Advice for family, friends and carers

It is important to remember that even when the person you are caring for is, or appears to be, sleeping or resting, they may still be able to hear you. Do not feel that you need to stop communicating with them. You might want to carry on speaking quietly and calmly to them.

You could also try letting them know you are there in other ways, for example holding their hand, reading to them or playing their favourite music.

Other changes may be noticed

Sometimes their breathing may become noisy. This is likely to be because they are not able to re-absorb or swallow the normal fluids in their chest or throat.

This is a normal process and may be unsettling to hear but it does not seem to cause any distress to the dying person. It can be like snoring, which affects those who hear it more than the person who is making the sound.

It may be helpful to change their position onto their side. The nurse can show you the best way to move them using a slide sheet.

The doctor or nurse may also suggest a medication which may help to reduce the fluids in their chest and throat. This is not always needed and it does not always make a difference.

After the death of the person you are caring for

If the person you are caring for dies at home, you will need to contact the community nursing team to attend to verify the death.

Most importantly, you do not have to do anything immediately. You may want to stay with them for a little while. You can take your time and you do not need to call an ambulance.

On occasions the nurse may contact your GP or the out-of-hours doctor to support this process.

Equipment such as a syringe pump needs to be left in place until the death has been formally verified.

Your GP also needs to be informed. If this is out-of-hours, the nurse will leave a message for the GP. You may wish to do this yourself.

Deaths will usually be certified by the GP, they will complete the paperwork needed to register the death or make a referral to the coroner (although anyone who has concerns about a death can complete the online referral on the Kent County Council website).

Deaths being certified by KCHFT doctors, will be referred through the Medical Examiner Service (MES) for scrutiny of the death and review of the care given – this will be carried out by an independent doctor.

The MES officer will contact you to make sure you have no concerns or worries over the care given to your loved one. Once this has been completed, if the death was expected and resulted from natural causes, the doctor will complete a medical certificate of cause of death.

The MES officer will contact you to discuss the cause of death to make sure you are aware and understand what was written. This will also give you formal notice that the medical certificate has been signed and the paperwork will allow you to register the death and make funeral arrangements.

• Find out more about the MES at kentcht.nhs.uk/leaflet/medical-examiner-service
• To return equipment previously ordered by clinicians you can contact NRS Healthcare on 01622 235300 or 0845 121 8111, email enquiries@kent.nrs-uk.net or visit customerservice@nrshealthcare.co.uk

Registering a death

A death needs to be registered within five days, however, this may be delayed if there is a coroner’s inquest.

You can book an appointment at the registrar’s office which will tell you everything you need to bring.

There is also a step-by-step guide produced by the Department for Work and Pensions – what to do when someone dies – which will also tell you what you need to do.

Arranging a funeral

Most people use a funeral director, although you can also arrange a funeral yourself. Choose a funeral director who is a member of one of the following:

• National Association of Funeral Directors
• National Federation of Funeral Directors
• Society of Allied and Independent Funeral Directors.

These organisations have codes of practice and they must give you costs when asked.

Some councils run their own funeral services, for example non-religious burials. The British Humanist Association can also help with non-religious funerals.

You may be worried about funeral costs, or be unsure about ways in which funerals are paid for. If you are on a low income, you may be eligible for a funeral payment, this amount depends on your circumstances.

The bereavement service helpline can also provide information about this and other benefits you may be entitled to.

• 0800 151 2012
• gov.uk/bereavement-support-payment/how-to-claim

Tell us once

The tell us once service can be used to report a death to most government departments in one go, rather than having to make lots of different calls.

When you register a death, ask your local registrar, who will give you a unique reference number to access the tell us once service online or by phone.

You will need certain information about the person who has died and if you are not the person’s next of kin or executor, you will need permission from the person who is and be able to provide their contact details.

The tell us once service will notify:

• HM Revenue and Customs (HMRC), to deal with tax and cancel benefits
• Department of Work and Pensions (DWP), to cancel benefits
• Driver and Vehicle Licensing Agency (DVLA), to cancel a driving licence
• Passport Office, to cancel a passport.

Bereavement and loss

Bereavement brings with it a complex range of emotions. Some people experience shock, numbness, overwhelming sadness, tiredness or exhaustion, anger, guilt, fear or loneliness. It is also common for people who have cared for someone to feel a lack of purpose when their caring role ends.

There are a number of support groups which can help bereaved people talk about their feelings. It can also help to:

• express thoughts and feelings
• allow time to feel sad
• keep a daily routine
• sleep
• eat healthily
• avoid things which ‘numb’ the pain, such as alcohol or medication.

Anyone experiencing particular problems around bereavement, can speak to their GP for advice. The GP can refer people to bereavement counselling. Hospices can also support bereaved families.