Palliative care

Procedures at time of death in hospital

  • 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).

    Goto Top

    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.

    Goto Top