Care after death at home

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This week, Kate Clark from Pushing Up the Daisies, shares her experience and tips for care after death at home. Kate has experience of caring for family members at home after death and also brings her expertise as a nurse. She reminds us: “caring for someone at home after death isn’t anything new, rather it’s a return to a traditional approach.”

Who is this information for?

This information is for anyone who is thinking about caring for someone at home after their death. This can be for a few days or until their funeral. Your choices will likely be influenced by your personal beliefs, past experiences, community culture or finances.

“Many people find it useful, healing, intimate, sacred or vital to care for a loved one after death,” says Kate. “Others find it too difficult, or not possible. It is a personal choice.”

Home care

Families nowadays often choose to care for a body at home as part of a home funeral, arranging everything themselves without a funeral director. Even if you choose not to prepare, wash and dress the body and use a funeral director to move the body and make the funeral arrangements, the positive benefits to you of being with someone you care for in a familiar place can be huge. When someone dies outside the home eg in hospital or care, it is still worth thinking about the benefits of taking them home – even for a few days after death or until their funeral. You can make a space to sit with the person and create a sense of ritual by using music and candles. Gathering with others or inviting visitors offers the opportunity for story-telling, sharing thoughts, laughter and tears: all important elements in the grieving process.

A last loving act

If a death is sudden, accidental or unexpected, taking care of the body may feel daunting because of shock, emotional state, or the condition of the body. There may also have been an autopsy, but neither necessarily prevents you from caring for the body. It can be a last loving act.

Handling a dead body is something few people are familiar with, but it can be a natural progression to caring for someone you’ve cared for in life.  It can be confronting – especially with the body of a child or young person –and also incredibly meaningful and beneficial in your loss.

5 first steps

  1. Discuss any worries or fears with the professionals around you.
  2. Find out what is involved.
  3. Consider what you want to do.
  4. Decide whether or not you want to do it. If it is too hard, let it go.
  5. If you decide to go ahead, prepare yourself. Professionals may discourage you since in our present culture it is “normal” for funeral directors to take care of the dead. Remember that there is help and advice available to do it yourself.

Next steps

  1. Wash and dress the person. (You may wish to do this with family/friends or ask a community nurse to help.)
  2. Keep the room and body cool and keep doors and windows closed as much as possible.
  3. Cover the face with a handkerchief or similar cloth with a few drops of cedarwood oil or insect repellant to guard against flies.
  4. Use flowers, music, incense and candles in the room and around the body as a last act of caring.
  5. It is very unlikely that anything will change but you need to check the body every morning and before any visiting to make sure nothing has changed.

Caring for a body

If initially preparing the body seems challenging, it may be useful to ask for help from someone who is familiar with this experience – like a nurse. Preparing the body takes less than an hour and even if you don’t want to  participate in this aspect, you can still benefit greatly from being in a familiar place with the body as you start to get used to the loss of an important person in your life. Being with a “significant other’s” body at home after their death often offers a gentle release and a healthier bereavement.

Frequently Asked Questions

Do I need specialist help ?

No, most definitely not. The main thing is having someone available who is comfortable touching and moving a dead body. The intimacy of this can be immensely healing for some but repulsive for others. It often depends on how involved one was in physical caring during someone’s days. If you have not done any physical, hands-on care then it would be wise to have assistance from someone who has experience in this. You will need two able people for the washing and dressing and six people for moving the body around the home.

Is there a rush to deal with the body?

Undressing, washing and dressing the body is best done before rigor mortis (stiffness) sets in. Rigor is caused by chemical changes in the muscles after death. It causes the limbs to become stiff and difficult to move or manipulate. It begins anywhere between 2 and 6 hours after death and eases again anywhere between 12 and 72 hours after death. So it is best to prepare/wash/dress a body within 2 hours of death. If no-one has left specific instructions about what the person wanted to wear then you can simply dress the body in appropriate clothing or wrap it in fabric.

Will the body smell ?

Any body will naturally decompose over time and create odours but this would very rarely be a problem in less than a week and can usually be easily controlled by keeping the body cool. A body can be kept wherever seems right to you – on a bed, in a special space or in a coffin. Wherever it is, it is most important to keep the body cool firstly by keeping the room as cool as you can. Sometimes people choose to keep a body in a sealed coffin. It is usually safe to keep the body open and in view with cool packs  placed around the body.

What about body fluids ?

Whilst body fluids definitely need to be considered, a few practical steps are all that is needed to deal with them.

  • Push down gently on the abdominal/pelvic area before washing to help empty the bowel or bladder.
  • Cover open wounds with a water proof dressing.
  • Be ready with a cloth at the mouth when turning the body. Sometimes fluid (also called ‘purge’) can drain out of the mouth from the lungs or stomach when turning or moving the body.
  • Keep the head slightly elevated during a vigil, or if you are moving the body.
  • You do not need to place cotton wool in the nasal, throat and/or anal passages, unless it is a cultural requirement.

What if the eyes or mouth don’t close?

Closing the eyes and mouth is optional, but usual. Gently close the eyelids and place an eye pillow or a small bag filled with rice or sand over them for a couple of hours. If the eyes are still not fully closed, you can place a cotton bud tip sized bit of cotton wool underneath the eye lid. If the mouth is open, you can try to close it by placing a rolled up towel or small pillow underneath the chin and tilting the head forward. Alternatively, try looping a scarf underneath the chin, tying it at the top of the head and removing it after a couple of hours. It may be that the eyes and mouth do not stay naturally fully closed. This is not a problem unless it is disturbing to someone, in which case a handkerchief can be placed over the face when needed.

Do we need special equipment to move the body ?

No. You need 6 able bodied people for an average sized body. You can move a body around the house e.g. from a bed to a coffin or special place of rest using a strong sheet or on a board. It is advised to clear the route, have a trial run and make sure one person is in charge. If moving a coffin then most definitely have a trial run without the body and also check that the coffin will fit in any vehicle for transport later.

What happens if something goes wrong ?

The only thing that can “go wrong” is relating to body fluid or odour. This is very unlikely if the body is cooled after death and kept cool.

Sources of help

You might want to contact an advisory service like the Natural Death Centre to talk through your plans or ask for help and advice. Phone them on 01962 712690 or get hold of their excellent Handbook.

If your loved one has died at home then very likely a community nurse will have been visiting and they can assist with any preparations, like removing a catheter.

Contact a local funeral director to advise you or ask them to take care of the body. Depending on the length of time until the funeral sometimes bodies are taken away for several days and perhaps brought back the night before the funeral.

For advice in Scotland contact Pushing Up the Daisies or call the helpline on 07871 775557.

 

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