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]

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.

I have called the funeral home immediately after pronouncing, as some of them can take 3-4 hours to arrive and we stay until they do (this is for home, not facility patients). Then I do the postmortem care you described-but usually without the aide.

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

I have called the funeral home immediately after pronouncing, as some of them can take 3-4 hours to arrive and we stay until they do (this is for home, not facility patients). Then I do the postmortem care you described-but usually without the aide.

The timing of the call to the funeral home depends on the family. Some want to do it themselves but after all the family have gathered to say goodbye. Some want the hospice nurse to do it but not right away so I do postmortem care and then call when they are ready. Some just want me to pronounce and they do postmortem care. Sometimes I show up and the family has already done postmortem care.

It is all different.

I had no idea there was a federal law about deceased bodies having to be removed by a certain time. I'll have to look in that because if there is, I've violated the law many times.

[Jensmom7, BSN, RN]

The timing of the call to the funeral home depends on the family. Some want to do it themselves but after all the family have gathered to say goodbye. Some want the hospice nurse to do it but not right away so I do postmortem care and then call when they are ready. Some just want me to pronounce and they do postmortem care. Sometimes I show up and the family has already done postmortem care.

It is all different.

I had no idea there was a federal law about deceased bodies having to be removed by a certain time. I'll have to look in that because if there is, I've violated the law many times.

I think the time constraint may just be a facility thing.

[HazelnutCream]

In addition to what has been mentioned (basic bed bath, clean linens, neutral positioning of body), I would remove any external lines (Foley cath, PICC/PCA pump) and dispose so funeral home doesn't have to deal with these. No body bag used here.

Usually in the home, the death visit is more about providing emotional support to the grieving family until the body is removed. Often our Chaplain comes out for these visits as well, for this purpose.

[iowahomecarenurse]

I usually close their eyes, reposition on their back (not elevated) and check their bottom for any soiling, put on a new brief, ask the family if they have special clothing they want family to wear to the funeral home. Most families are interested in helping and having a hand in sending forth their loved one. Also removing any fentanyl patches, lines, and catheters. Other than that, I place the bedding nicely over the body and wait for the funeral home. I will stay and help the funeral home move the body, and support family as the body is removed from the home. Then I also make the bed, even if just a sheet, before leaving the home.

[A&Ox6, MSN, RN]

Just wanted to comment that there are a lot of cultural, religious and family customs related to death. Prior to cleaning the deceased or removing any lines, check what the family preferences are.

I would assume that in hospice this has already been discussed, but it is always great to be reminded.

[BerryhappyRN, MSN, RN]

Can I just say, please don't call them "a dead person"? No offense, just some educating here. The person should always be referred to as "the patient", or "your mom", "your dad", "your baby", "your husband", "your wife", "your love", even "the deceased", but never "a dead person". By calling them a dead person you are removing their individuality, and their identity. Sometimes their identity is all a person has.

As far as post-mortum care, if the family wants to be involved, allow them, if they don't no problem. Lie the bed flat. Remove all artificial connections IV's, foley cath's, nasal cannula's, remove anything that is attached due to their disease, also TURN OFF THE AIR MATTRESS, if you don't at an inconvenient moment the patient may appear to move which will startle the family and just make things uncomfortable. Also, if there is an oxygen concentrator, turn it off. The silence of the machines help the family to understand the finality of the moment. If you have to give the post-mortum care, with or without the family, you will bathe them just as gently as if they were still breathing. Put a clean brief on them, dress them however the family wants, and if possible close the eyes and mouth (usually impossible). Lower the temperature in the room in case it takes hours for the patient to be picked up, and close the blinds. If they have secretions coming from their mouth, try to remove as much as possible before family sees them.

It all sounds worse than it is, it is really very simple.

[aeris99]

I have done post-mortem care a few times as a LNA. The only thing I did not see mentioned (forgive me if I missed it) was if they have dentures, clean them and get them back in place. We used to roll a washcloth up and tuck it under the chin to help keep the jaw closed.

Be respectful, care for the deceased as if they were your family. It's just my opinion but I have always felt that it is an honor to be able to be present during and after someone has passed.