Procedures at
time of death in hospital
There are a number of key factors to consider at the time a
child dies in hospital. The Clinical
Guidelines on the RCH website contain helpful information.
- A member of the medical staff will be required to pronounce
life extinct and document this in the medical record.
- Facilitate privacy
- The family will need support and gentle guidance in
- Including siblings and extended family
- Spending time with the child
- Washing and dressing the child
- Taking photographs, footprints and other mementos
- Contacting a funeral director
- Considering taking the child home if they wish
- The issue of organ or tissue donation may be important
- Is a coronial examination required? (see RCH/Clinical
Guidelines-death)
- Is an autopsy required?
- An information booklet for families is now available
- New consent forms are now in use
- Support and advice regarding speaking with families about
autopsy is available through Laboratory Services or Contact Us
- Completion of Death Certificate and Cremation Form see (RCH/Clinical
guidelines-death)
- Informing key staff (eg. the child's paediatrician, general
practitioner)
- Arranging follow-up by the paediatrician
- Providing information about potential sources of support should
they be required (The Royal Children's Hospital has a Bereavement
Support Program - see Bereavement
Section).
Procedures at time of
death
(This section is reprinted with permission from 'A Guide to
Paediatric Oncology Palliative Care' published by the Royal
Children's Hospital, Brisbane. Please see the Acknowledgements
section for further information regarding this
publication)
The most important message to relay to parents is that nothing
needs to be done in a hurry when their child dies. This is very
much a private time for family to say their individual goodbyes.
Saying goodbyes and performing 'rituals' are important as they
enable parents, siblings and other family members to express their
love, sorrow, relief, regrets and share precious memories. Washing
the child for the last time, dressing the child in special clothes,
taking photos, playing favourite music, praying together, touching
and cuddling the child, talking to the child, taking foot and
handprints, cutting a lock of their hair and writing a message or
poem for the child are all examples of rituals that families have
found helpful and necessary.
When the family are ready they need to phone their local GP who
will visit the home and (in Victoria, pronounce life extinct). This
is required by the funeral directors before they can collect the
child&.A Death Certificate will also need to be completed. This
does not need to be done at the time of death. A doctor who has
treated the child in the last 3 months must complete it. This is
usually done by the GP, paediatrician, or oncologist (or other
subspecialist paediatrician) and collected by the funeral director.
Parents often ask if the police need to be phoned once the child
has died. As the child is dying of a progressive disease and death
is expected the police do not have to be contacted at the time of
death.
Besides the GP, the only person who needs to be phoned is the
funeral director. If preparation for death has been encouraged,
then most families will have already chosen the funeral director
they wish to use. Parents need to inform the funeral director of
the time they wish for them to come and collect their child. It is
very important that parents remain in control of the timing and
they are not hurried. Funeral directors are on call 24 hours a day
and parents can phone at any time. There is however, an extra cost
if the child needs to be collected after normal working hours.
When preparing parents for what happens at the time of death it
may be helpful to explain how the funeral director will collect
their child. It is the policy of some funeral homes to put the
child in a body bag to comply with workplace health and safety
regulations, before placing the child on a stretcher and taking
them to the vehicle. If families are unaware of this practice they
may find it very distressing. Some parents request that the bag not
be zipped up until the child leaves their home. Families often like
their child to leave with their doona, pillow and favourite toy.
These can be collected later from the funeral director.
More information about funeral directors may be obtained by
phoning the Australian Funeral Director's Association on
9859 9966 in Melbourne.