Cleaning up a dead person in a hospice setting

[PhoebotNiChungngay]

Just want to hear from all of you

My line of Nursing was in Surgery and then in a psyche unit and now i have this PRN hospice work that i will try my hands on in the near future. Unfortunately, in my many years of nursing, I never had the opportunity to really clean up a dead person. Now in this hospice work, i would be expected to know how to clean up a dead person and put them in a body bag. Would appreciate to hear your stories and maybe some comments and advices are all appreciated.

Thank you so much.

[Jensmom7, BSN, RN]

And I don't know about everyone else but I would never refer to them as a dead body. They are deceased, a deceased patient. It's semantics I know but I would never want to accidentally offend a family/friend of the patient by having them overhear me casually refer to their loved one as a dead body.

No one I know who works in Hospice would, either.

I even talk to the deceased while I'm doing post mortem care, and call them by name.

[verene, MSN]

And I don't know about everyone else but I would never refer to them as a dead body. They are deceased, a deceased patient. It's semantics I know but I would never want to accidentally offend a family/friend of the patient by having them overhear me casually refer to their loved one as a dead body.

I realized I used body when writing my above post, but I typically refer to them as "patient in room X" or by name with other staff/professionals and "your wife/father/sister etc" or by name when interacting with families and name or "the deceased" with mortuary staff.

"Body" just made sense in the context of the forum post where I don't particularly have to worry about offending someone.

[poppycat, ADN, BSN]

When my dad died in hospice, the nurse & CNA cleaned him & changed the linens (this was an inpatient hospice unit). We then we're able to stay with him until the funeral home arrived. He was never sent to the morgue.

[traumaRUs, MSN, APRN]

Moved to hospice forum

[WKShadowNP, DNP, APRN]

From my time in hospice, the procedure varied. The ones at home I would do if I were the was pronouncing (or technically declaring absence of vital signs since in my state I can't legally pronounce.) Those in a facility would be cleaned by the staff. In all cases family whether present or not would have a say in preferences and requests pertaining to that part.

One memorable one occurred in a location two counties from me (we had a large large area) and I had to call for back up to drive with me at 3am. We waited at the house for a long time for the mortuary to come. Such a small room but we just all had coffee (boiled in the water on the stove) and sat around waiting. Has to be one of my more odd ones (due to the wait and method of interaction during that time.) Nice family though.

[Mavrick, BSN, RN]

My experience with an ICU death always included putting their teeth back in (while you can) and slightly elevating the head of the bed (to prevent blood from collecting in an unsightly pattern on their neck).

[Spidey's mom, ADN, BSN, RN]

Are you sure about that? Typically the mortuary does that.

As hospice, we do postmortem care in the homes. In the hospital, most of the times the awesome CNA's beat me to it by the time I'm called and arrive at the hospital. I pronounce death. We don't send anyone to morgues. Nor is the coroner called. The mortuary comes to pick them up. We can help with placing the patient in a body bag.

This post reminded me of when my grandfather died at my aunt's house. He was on hospice and died sitting in hit favorite chair. By the time we got there to wait for the funeral home to come, I suppose he was already cleaned up, but still sitting in the chair. We all sat around in the room with him telling our favorite stories about him and drinking his favorite wine. A fitting send off for a legend!

We typically do not have to wait for the mortuary to show up. Some families ask me to simply pronounce and help with clean up and then leave. Sometimes they want me to stay. I've had patients die in their recliners too. And have sat with families and listened as they shared stories about their loved ones.

Lots of interesting stories in hospice.

[BuckyBadgerRN, ASN, RN]

First of all, I would stop referring to your deceased clients as "dead persons". Secondly, in my experience the mortuary will place them into a "body bag" for transport to the funeral home

[melizerd, ASN, RN]

I work on an oncology floor that also does quite a bit of comfort/hospice care.

When a patient dies the aides do most of the cares but I frequently help too. We remove lines and drains, bathe and gown the patient. We tie their hands together across their chest and their chin closed (dentures in place), then place the tag on their toe, place them into the bag and tag the bag as well.

Security takes them to the morgue area until the funeral home arrangements are made and they are picked up.

[FurBabyMom, MSN, RN]

When I worked the floor I we had a lot of hospice/comfort care patients. We had to call the organ procurement agency (sometimes the ICUs did this, sometimes we had to "right then" - when codes had an unsuccessful resuscitation), and our unit's policy was to call when we either got comfort care patients transferred to us or patients/families changed code status and elected comfort measures only. Often we'd have them for a while (day, two, etc) and discharge them to hospice - home health or inpatient/residential. When we had patients die as comfort care on our unit, we handled pronouncement, then started with the post-mortem care. We removed all lines/drains/tubes, cleaned the patient up, handled any applicable documentation. We were there for the family (if present) and allowed family to visit (if they wanted to). Most hospice patients were "discharged" via the funeral home staff but if they were unable to come pick the patient up within a timely manner (or house census was such that we had to make arrangements to accommodate other patients) we transferred to/"discharged to" the morgue.

I work in the OR. Everything we do is opposite from what we did on the floor. All of our deaths (in situations other than where the family has elected organ donation) are an automatic medical examiner case, families cannot opt out of this. We have to leave all tubes/drains/lines intact for ME purposes. We close surgical incisions as appropriate, and clean the patient up as good as we can. We do make arrangements (whenever possible - every effort is made to do so but some patient are unfortunately unidentified when they expire in the OR) to allow patients' families to see them before transfer to the morgue. Patients are then transported to the morgue, released to the medical examiner's office and then released from the county ME to the funeral home/mortuary of choice.

Edited to add - none of what I typed had to do with the question, since it was asking specifically for hospice.

[neuron]

I believe it is federal law that a deceased body had to be picked up within 4 hours of death at a facility. In my experience when someone dies, a bed bad should be done, and clean garments should be put on. As a poster said, to make them presentable. Family and friends may come to visit. I was always fascinated how when the funeral home came to pick up the body they are always dressed in suits. They go out 'head first' when leaving. In our facilities, the doors in all pts. rooms are shut when the body is taken down the hall.

Those are just some observations.

[Deschesnes]

Prior to calling the funeral home, I ask family for pajamas or clothing they want put on their loved one for the ride to the funeral home. I don't care how difficult it is to put on them, I do it. Jeans and a flannel shirt are difficult but able to be done. I always call the pts CNA and she comes out and helps if she can. We bath,wash hair,shave,swab the mouth and apply cologne or perfume. We reposition them and straighten the bed linens on them and have them presentable for the family. We give them time to say their last goodbyes before the funeral home arrives. I put myself in their place, I would much rather lay my head over on my loved one and smell that familiar cologne or perfume one last time. We do not put them in body bags. Most of our funeral homes pick up the body without putting in a body bag. We have one funeral home that makes up the death bed and lays a single red rose on the pillow. How you treat the deceased body is a reflection on you and your facility. I have actually witnessed nurses just go in and pronounce and then call the funeral home. Never changing dirty linens or diapers. To me this is unacceptable.