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At the Time of Death

Some people wish to have someone present when they die; others choose to die alone. There are many stories of families who kept vigil around the clock and yet the person died in the brief moment when everyone stepped out of the room. Likewise, there are many stories of caregivers and medical staff who expected death to be imminent and the dying person holding on until one particular family member arrived. Death is not easy to predict.

Immediately after someone dies simple tasks may seem overwhelming to the survivors. Even if you were prepared you may still feel shocked. What you need to do next may not be clear and depends on the location and circumstances of the death. Did the death occur at home, in a hospital or a nursing home? Was it expected or unexpected? Is hospice or a physician involved? Are arrangements in place for what is planned after the death?

Regardless of the location or circumstances, you should feel comfortable to take the time you need to be with the deceased. How you choose to spend this special time to honor your relationship and the person who has died is influenced by culture and tradition as well as personal choices. In a hospital or nursing homes you can call the chaplain to ask for help with your needs at this time.

Get Support: Call a friend, family member or clergy to be with you.

After a Death in New York State

  • An attending physician (MD) or nurse practitioner (NP) signs the death certificate (“certifies” the death).
  • In New York State, a licensed funeral home is required to handle the body after death. The funeral home transports the body to its facility and makes arrangements for burial or cremation.
  • The funeral director orders original death certificates for the surviving family. Depending on the size and complexity of the estate, most families order between 10 and 30 death certificates.
The death certificate:

  • is a legal document, certifying the date, time and cause of death
  • is signed by a physician or nurse practitioner in New York State
  • is the only legal proof that someone has died
  • is used by families to settle their affairs
  • is used by New York State to stop Social Security payments and other benefits
  • is required by financial institutions and insurance companies – they only accept originals, no photocopies

Death Occurring in the Home

  • If the deceased had hospice care, you will call the hospice number you have been given. The hospice nurse will come to the home to “pronounce death” and will contact the physician, the medical examiner, and the funeral home.
  • If the death was expected but hospice was not involved, you will call the physician or medical provider who cared for the deceased. He or she will instruct you about the next steps.
  • If death was unexpected, you need to call 911. The Emergency Medical Service (EMS) or police responder will determine if one of them can pronounce death in the home or if transportation to the emergency room of a local hospital is required. If death is pronounced in the home, a physician needs to be called to certify the death. The physician will contact the medical examiner. When the medical examiner has “released the case,” you or the physician will need to call the funeral home.

If someone dies at home you will need to dispose of the deceased’s unused medicine and return rented medical equipment. There is no immediate rush to do this.

  • Disposal of Medicine – The hospice nurse or EMS can instruct you on how to dispose of the deceased’s unused medicine in the home. The U.S. Food and Drug Administration has recommendations for disposal based on the kind of drug.
  • Returning Medical Equipment -If the deceased was enrolled in hospice, ask the hospice which items should be returned and how to do it. If hospice was not involved, call the vendors (companies) that supplied the equipment. They can tell you which items were rented and need to be picked up and which were purchased and belong to the deceased. Purchased items can be kept or donated to organizations such as Goodwill.

Death Occurring in a Nursing Home Hospital

  • A process will be in place for certifying the death.
  • Contacting the funeral home is usually the responsibility of the family. You will notify the funeral home of the location of the deceased. The funeral home will then make arrangements to obtain the signed death certificate from the facility and transport the deceased to the funeral home.
  • Make sure to take the personal possessions of the deceased home with you. The nurse is the best person to ask, as there may be items not in the room that were put aside for safekeeping.
  • If you were not present at the time of death and want to see the body of your family member, ask the staff to hold him or her in the room. This can usually be done for an hour or two. After that the body will be transferred to the morgue.
  • When a death occurs in a hospital in New York State, the hospital is required to notify the New York Organ Donor Network at the time of death. If the deceased is considered a candidate, the organ donor network will contact the deceased’s surrogate or next of kin to discuss options.