June 19, 2007 9:09 PM   Subscribe

what do you do, or who do you call, when someone dies at home? not suddenly or unexpectedly, nothing you can do to prevent it. they're just sick and you know it's coming.
posted by andywolf to Health & Fitness (39 answers total) 9 users marked this as a favorite
You may want to call your local funeral home beforehand, I'm sure they know exactly what you need to do.

I'm sorry if this is something you will needing to do.
posted by bottlebrushtree at 9:15 PM on June 19, 2007

The funeral home. They get the cogs going for you. In my experience, from phone call to people showing up was less than 20 minutes. It's their job to swoop in and be organizational and calm and they're very good at it. If you haven't already found someplace, that would be top on my list of things to do.
posted by dness2 at 9:18 PM on June 19, 2007

Yes, funeral home. The funeral director will arrange removal of the body, etc. I have gone through this. They asked if I wanted to help with the removal, which I did, and which I considered an honor.

Sorry you are faced with this.
posted by The Deej at 9:24 PM on June 19, 2007

If you have access to a hospice, they will provide information on funeral homes in your area as well as make the phone calls and handle the arrangements the day of.

Of course, the real benefit of hospice is the end-of-life care for the patient - so if this is a situation where the person could benefit from pain management, counselling, in-home care, you should look for a hospice in your area. They will help ease the burden on both the patient and caregivers.
posted by annathea at 9:26 PM on June 19, 2007

The funeral home will also tell you whether you have to inform the authorities directly or whether (and this is the case in most of the UK, Canada, and the US) they can do it for you.
posted by watsondog at 9:27 PM on June 19, 2007

You make can arrangements with the funeral home, but you call 911. Then the paramedics show up, declare the subject dead, and they'll call the funeral home when you give them the info.

If it's a conscious but dying person, get a Do Not Resuscitate order signed right now (or you have the person with Power of Attorney present). Like now. Super important. I know from experience that you have to do this now if you haven't.

My apologies if this isn't just "in theory". It gets better (very slowly) after s/he finally goes.
posted by Mayor Curley at 9:29 PM on June 19, 2007

When my mother died, a doctor who was a close friend of the family, came out and confirmed the death. After that we called the funeral home. As dness2 said, they came quite promptly.
posted by metahawk at 9:29 PM on June 19, 2007

A google search provided a number of Canadian Gov sites with this (or similar) booklet about preparing for a death at home. While the phone numbers would be of little help if you are not in Canada, I believe the information provided will be useful.

The main consensus seems to be
- Prepare for the situation by contacting the funeral home and the person's doctor before hand.
- Do not call emergency services as police & EMS may be required to treat the death as suspicious, even if everyone involved knew of it was unavoidable.
- Contact the person's primary doctor
- Contact the funeral home that has been charged with handling the person's arrangements.

The best way to handle the situation is to contact your doctor and the funeral home. They will know exactly how to handle this from all the angles (medically, legally, etc) They have dealt with this before and have been special trained to do so. Rely on their expertise during this time.
posted by aristan at 9:40 PM on June 19, 2007

That's exactly what happened with my dad, who died of cancer. My mom had already made arrangements with a funeral home, and there was a 24-hour number for her to call. She got up to give him a pain shot at 3AM, found that he was no longer breathing, and called them. They came within an hour.
posted by Steven C. Den Beste at 9:51 PM on June 19, 2007

when a man of distinction and achievement dies in pacific palisades, california, the mortuary sends out two vans to pick him up. my dad went away in one of them; over a decade later i still wonder what the other one was for.
posted by bruce at 10:06 PM on June 19, 2007 [3 favorites]

Don't people have to be declared dead before the funeral home can take over? This is usually the duty of a coroner or doctor. For example, at least at one point locally, if an ambulance team went to (say) a car accident and found someone obviously dead, they still had to scramble to get him to the hospital since they had no official or legal credentials to make the call on their own. Maybe it's a regional thing.
posted by RavinDave at 10:19 PM on June 19, 2007

I'm not the OP, so I apologize if it's poor etiquette to 'answer' by asking a question, but I wonder the same thing as RavinDave: how can funeral homes cart people off without EMTs/doctors/hospitals getting involved? I find it hard to believe that notifying the authorities isn't required first.

I'd speculate that funeral homes have the authority to pronounce people dead. Is this the case?
posted by fogster at 11:14 PM on June 19, 2007

i can only speak for australia-land.... but i'm assuming it's similar everywhere...

here you need to call a doctor first. your family doctor should do the death certificate and then the undertakers will, um, undertake.
posted by taff at 12:39 AM on June 20, 2007

Response by poster: thanks everyone, ravindave's question is exactly why i asked. i worked on an ambulance in the past and we were told you needed someone to declare the person was dead. maybe i should've been a little clearer.
posted by andywolf at 12:40 AM on June 20, 2007

Maybe look up the number of the local coroner and pose the question to them; they can probably tell you better than anyone. Funeral homes will also be likely to know, of course.
posted by SuperNova at 12:46 AM on June 20, 2007

My first thought was "a doctor", but the funeral home will surely have someone they can call on to take care of that.
posted by robcorr at 12:53 AM on June 20, 2007

I just keep thinking that having a funeral home merely pick someone up is open to dire abuse. "Hello? Funeral home? My really, really rich and abusive husband evidently had a heart attack. Can you pick him up and take him to the crematorium? Fast?"
posted by RavinDave at 1:03 AM on June 20, 2007

Some hospice nurses can declare death. Depending on the state you are in, (USA), you can handle all death arrangements without a funeral business.
posted by flummox at 3:22 AM on June 20, 2007

Anecdotal: in the 1980's in Texas (though I'm pretty sure it's still this way today), someone had to officially pronounce the death, even in the case of end stage of a terminal illness. So, in our situation, much like metahawk's, first call was to the doctor, second was to the funeral home, and the former authorized the latter by phone. Both of those parties were expecting the call.

(This particular situation was slightly unusual, as the county ME was a family friend, so he issued and signed the death certificate and filed it -- but I was always under the impression that any licensed medical doctor on the scene could have performed the task)

Death certificates signed by a physician are required in most Western countries but I would guess the finer details of the process are regionally regulated.
posted by pineapple at 4:27 AM on June 20, 2007

It's been my experience that you should contact a local hospice beforehand or at least have "do not rescuscitate" paperwork filed with the local police department beforehand. When the individual passes, you call the hospice, who will contact your local police and report a hospice death. This means the hospice can declare time of death.

If a person passes at home with paperwork on file, a police officer is dispatched and they will request a time of death from a hospital.

If a person passes at home without paperwork on file, you should call 911 when it happens and report the death (although a funeral home may handle this for you). This will mean an ambulance visit to the home (even if they don't pick up the body) that you will be billed for, which is why it's a good idea to set this up beforehand.
posted by disclaimer at 4:32 AM on June 20, 2007

Sorry, my second paragraph is unclear: If a person passes at home with no hospice care AND with DNR paperwork on file...
posted by disclaimer at 4:33 AM on June 20, 2007

Is there a procedure for this scenario that cuts the multi-thousand-dollar bill from the funeral home out of the picture? When the deceased doesn't have friends or family, for instance. Or has expressed a wish to have no service or showing?
posted by Thorzdad at 4:49 AM on June 20, 2007

the funeral home will tell you what to do. if you don't have one yet, call the police 24-hour non-emergency line (or the nearest precinct's front desk). they'll get you sorted out. you can call 911, too.

if you have time, you might also want to consult with the individual's doctor about the procedure. they will probably know.
posted by thinkingwoman at 5:20 AM on June 20, 2007

This is a really interesting and moving documentary about dying at home - I saw it a couple of years ago, but remember it very favorably. It especially deals with Thorzdad's question about circumventing the funeral Home industry/machine. I got it through Netflix.
posted by nnk at 6:03 AM on June 20, 2007

Best answer: Is there a procedure for this scenario that cuts the multi-thousand-dollar bill from the funeral home out of the picture? When the deceased doesn't have friends or family, for instance. Or has expressed a wish to have no service or showing?

Certainly. There's been a lot of good info in this thread.

To summarize:
1. Get papers in order.
2. Contact doctor.
3. Arrange for end-of-life hospice care.
4. Contact funeral home.

If someone has no friends or family and has expressed an interest in no service, usually when they die, they'll be turned over to a coroner's office and buried in a pauper's grave. Many cemeteries provide a space for those unable to pay. Incidentally, these bodies are almost NEVER cremated, because long-lost relatives have a habit of turning up and demanding the body be buried elsewhere.

While there are certain places you can donate your body: medical schools, body farms, etc., it is often difficult to get on the waiting list for these, so apply soon. And, take into account, you will most likely be refused if you are not in good physical condition. (Ah, the paradox).

Here's what your funeral home will do for you:
1. Remove the body
2. File for your death certificate.
3. Prepare the body for viewing or cremation
4. The day after the death occurs, you'll have an arrangement conference with the funeral home to discuss your options.
5. File your obituary for you.
6. Process any life insurance you have.
7. Contact a minister, if needed (even if you don't have a minister, but would like a Christian burial, most funeral homes have a list of "ministers for hire" who can give you a dignified send-off)
8. Conduct the services
9. Transport the body to the final resting place.
10. Bury or cremate the body.
11. Answer any technical or legal questions you have about settling up the person's accounts.

Email's in profile in case you have any other questions you'd rather not ask publicly.
posted by ColdChef at 6:13 AM on June 20, 2007 [10 favorites]

ppsssst ... in case you didn't know it andywolf, ColdChef is the go-to guy on this sorta thing.
posted by RavinDave at 6:33 AM on June 20, 2007 [1 favorite]

ColdChef has it - that's exactly what happened when my dad died at home in February. Hospice nurse confirmed death, called the funeral home, and they showed up about three hours later (they waited for my brother and I to drive home so we could be there for my mom). Because my dad was in hospice, I guess there was no need to call a doctor to declare time of death. In fact, a doctor never saw him before he was prepared for viewing. She came and signed the death certificate later. I was led to believe this is fairly standard when the death is not unexpected and the individual is cared for in hospice.
posted by BuddhaBelly at 7:19 AM on June 20, 2007

When my father-in-law died at home last year, the hospice nurse came and confirmed the death, and also removed all controlled prescription drugs (morphine) from the house. Then we called the crematorium that we chose, which handled steps 1, 2 and 10 of ColdChef's list. No funeral home was involved.
posted by FuzzyVerde at 7:35 AM on June 20, 2007

Similar experience to BuddhaBelly. Grandma was tended by a hospice nurse for the last few weeks of her life. When the time came, the nurse was able to call Mom and my uncle so they could be with her as she passed. Grandma died with some of her children with her. The nurse declared time of death and then waited for Mom to say it was OK to call the funeral home, giving them some quiet goodbye time. Everything was already arranged with the funeral home. Grandma was quickly cremated and her cremains were interred in a niche next to Grandpa.

The funny part in all this was that Grandma had only prepaid the funeral home for her cremation and their services. She had not picked out her coffin or container for her cremains. Mom did that. The state required that the body be in a state approved container for the cremation. The choices were a casket ($$$) or a cardboard box. Grandma went in the cardboard box.
posted by onhazier at 7:43 AM on June 20, 2007

A lot of people have suggested calling 9-1-1, which is a really bad idea.

9-1-1 is for emergencies and by definition, when someone is sick "not suddenly or unexpectedly, nothing you can do to prevent it. they're just sick and you know it's coming" it is not an emergency.

Think of it this way--if you were on the phone with dispatch reporting a fire or a heart attack, would you want the call-taker to either put you on hold or rush through your call so that s/he could get an incoming 9-1-1 call for a non-emergency?

Emergencies are not situations which are pre-planned.
posted by leftcoastbob at 9:06 AM on June 20, 2007

Response by poster: i was just going to say the same thing leftcoastbob. thanks everyone. it all seems so obvious once i started reading it all. just didn't even know where to start, luckily it's all several months away. it was just nagging at the back of my mind.
posted by andywolf at 9:37 AM on June 20, 2007

andywolf, enjoy the time you have left with her. Stay positive. Email's in my profile if I can help.
posted by ColdChef at 9:58 AM on June 20, 2007

Also, andywolf, I'm sorry about the situation and didn't mean to preach. Ditto on what ColdChef said.
posted by leftcoastbob at 11:13 AM on June 20, 2007

The Natural Death Centre has information and links for people wanting less of the usual funeral director hoopla, with pages for UK and Europe, US and Canada, and Australia and New Zealand. That led me to a US site for the Natural Deathcare Project which has a page titled "Legalities". The Funeral Consumers Alliance has an interesting FAQ, which says that you should be able to get a printed price list of services from any US funeral director in advance, and gives advice about refusing unwanted services.
posted by Idcoytco at 11:34 AM on June 20, 2007

During my father's long illness and subsequent (peaceful) death at home, our hospice organization specifically told us not to call 911 when he died, for some now-forgotten administrative reason. They instructed us to call them instead. His doctor, who lived in the neighborhood, asked us to call her as well. As I recall, she formalized the time of death, etc.

If you (or the patient) choose to seek hospice care, they'll be able to advise you on the proper procedure. I'm so grateful for all the help and guidance from our hospice.

[I don't know if the following is any use to you at all. If not, please forgive me and ignore it. In our case, having a DNR and a medical power of attorney helped simplify the last few days and weeks, much to my father's benefit. I wish my late partner and I had had the foresight to do the same when he was ill.]

I'm so sorry, andywolf. My thoughts are with you and yours.
posted by Elsa at 1:24 PM on June 20, 2007

I'm picking a nit: A friend's long-term partner died at home, at night. It was expected. He left no papers on file with anyone - hospice or a will. The funeral home insisted we call 9-1-1 because they needed a coroner's report. When we called we instructed the operator that it was not an emergency, and EMS responded in about a half hour, no sirens, no "emergency" service. It was simply a procedure that had to be followed. This may or may not be true in all jurisdictions, but it was, in ours.
posted by disclaimer at 4:36 PM on June 20, 2007

And andywolf, my thoughts are with you as well.
posted by disclaimer at 4:36 PM on June 20, 2007

The funeral home insisted we call 9-1-1 because they needed a coroner's report.

That funeral home needs to be better educated. They may need to contact the proper authorities so that a report can be generated, but there are venues other than dialing 9-1-1 to do so.

Every dispatch agency has a non-emergency number through which you can contact the same agencies as you can when you dial 9-1-1. The difference is that in times of peak activity, the non-emergency number can be ignored or put on hold until the cluster of actual life-threatening emergencies has been dealt with.
posted by leftcoastbob at 7:42 PM on June 20, 2007

That funeral home needs to be better educated. They may need to contact the proper authorities so that a report can be generated, but there are venues other than dialing 9-1-1 to do so.

Not to take this derail any further, but this is not always the case. I live in a very small rural community where 911 is the preferred way of contacting the police department. Regular lines are turned off at midnight and re-routed to 911, so the calls all go to the exact same person. Yes, it would be much better if there were non-emergency and emergency lines that were separate, but there's no immediate need in our small community. YMMV.

All police departments are different. Check with your local authorities.
posted by ColdChef at 7:49 PM on June 20, 2007

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