Chapter 28: End of life care
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Post‐procedural considerations
Immediate care
Relatives’ time with patient after death
As there is a limit to the time a patient should remain in the heat of a ward, the senior nurse will have to exercise discretion over when to send the patient to the mortuary. This will vary according to family circumstances (there could be a short delay in a relative travelling to the ward/area) and the ward situation (side rooms are obviously easier for the family/other patients).
Viewing the patient in the viewing room
Families may wish to view the patient in the viewing room again (Figure 28.3). It is important to ensure that the patient is in a presentable state before taking the family to see them.
Spiritual, emotional and bereavement support
The bereaved family may find it difficult to comprehend the death of their family member and it can take great sensitivity and skill to support them at this time. Explaining all procedures as fully as possible can help understanding of the practices at the end of life. Offering bereavement care services may be useful to families for that difficult period immediately after death and in the future. National services such as Cruse (www.cruse.org.uk) can be useful if local services are not available.
Relatives may express extreme distress; this is a difficult situation to handle and other family members are likely to be of most comfort and support at this point. The family member may wish for their GP to be contacted.
Maintain a high degree of sensitivity when outlining the process after a patient has died because families frequently have to attend the hospital in the very near future in order to collect the documentation for registering the death.
Education of patient and relevant others
Helping the family to understand procedures after death is the role of many people in hospital but primarily it falls upon those who first meet with the family after their relative has died. Information for relatives/friends on what to do after someone dies can be found at www.gov.uk/after‐a‐death/
If the family states that they feel the death was unnatural or that it was interfered with, we have a responsibility to explore these feelings and even outline their legal entitlement to a post mortem.
- Prepare the family for what they might see.
- Invite the family into the bed space/room.
- Accompany the family but respect their need for privacy should they require it.
- Anticipate questions.
- Offer the family the opportunity to discuss care (at that time or in the future).
- Offer to contact other relatives on behalf of the family.
- Advise about the bereavement support services that can be accessed. Arrange an appointment if requested.
- Provide them with a point of contact with the hospital.
Some families may wish for a memento of the patient, such as a lock of hair. Try to anticipate and accommodate these wishes as much as possible.
