when post-mortem care makes the patient look too "dead"

[esperanzita]

Hello everyone, I'm hoping for thoughts/advice :)

Since I started doing hospice after-hours/on-call visits, I've been doing a lot of death visits. As part of the visit, I do post-mortem care. It's not required, but I can't bear the thought of sending the patient to the mortuary with a brief full of BM.

A "problem" sometimes arises. After passing away, the patient looks so peaceful, as though they're sleeping. Then, after post-mortem care, they look... dead. Some of the families have commented on this: "He looked better before [post-mortem care]."

I think part of their dislike is that I lower the HOB. I'm afraid that if I leave the HOB elevated as high as the families like (30-45 degrees), the body will stiffen, traumatizing the family when the body is transferred onto the gurney for transport to the mortuary.

I would love ideas about how to bring more grace into this process!

Thanks.

[toomuchbaloney]

Hello everyone, I'm hoping for thoughts/advice :)

Since I started doing hospice after-hours/on-call visits, I've been doing a lot of death visits. As part of the visit, I do post-mortem care. It's not required, but I can't bear the thought of sending the patient to the mortuary with a brief full of BM.

A "problem" sometimes arises. After passing away, the patient looks so peaceful, as though they're sleeping. Then, after post-mortem care, they look... dead. Some of the families have commented on this: "He looked better before [post-mortem care]."

I think part of their dislike is that I lower the HOB. I'm afraid that if I leave the HOB elevated as high as the families like (30-45 degrees), the body will stiffen, traumatizing the family when the body is transferred onto the gurney for transport to the mortuary.

I would love ideas about how to bring more grace into this process!

Thanks.

I frequently ask the family if they would like to assist me. Many times they are grateful to participate and that bridges the gap of perception.

[softrbreeze]

I think they're going to look more "dead" anyway because more time has passed. Most of the time the funeral home arrives within 1-3 hrs. I have never in 10 years had a body stiffen to the point the funeral home personnel have not been able to lay them flat. If you change their clothes at all, it may also help to pick out a shirt or gown with the color pink in it. It helps to reflect some color back into their skin.

[HazelnutCream]

Agree that passing of time will account for some of this regardless. I usually leave HOB just slightly elevated (which even if they do stiffen in that position is not dramatic enough to be traumatic), arms neutral at side or folded on chest, sheet pulled up to chest, and mouth/eyes as closed as possible).

I've also encountered the opposite where a patient passed during the night in an awkward position (partially turned and reaching upwards) and family tried to reposition, but body already beginning to stiffen. When I arrived and provided care, I was able to position in a neutral position through gentle but firm pressure and family is so appreciative to see their loved one looking more at peace.