People often thank us for not rushing out in the middle of the night,” he says. “They say things like, ‘We’re really pleased we didn’t let Dad go last night because the time between when he died and now have been really precious moments.’”

There are some things you need to do reasonably quickly if someone dies at home, such as contact their doctor so they can issue a medical certificate of cause of death. This can also be done by a nurse practitioner.

If the death is expected, the certificate can be issued without seeing the body – though many doctors will come to the house if possible. However, unexpected deaths (including those caused by accidents) must be reported to the police, either by a family member or by the doctor. The police will then take over and may refer the death to the coroner for further investigation.

A doctor or nurse practitioner must also view the body and verify a person’s identify before they can be cremated. This doesn’t have to be done immediately – it can happen at the funeral home.

In fact, says Taylor, there’s no hurry to do anything – particularly if someone dies in the middle of the night.

“There’s nothing that says the moment someone dies you have to be on the phone. If they’re in bed, or somewhere you feel comfortable about them being, just close their eyes if you feel capable of that and deal with the situation in the morning.”

This article was first published in the February 2, 2019 issue of the New Zealand Listener.

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