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After death is confirmed

Aim to openly and sensitively talk about what happens after a sudden and unexpected death and the legal processes that will need to take place. Provide information without giving misleading timescales and always offer to refer families to organisations providing long term support.

Families tell us that they can feel abandoned, afraid and often are left alone, not knowing what will happen next. A lot of different staff become involved very quickly from different agencies and this can be overwhelming.

What do we need to do?

Procurator Fiscal and post-mortem examination

  • Remember to keep within the scope of your practice when providing information, explaining procedures or answering questions. Be prepared to consult with or refer to suitably trained colleagues whenever necessary.
  • Sensitively explain to the family that they will not be able to register the death or arrange the funeral for some time as the death will be referred to the Procurator Fiscal.
  • Explain that the Procurator Fiscal will order a post-mortem investigation, and that the family will not be able to choose whether this takes place. This may be very difficult for some families, and this should be acknowledged.
  • Ensure families are aware they can choose to see, hold and spend time with their child again after the post-mortem examination is complete.
  • Support the family to understand that their baby’s body will not be released for funeral until certain investigations are complete.
  • Explain a named support professional within the Procurator Fiscal service will have regular contact with the family and will update them on results awaited and likely timescales.
  • Bear in mind that the baby’s body will often have to travel, sometimes long distances, to a specialist centre for the post-mortem examination and this can be very upsetting for families.
  • Remind families their key healthcare professional will keep them up to date with where their baby has been moved to and when the post-mortem examination is going to take place. The paediatric pathologist should contact the key healthcare professional, and also parents if appropriate, to say who they are, where and when the post-mortem will take place and offer to meet with them to explain results.
  • Take care to ensure the family receives timely, sensitive responses to any questions and are supported with any decisions they need to make.

Registration of death and funeral

  • Explain to the family that:
    • A funeral can only take place once an initial death certificate is issued by the pathologist, pending further investigations. Ask the pathologist for likely timing.
    • Once all post-mortem results are available, a final death certificate will be issued which may have an amended cause of death.
    • The Procurator Fiscal investigation and post-mortem tests can take many months.
  • It is likely that a period will now have passed since baby’s death and it is maybe a different healthcare professional working with families. These professionals should encourage families to consider the different options for a funeral. Funeral directors are experts in bereavement care and will support families to make the best decision for them in advance of the funeral.
  • Funeral directors in Scotland offer a simple funeral free of charge. Ensure that families are aware of this and that they are also aware of any hidden costs such as order of service printing, coffin costs if the one on offer is not used, flowers and so on.
  • Verbal and/or written information should include that a financial support payment is available to families on low income via Social Security Scotland.
The care from the hospital staff. There was none. No one spoke to me, I was left in a room on my own with no one with me. No idea where my other 2 kids (age 3&2) were and then a doctor came in and said “your daughter is dead” that exact phrase. And then I was approached by police and told they were taking her for a post-mortem. They gave me no time with her and I didn’t see her again till in the funeral home.
I tried to be as open as possible. Even 4 years later the words and lack of sympathy hurt more than I can describe in words. I was 20 years old, my baby was only 5 weeks, I was still recovering from her birth but the sheer coldness of so many ‘professionals’ was unbelievable.

How will we know we have achieved our aim?

Families will tell us that they were treated with kindness and compassion, had time with their baby and knew what would be happening in the following days and weeks. They will say they were fully informed of lengthy time scales.

Staff will tell us they feel confident and competent providing bereavement care within the constraints imposed by the early police investigation and legal investigation. They will say
they are clear about processes and timescales and fully able to explain these sensitively.

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