First national guidance on post-death care
The guidelines have been developed by the National Palliative Care Nurse Consultants Group and undertaken in partnership with the NHS National End of Life Care Programme (NEoLCP). They were created in response to the lack of training and guidance for the profession on caring for patients after death.
The guidelines have been endorsed by the Royal College of Nursing and the Royal College of Pathologists.
Guidance for staff responsible for care after death (last offices) states that care after death can be made less stressful by discussions while the patient is still alive about issues such as organ donation.
Guidance is given on a broad range of issues relating to death, including:
- Honouring the spiritual and cultural wishes of the deceased person and their family/carers
- Ensuring that the deceased and their family/carers have their privacy and dignity respected at all times
- Honouring people’s wishes for organ and tissue donation
- Ensuring the health and safety of everyone who comes into contact with the body
- Ensuring that if the death is being referred to the coroner no action is taken which might impede establishing the cause of death
- Ensuring correct certification procedures have been followed
The new guidelines refer to 'care after death' rather than the previously used 'last offices' in a deliberate move away from military and religious connotations. Although primarily aimed at nurses, they are intended to be relevant to all staff involved in the 'care pathway'.
Lead author and a member of the nurse consultants group, Jo Wilson, said: “This document articulates pathways of care for the person who has died from the time of death to burial or cremation. Many professions are involved in providing care after death and it is excellent that all relevant national organisations have provided input to the document.
“This has resulted in a document which gives guidance to ensure the deceased and their family are kept at the focus of care with their privacy and dignity maintained. It shows how this can be achieving while ensuring that issues such as tissue donation, coroner’s requirements, and the health and safety of all staff are addressed.”
The document states that in NHS hospitals and private nursing homes the personal care after death is the responsibility of a registered nurse, although it may be delegated to an “appropriately trained” healthcare assistant.
It also says staff should “convey respect” in their attitude and behaviour, highlighting that “the deceased was once a living person and therefore needs to be cared for with dignity”.
The guidance will soon be reinforced by two new learning sessions on care after death available through e-ELCA (End of Life Care for All). This resource, developed by the NEoLCP in association with e-Learning for Healthcare and the Association for Palliative Medicine, is available free to many health and social care staff.
The guidance is the first in a series of forthcoming publications around care after death - including a revision of the Department of Health’s 2005 document, When a Patient Dies.
The new guidance can be downloaded at www.endoflifecareforadults.nhs.uk