From Death’s Door

Aug 30, 2009 | 0 comments

Someone you love has died. Who do you call first? What do you do next? How do you proceed through the next few days?

First, take a deep breath, and exhale. Don’t forget to breathe! Your brain needs plenty of oxygen to cope with the emotions, the decisions to be made, and so many details to work out. Fundamentally, breathing is what sets the living apart from the dead. Don’t hold your breath when faced with great challenges. Breathe.

The countdown to a funeral or memorial service begins when a death is officially pronounced, stating the date, time and cause of death. Nothing can be done with the body until pronouncement takes place, clearing the way for the preparation of a death certificate. After pronouncement, the body can be moved to begin preparing for final disposition.

In an unattended death, when a body is discovered and no one knows how the person died, the first call goes to police, who will involve the Coroners’ Office or the Office of the Medical Investigator or Office of the Medical Examiner (OMI or OME). The coroner may take the body to their facilities, or with family involvement, a funeral home may take it. If the coroner takes the body, they may perform an autopsy, or they may do a search of the person’s medical records to determine a probable cause of death from pre-existing conditions. The circumstances of the situation, state laws, the wishes of relatives, and religious/cultural dictates can also play a role in whether an autopsy is conducted.

In an “expected” death, one that happens more often than not in a hospital, nursing home or hospice setting, a doctor or hospice nurse makes the pronouncement. Note that when a patient dies in a hospital, very often the family will be asked about organ donation, even if the patient was extremely old and you’d think no one would want their organs. This happened with my father-in-law, who was 82 when he died in the hospital, and that’s exactly what my mother-in-law said: “Who would want them?” His organs, and his pacemaker, were left in his body.

The family needs to know in advance if the deceased wants their organs donated. Some states have laws that require hospitals to ask the organ donation question. This is when documents like advance medical directives come in handy. The organ donation question does not come up when a hospice patient dies, because quality can’t be assured, and organ harvesting in a home death setting is problematical.

More to come on steps to take…

A Good Goodbye