Care After Death guidance

The aim of this guidance is to provide a framework for the timely verification of expected adult deaths by experienced (assessed as competent), registered nurses (RN).

It is anticipated that local areas will develop their policies based on the guidance, but sensitised to the local area, enabling staff to care appropriately for the deceased, supporting and minimising distress for families and carers at any time of the day, night, or week. This guidance has been developed in line with the person and family centred care recommended in national documents.

Timely verification – within one hour in a hospital setting and within four hours in a community setting – is supportive to bereaved families, and is necessary prior to the deceased being moved to either the mortuary or funeral directors, We recognise that this timeframe may not be achievable under current sustained COVID-19 infection circumstances, in these cases it may be appropriate to offer guidance to families regarding the positioning of the deceased person and the maintenance of a cool environment.

Families should be advised that there might be a difference between the time of the last breath and the official time of death.

This guidance ensures that the death is dealt with:

• in line with the law and coroner requirements (see Appendix 1)
• in a timely, sensitive, and caring manner
• respecting the dignity, religious and cultural needs of the patient and family members as far as is practicable
• ensuring the health and safety of others, e.g. from infectious illness including COVID-19, radioactive implants, and implantable devices

A competency assessment tool (see Appendix 2) accompanies this guidance for RNs to demonstrate their practical skills, knowledge and understanding for verifying an expected adult death. RNs already competent in verification of an expected adult death are not expected to repeat the competency assessment, rather to familiarise themselves with the changes within this guidance and adopt the changes into their practice.

There has been an e-learning module for the Registered Nurse Verification of Expected Adult Death developed by e-Learning for Health and this may provide a useful resource. Local areas may want to adopt a pragmatic approach to training. If the RN does not feel confident after completing training, they could undertake the verification of death with the remote support and guidance of a more experienced colleague.

This guidance may be used to inform training for other registered healthcare professionals who are  regulated by a professional body who, under statutory regulation, are recognised by the Professional Standards Authority.