Post-Mortem Care

Nursing Students CNA/MA

Published

Well..I had my first experience with a patient dying on my shift last week. I was expecting her death was going to be in the next day or so since she was on hospice, not eating/drinking, and had bloody stools when I changed her the night before. So I thought to myself, "watch..she is going to pass on me tonight, knowing my luck and especially since I'm new and scared about it." Sure enough, I got there and as soon as I started my rounds..I got to her room and she had just passed (she was still pretty warm). I'm gonna have to say, I'm pretty good at dealing with death...I didn't feel sad, I didn't cry, and I didn't panic. However, I had a hard time doing post-mortem care! She died with her mouth open and there was dried up blood all on her tongue that I had to clean off. I couldn't do it. Her gown was soaked with all of her left over perspiration and I had to change that. I couldn't do that by myself. I had to pretend she was still alive to even be next to her. I guess I had the "heeby-jeebys" more than anything and I was feeling pretty grossed out. I am looking for any advice on doing and dealing with post-mortem care! I would also love to hear any and all of your experiences so that I can know a little more about what exactly happens when they pass and how you felt about it. Thanks!

Specializes in CNA/ ALF & Hospital.
for a bad case of the heeby-jeebies, 2 recommendations:

- talk to the pt/body/deceased. seriously ! it helps you remember that it's a person in front of you and not a Scary Dead Body OMG.

- if taking care of them makes you sad, just try to remember that death is as important a part of life as being born. you're with someone at a momentous time, and the opportunity to perform care helps show respect for a life that has been lived. kind of like the first rec, this is part of remembering that you're still taking care of a person.

I agree with you more than yu even know! I have talked to them as I do a full bed bath until I rool them in the morgue .

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Specializes in Medical.
Actually....talking to the deceased is not silly or crazy

'm in the process of doing research into why health care practitioners who speak to the dead while performing death work do so - if anyone's interested in participating (by writing about their practice) I'd love to hear from you :) And for anyone concerned about being thought of as silly or crazy - the research comes from my own practice!

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Specializes in alzheimers, hospice, dialysis.

a few thought's i have....

1. yes it's normal to speak to the dead as though they are living. we really don't know WHEN the soul leaves the body. i personally believe they are still there for a while.

2. i don't think post mortem care has to be done in a certain amount of time. yes, the body needs to be cleaned, and if the patient had a foley, ostomy bags, port, etc etc etc those things need to be removed, and the body needs to be taken to the morgue. but where i live, the family gets 3 hours with the body to say their good byes legally.

my grandfather passed away this summer, i was with him when he passed, and i stayed the full 3 hours. he lived in a nursing home ward, and you wouldn't believe all of the cna's, lvn's, rn's, MD's, physical therapists, respiratory therapists, social workers, that came to say good bye to him. he had lived there a long time, and was one of the few patients who still had his mind and wits about him. the MD who called his time of death cried herself, he was all very close to these people.

i guess i'm just trying to say, remember you are performing care on someone's father or mother, or someone's child. we forget that these people who are 90 years old were once just infants, they were someone's baby at one time. for those of us who witness them leaving this life into another, remember this is a miraculous event, you are seeing them leave, and remember the people who saw them enter.

lastly, think about how you would want your own body treated. this should help you in knowing what to do. :)

sorry this is so long....i've done hospice for quite some time now, so i have so many opinions.

happy holidays.

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for a bad case of the heeby-jeebies, 2 recommendations:

- talk to the pt/body/deceased. seriously ! it helps you remember that it's a person in front of you and not a Scary Dead Body OMG.

- if taking care of them makes you sad, just try to remember that death is as important a part of life as being born. you're with someone at a momentous time, and the opportunity to perform care helps show respect for a life that has been lived. kind of like the first rec, this is part of remembering that you're still taking care of a person.

Wow that's a fantastic post !! :yeah: That's a great perspective on post-mortem care. :eek:

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Such good responses!!! On my first day of work at my first CNA job EVER(med/surg), a patient died. The CNA I was following had him as a patient, and I figured I might as well get the post mortem stuff out of the way.

....eh, not quite. I ended up hyperventilating and crying and left the room. My fear of death(I used to have nightly panic attacks as a small child) mixed with his cause of death(a cancer that 4 of my relatives are currently diagnosed with) made it too much. And it being my first day.

They were all really nice about it....told me it was okay that I cried, that they shouldn't have expected me to do it, and they told me that it was tough for them too. They also said that they'll talk to them, or sometimes just explain what they're doing, as if the pt. is still alive. I'm not sure if it's out of habit or putting their own mind at ease, but they all assured me that my anxiety over it will pass.

Since then only one patient has died during my shift. I did poke my head in the room just to see him, which may seem weird, but the noticeable difference that occurs in minutes is what freaks me out. Just the fact that you can TELL their sould has left them....I think that's the hardest part. So I'm working on my fears slowly. The people I work with consistently are aware of my fear/anxiety and so if any of my patients die in the near future, I know they'll be there to hold my hand so to speak. For now, I'm just trying to expose myself to death little by little so it's not so terrifying. That, and keeping it in my head that post mortem care is the last care that I can do for them....I can provide them with dignity, etc. etc. and care for them even though they're "gone". I see my family members in all my patients, which helps keep me compassionate. I only hope that it won't be my downfall when it comes to death.

Good luck and hang in there! It's a tricky situation....most people don't have to do it. We really don't either if you think about it, but we should want to. I like the idea of being able to continue to care for someone, even after they've passed. I know they'd appreciate it.

Enough rambling....haha

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Specializes in CNA.

I think post-mordem care may be the hardest thing an aid has to do, especially if you are not used to death. One of the young aids in my CNA class had said she does not know anyone who has ever died! I have been around two aunts, and a grandmother who were in the death process but of course we let the hospice nurses provide the Post-mordem (pm) care once they passed. I have not personally had to do post mordem care yet on any residents and I am not really sure how I will handle it. I would like to think I will be ok and do it 'right', but you never know. I have become attached to a couple of my residents (alzheimers patients) and if they passed on my shift, i wouldn't want anyone else to do the pm care on them but I think I would probably cry a little and be sad for while. Its natural to have emotions on someone's passing, and it will get easier to deal with the longer you are in this profession. As others have said, remembering them as a person will help and know that you are giving them the best care possible.

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A resident passed on my evening shift the other night. I had just finished my charting and clocked out when the nurse confirmed the death. OK yeah, I was curious so I went to the room to observe the post-mortem care. I asked the two aides working on him if they could tell when it happened, as he had appeared to be alive throughout the entire shift other than being unresponsive but breathing. They said it must've just happened during shift change because he was still warm. I touched him and yes he was. Probably sounds kinda morbid that I did that, but I just wanted to confirm it to myself that I could handle it. :uhoh21:

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A resident passed on my evening shift the other night. I had just finished my charting and clocked out when the nurse confirmed the death. OK yeah, I was curious so I went to the room to observe the post-mortem care. I asked the two aides working on him if they could tell when it happened, as he had appeared to be alive throughout the entire shift other than being unresponsive but breathing. They said it must've just happened during shift change because he was still warm. I touched him and yes he was. Probably sounds kinda morbid that I did that, but I just wanted to confirm it to myself that I could handle it. :uhoh21:

Not morbid at all. I've seen many aides hold the deceased's hands or touch their forehead when they say their goodbyes.

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Not morbid at all. I've seen many aides hold the deceased's hands or touch their forehead when they say their goodbyes.

Yep. I do both, and if I'm really close to them, I will kiss their cheek.

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Specializes in 6 yrs LTC, 1 yr MedSurg, Wound Care.

In the last month, I've helped with twice with post-mortem care. Neither was on my hall. The first man was my first. He had just passed. I was nervous and not too sure what to do and there was another aide already there along with a family member. My thought was to get in there and just do it. I wanted to give him the kind of care that I would want given to my family or myself.

The second, was a man that had been found on the street homeless and sent to the ER. They sent him to us. We only knew his name. He had AIDS, hepatitis, etc. and while he was there, barely anyone even went in his room at all. Hospice came in but didn't do too much since it was a charity case. My friend at work went out of her way to bring him clothes and socks since he had nothing. The day he died, hospice had been in and just left him there with no PM care at all. When my friend found out he had passed, we both went in to see him. He had been left with one arm up by his head, twisted in a weird angle, and his head cocked to the side. We were so angry! Rigor mortis had already started to set in. It was difficult but we managed to get his arm down and interlocked his hands, and got a pillow tucked under his head to straighten it out. Regardless of who he was, how much money he had, or what he had done with his life, he was still a person and deserved more respect than what he got. There wasn't much more I could do for him other than that, but I'm glad I was able to do something.

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Specializes in HHC.

I am a nurse and my husband is a Funeral Director. I am appalled at the stories he tells me about the bodies that he gets. Now understand, these people were not going to the Medical Examiners office, they were a direct to a funeral home. Their IV's are still in (bags attached), urinary and stool caths and bags are still in place (and often full and leaking of stool and urine), electrode pads and wires are still attached, trachs are still in (some times with the hoses attached) and airways are in place and inflated...

I think this is horrible nursing care...I've done post-mortem care and I can't believe that a nurse would allow a body to be taken in such a state...sad...very sad...Susan

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WOW! s1ingram, that is so sad! I cannot believe this either :(

Dondie...I loved hearing your post! You have a heart of gold!

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