Royal Devon and Exeter Hospital Bereavement Booklet

NHS

Royal Devon University Healthcare NHS Foundation Trust

Help for the Bereaved Making arrangements following a bereavement includes deaths in the emergency department

“Memories are the loveliest thing, They last from day to day, They can’t get lost; They don’t wear out, And can’t be given away.”

(Anonymous)

The following is a quick-step guide to help you 1. Consider organ and tissue donation 2. Contact a funeral director 3. Awaiting a call from the Bereavement Team

A member of the Bereavement Team will contact you by 2.00pm the next working day to introduce themselves and guide you through the process.

If we have been unable to contact you by 2.00pm please call 01392 402349 in office hours to speak with us.

If you come by car to the hospital to collect the Medical Certificate of Cause of Death, you can park free in any of our patient or visitors car parks - you will need to display this booklet with the front cover showing on your dashboard.

Useful telephone numbers Bereavement service Mortuary Coroner officers

01392 402349 01392 403060 01392 225696

For Emergency Dept. deaths:Emergency Department Reception Emergency Department Secretary

01392 402310 01392 402170

Our condolences When someone dies, particularly if it is in our Emergency Department, it is often sudden and unexpected and therefore especially difficult for you as a relative or close friend.

We would like to express our sincere condolences to you at this sad time. Bereavement is a time of grief and sorrow and the death of someone close can come as a dreadful shock.

Some people may feel overwhelmed, confused, even numb at first. Crying and feeling angry or guilty are also natural feelings that can last a while. Questions such as “why us?” and “if only?” are normal.

Your concentration, appetite and sleeping may be affected and you may feel more tired than usual. Some people feel anxious or experience feelings of panic and it is quite natural to feel depressed. Your life has been turned upside down and it will take time to adjust. Each of us will react in different ways at different times and there are no ‘set’ feelings that you ‘should’ have.

Mourning is an essential yet painful process and sharing our emotions with someone else can often help. An important first step to think about is whether there are people you might contact to support you, or even be with you, over the first few days.

Information in this booklet Information to help you during a bereavement............... 1 Bereavement Team............................................................................................... 1 Different information formats............................................................... 1 How we can help.................................................................................................... 1 1. Tissue donation......................................................................................................... 2 2. Making contact with a funeral director...................................... 3 3. The Bereavement Service.............................................................................. 5 4. Medical Examiner................................................................................................... 6 5. Dealing with the Coroner (if applicable).................................... 7 6. Arranging to see your loved one........................................................ 9 7. Collecting property and valuables..................................................... 10 8. Hospital Post-Mortem....................................................................................... 11 9. Registering the death........................................................................................ 12 10. Questions after a death in the Emergency Department.................................................................................. 15 11. Other help available........................................................................................... 16 12. Stopping Junk Mail to the recently deceased...................... 20 13. Bereavement- some do’s and don’ts............................................... 21

Information to help you during a bereavement Bereavement Team We provide sympathetic support and assistance to bereaved relatives and carers to help them through the procedures following the death of a patient at the hospital. This booklet is designed to help you cope with these practical steps over the coming few days or weeks.

We are always willing to make this information available in other formats or languages.

If you need to receive this information in another format or in a language other than english, call us on 01392 402349 and we can discuss your needs.

How we can help To ensure that the practical arrangements are handled in a caring, professional and timely manner the RD&E’s bereavement services can help you in your dealings with the following people: • • • • • • •

The RD&E’s Mortuary staff Hospital Chaplains Medical Examiners Funeral directors (undertakers) The Coroner and Coroner’s Officers The Registrar of births, deaths and marriages GPs (General Practitioner) 1

1. Tissue donation Most people can be considered for tissue donation after death but there is only a short period of time for this to happen. All adults in England will be considered to have agreed to be a donor when they die unless they have recorded a decision not to donate. You still have a choice about whether or not you wish the deceased person to become a donor.

Following a death, staff at the hospital will check the Organ Donor Register to see if the deceased had made a decision regarding donation.

If you wish to consider donation, eyes for corneal transplant may be donated up to 24 hours after death.

Donation will not delay funeral plans or alter the appearance of the deceased.

Each donation can help at least two people to see again and sometimes more. Some people find that donating tissue for transplant can help the grieving process.

If you would like to discuss this further or find out more please contact any one of the following: •

The Exeter Tissue Donation Team on 01392 406255

•

The Bereavement Team on 01392 402349

•

The Mortuary Team on 01392 403060

•

The NHS Blood and Transplant Service 0800 432 0559

•

A doctor or nurse involved in the care of your relative

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2. Making contact with a funeral director You can contact a funeral director following a death and can start making arrangements. If you are unsure of the wishes of the deceased regarding funeral arrangements you may find they have included this in their will.

Funeral directors are available during office hours, which are Monday to Friday 8.30am–5.00pm. However, they can be contacted 24 hours a day, every day, for emergency calls. To minimise waiting time, it is helpful to telephone the funeral directors to make an appointment to see them.

They will make all the necessary arrangements with you.

When you see a member of the Bereavement Team you will be asked to sign a release form. This form allows the funeral director to collect the deceased from the hospital.

The cost of a funeral varies and you may wish to see a brochure and price list or contact several funeral directors to compare prices, services provided and facilities available before making a decision.

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A list of funeral directors can be found via: •

The British Institute of Funeral Directors, National Office, 2 Heather Ridge Arcade, Heatherside, Camberley, Surrey, GU15 1AX Telephone: 0800 032 2733

•

The National Association of Funeral Directors, 618 Warwick Road, Solihull, West Midlands, B91 1AA Telephone: 0121 711 1343

•

The National Society of Allied and Independent Funeral Directors, 3 Bullfields, Sawbridgeworth, Hertfordshire, CM21 9DB Telephone: 0345 230 6777

•

Internet search

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3. The Bereavement Service Certain formalities must be dealt with following a death.

The death will need to be registered and to do this you will need a Medical Certificate of Cause of Death. This certificate is completed by a Doctor at the hospital. It normally takes a few days for the Medical Certificate of Cause of Death to be completed.

When we call you we will ask if you are planning to have a burial or a cremation funeral service. This is so we can arrange the relevant forms. Once all the legal documents have been completed the deceased can be moved to the funeral director.

You will receive a call from the Medical Examiner whose role is discussed in the next section of this booklet. Once this has happened we will contact you to help you arrange the registration of the death.

We will be able to book you an appointment at the Registry Office once we have the certificate ready. We can book an appointment for you at any Registration Office in Devon except Plymouth and Torbay. You may book your own appointment at the Register Office but please wait until we or the Coroner’s Office advise you to go ahead, otherwise you may be unable to attend.

Our phone number is: 01392 402349

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4. Medical Examiner Within a few days of the death of your loved one, you will be contacted by telephone by a Medical Examiner or one of their Officers. A Medical Examiner is a senior doctor who has not been involved in the care of your loved one. Their job is to review the care your loved one has received and ensure that the paperwork and processes following death are as streamlined as possible.

During this conversation, the Medical Examiner will tell you what the cause of death will be recorded as, on the Medical Certificate of Cause of Death. You will have the opportunity to ask questions about the cause of death or about any aspect of your loved ones last illness.

Following the call the Medical Examiner will release the Medical Certificate of Cause of Death and other legal documents to the Bereavement Team. You will then be able to arrange registration of the death and transfer of the deceased person back to the care of your chosen funeral director.

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5. Dealing with the Coroner (if applicable) Under certain circumstances, it is a legal requirement to inform the Coroner of a person’s death. For example, •

If a patient dies having had a fall or an accident

•

If the death was sudden and unexpected

•

If they had been in hospital for less than 24 hours or had a recent operation

•

If there is a possibility of it being an unnatural death

Most unexpected deaths in the Emergency Department will initially be reported to the Coroner.

If there is a need to contact the Coroner, the Coroner will then decide if the hospital Doctor can issue the Medical Certificate of Cause of Death or whether a post-mortem is needed.

If the Coroner requests a post-mortem, your permission is not required. You may then contact the Coroner’s Officers on 01392 225696 for further information. The office is open Monday to Friday 9.00am to 4.00pm.

If a post-mortem is needed, the Coroner will issue a certificate to the Registrar once the cause of death has been established and enquiries are complete. You should then proceed with registering the death as described in Section 9.

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It will be necessary to telephone the registrar first to ensure that the necessary paperwork has been received from the Coroner prior to making an appointment to register the death.

Please let your funeral director know if a post-mortem is being arranged.

If a post-mortem is not needed, the Coroner will inform the Hospital Doctor that the medical certificate can be issued.

The Bereavement Team will then contact you to arrange registration of the death.

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6. Arranging to see your loved one 6a) in the Emergency Department (where applicable) It usually helps to see your loved one after death. This can be arranged while still in the Emergency Department. We usually encourage this as it seems to help in the long term; however, it is your choice. Fears concerning the appearance of your relative/close friend are generally unfounded and they look peaceful. Staff will however warn you if needed.

Children, with support, should not be excluded from this opportunity. At the time and in the first few hours this will usually be in a special room in the Emergency Department.

If you are not able to be here in the first few hours, please contact the nurse in charge of the Emergency Department on 01392 402310 as soon as possible, or the Mortuary.

6b) ward deaths and later If you wish to visit your relative whilst they are still at the Hospital please call the Mortuary, 01392 403060 Monday to Friday 9.30am to 3.30pm to arrange this. At weekends and Bank Holidays the Mortuary is closed.

In exceptional circumstances we may be able to arrange an out-of-hours viewing between 9.00am and 12.30pm.

To arrange a visit during these times please telephone the hospital switchboard on 01392 411611 and ask the operator to call the on call Mortuary Technician.

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The funeral director will arrange to collect the deceased from the hospital. Relatives can arrange to see the deceased at the funeral home. Should you wish to arrange to see your loved one please contact the funeral director to make an appointment.

7. Collecting property and valuables When you collect the Medical Certificate of Cause of Death from the Bereavement Team you should also collect from the ward any property and valuables that have been held for safekeeping. You will need to sign for these so a member of the ward staff may need to seek authorisation if you are not the next-of-kin/executor.

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8. Hospital Post-Mortem The Hospital Doctor issuing the Medical Certificate of Cause of Death may ask you to consider a Hospital Post-Mortem.

They will discuss this with you and explain the reasons why.

Please note that only certain family members can sign the consent form to allow this to take place.

A Hospital Post-Mortem does not normally delay funeral arrangements and registration of death can still take place.

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9. Registering the death Once the Medical Examiner has released the Medical Certificate of Cause of Death the Bereavement Team will be able to make an appointment for you at the Register Office.

You may book your own appointment at the Register Office but please wait until we advise you to go ahead. If the Coroner is involved check with the Registrar first.

In order to register the death you must be either a relative of the deceased or the person making the funeral arrangements.

You may wish to take someone along to support you whilst making the arrangements.

You may now register anywhere in Devon except Torbay or Plymouth as they are in separate Unitary Authorities and have their own registration services.

A Registrar will talk to you in private about the person who has died and you will need to know the following information: •

The full names and surname (correctly spelt) and the maiden surname if the deceased is a woman who had married

•

Their date and place of death

•

Their date and place of birth (it may be helpful to take their birth certificate)

•

Their previous occupation (and if the deceased was a married woman or a widow, the name and occupation of her husband) 12

•

Their usual address

•

Whether they received a pension or allowance from public funds

•

The date of birth of a surviving widow or widower if the deceased was married

•

Their NHS (medical) card if available

This information is entered into the register and the person registering the death must sign this with their usual signature, using special registrar’s ink. You will be required to read the entry so please make sure you have your reading glasses if you use them.

The Registrar offers a “Tell Us Once” service which alerts other government agencies to a death.

You will then be given a certificate for burial or cremation (‘green form’). This is for your funeral director and authorises them to make arrangements on your behalf.

You will need to get copies of the death certificate for a number of official purposes. We cannot say how many you will need as individual circumstances vary, but as examples you may need copies for such things as insurance, premium bonds, bank accounts and private pensions.

There is a fee for providing copies of the death certificate: please ask us for advice of the current charges.

Please note that there is no free copy of the certificate.

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People you may need to notify: Legal / Financial q q

Bank / Building Society Solicitor

q q

Insurance companies Credit card companies

Employment / Pension q q q

Dept for Work & Pensions q Social Security office q Inland Revenue

Employer Trade Union

Domestic & Personal q q q q q

TV Licensing Gas / Electricity / Water Newspaper / Milkman Telephone company Rental companies

q q q q q

Vehicle Licensing Council Offices Cancel appointments Clubs / Associations Royal Mail deliveries

q q q

Passport National Insurance card Library cards / season tickets

Items that may need returning: q q q q

Pensions / Benefits books Driving Licence NHS equipment on loan Store cards / loyalty cards

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10. Questions after a death in the Emergency Dept You may be feeling bewildered and if you have any anxieties or questions please ask the staff in the Emergency Department or ring the secretary below at any time. The Medical Examiner’s Office (see section 3) will contact the bereaved in a few days to provide information and to answer any questions.

If you require further medical information, Dr. Jo Webber or another Emergency Department consultant will be able to provide this by telephone or in person. Please contact their secretary on 01392 402170 or 402085 to arrange an appointment or to be called back.

You or another family member/friend may also receive a letter from us in the Emergency Department inviting you to discuss such details. Please feel free to pass this on if there is someone else who might benefit. This invitation stands for as long as you need, whether it is for a few weeks or many months after.

For details of our chaplaincy service please call 01392 402024 or call the hospital switchboard on 01392 411611 and ask them to contact the chaplaincy. You can leave a message at the chaplaincy office next to the hospital chapel, Level 2, Area E, RD&E Hospital (Wonford). You can also ask your own pastor, minister, priest or other religious or spiritual leader to contact them on your behalf.

Your general practitioner (GP) is concerned with all aspects of your care, especially at this difficult time.

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11. Other help available As part of the Trust’s commitment to continuous improvement, we invite you to provide your views on the quality of care that your loved one received during their time with us. We are always happy to hear about experiences that have exceeded the expectations of patients and loved ones. We are also very keen to learn when we could have done better to meet the needs of our patients.

Where you wish thanks or praise to be passed on, we will ensure that happens. If you have concerns, we will look into the matter for you, include you in the review process and then share the outcome with you. You will have the opportunity to discuss any issues that you would like to raise with the Medical Examiner, who will contact you in the days following the death of your loved one (see p5), and they will advise you how to take things further if you should wish.

Alternatively, you may make contact, • Face to face: Patient Advice & Liaison Service (PALS) at the main hospital entrance weekdays between 9.30am - 4.30pm (no appointment required) • By telephone: the Bereavement team on 01392 402349 or the Patient Advice & Liaison Service (PALS) are contactable on 01392 402093 weekdays between 9.30am - 4.30pm • Online: via the ‘Get in Touch’ button on the Trust website www.rdehospital.nhs.uk

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The Hospital Chaplaincy is a team of experienced Chaplains and volunteers drawn from a range of religious and belief traditions.

You may wish to contact other services and organisations such as those listed below for ongoing help and support following your bereavement: •

Stop Mail 0333 006 8114 A service developed by the Bereavement Support Network to help families stop junk mail being sent to the recently bereaved. www.stopmail.co.uk

•

Age UK Exeter 01392 202092 Support older people throughout Exeter. www.ageuk.org.uk/exeter

•

Care Direct 0345 1551 007

•

Carers UK 0808 808 7777 Advice and support for carers, including in bereavement. www.carersuk.org

•

Devon Carers 0345 643 4435 If you care, have cared or now need to care for someone, Devon Carers are here to help. www.devoncarers.org.uk

•

Citizens Advice Bureau 0808 144 8848 www.citizensadvice.org.uk

•

CRUSE Bereavement Care 0808 808 1677 Support, advice and information to children, young people and adults when someone dies. www.cruse.org.uk

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•

Compassionate Friends 0345 123 2304 Support and care for bereaved family members who have suffered the death of a child or children of any age. www.tcf.org.uk

•

The Lullaby Trust (formerly known as the Foundation for the Study of Infant Deaths (FSID) Gives extra support to parents whose babies have died unexpectedly and offer to befriend newly bereaved parents.

24hr helpline: 0808 802 6868 General Enquiries: 020 7802 3200 www.lullabytrust.org.uk

•

Winston’s Wish 08088 020 021 Support for children and young people after the death of a parent or sibling. www.winstonswish.org

•

SANDS (Stillbirth and Neonatal Death Society) 0808 164 3332 Sands provides bereavement support services for families who are recently bereaved through stillbirth and neonatal death. www.sands.org.uk

•

Samaritans 116 123 Available day or night, 365 days a year. www.samaritans.org

•

Brake 01484 559909 Supporting families and friends who are bereaved due to a road accident. www.brake.org.uk

•

Road Peace 0800 160 1069 Offers information and support to bereaved survivors of road deaths. www.roadpeace.org 18

•

Department of Health and Social Care See section on ‘what to do when someone dies’; a step by step guide for the bereaved. www.gov.uk/after-a-death

•

Victim Support 0808 168 9111 Offers support and help to victims or surviving relatives after crimes or violence. www.victimsupport.org.uk

•

Switchboard LGBTQIA+ 0800 0119 100

•

Post-Traumatic Stress Disorder If you have particularly severe symptoms following a bereavement or they do not subside, you may be suffering from the above disorder. It is not unusual but important you should seek help via your own doctor (GP), or from the specialised organisations below. a) Traumatic Stress Clinic 0203 317 6820 Address: 4th Floor, West Wing, St. Pancras Hospital, St. Pancras Way, London, NW1 0PE b) Centre for Crisis Psychology 01756 796383 Address: Retort House, the Water Mill Park, Broughton Hall, Skipton, North Yorkshire, BD23 3AG Email: Info@ccpsupport.co.uk www.ccpsupport.co.uk c) PTSD UK www.ptsduk.org

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12. Stopping Junk Mail to the recently deceased If someone you know has died, the amount of unwanted marketing post being sent to them can be greatly reduced which helps to stop painful daily reminders.

By registering with the free service www.stopmail.co.uk the names and addresses of the deceased are removed from mailing lists, stopping most advertising mail within as little as six weeks. If you cannot access the internet you can call 0333 006 8114, where you will be asked for very simple information that will take only a few minutes to complete.

Alternatively, ask the bereavement team for a leaflet that can be returned in the post.

This free of charge service provided by the Bereavement Support Network will actively reduce the unwanted marketing mail but also can help reduce the likelihood of identity theft following the death of someone close.

The information is not used for any other purpose and you only have to complete this once. Additionally to Stop Mail a comparable service can also be accessed from the Bereavement Register or Deceased Preference Service if you would prefer to use them.

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13. Bereavement Do’s and Don’ts Each of us will react in different ways at different times.

There are no “set” feelings that you “should” have. This is important to recognise when you are part of a family when others feel sad too. Healing may be slow, like a deep wound, but be assured that as the months pass the pain will get less and life will be good again, although in a different way.

DO • Get support from someone close to you to help with the practicalities.

•

Talk through what has happened with family, close friends or support groups.

•

Involve children; their fears and fantasies need more facts and explanation, not less.

•

Keep in touch with friends and family, but remember, many people will feel embarrassed to offer help and may avoid you, but will usually feel honoured if asked.

•

Take things at your own pace, you don’t have to be “brave”.

•

Look after yourself - by eating and resting well and be careful, (accidents are more common at this time).

DON’T • Bottle up or hide your feelings.

•

Be pressurised by other people’s expectations for your recovery.

•

Forget children will have similar feelings, including possible guilt and may express these in different and unexpected ways.

•

Rush into major life changes, although discussing long term plans may give you something to look forward to.

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Whilst the Trust is grateful for the support of companies advertising, we stress that any inclusion of any advertisement in this booklet does not imply approval or recommendation of the advertisers by the Trust, nor does the Trust necessarily support the product advertised.

Booklet ref: TW/05 002 004 Review date: October 2027 Publication date: October 2025

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The Hospital would like to thank RNS Publications for publishing this information and the following pages contain some features from services offering their help at this time.

Whilst the Hospital is grateful of their support it does not endorse or recommend any of the services that they provide.

STOPPING JUNK MAIL If someone you know has died, we can reduce the amount of unwanted marketing post being sent to them, stopping painful daily reminders.

By registering with our free service, the names and addresses of the deceased are removed from mailing lists, stopping most advertising mail within as little as six weeks.

Call: 0333 006 8114 OR

Visit our website: www.stopmail.co.uk

bereavement support network stop mail

here to help

Calls are charged at standard landline rates. Calls from mobiles are included in inclusive call packages. © Bereavement Support Network Ltd 2025

Do you need help with

Probate?

You may need help, support or advice on what to do when someone dies in relation to probate. It may not always appear obvious if it will be required.

Call: 0333 240 0360 We offer free guidance on the legal and financial aspects of bereavement including your responsibilities and whether probate is required.

You may need to establish whether a property is held in joint names or tenants in common, we can perform a simple check at no cost to establish the title deeds.

This service is provided by

bereavement support network here to help

Connecting you with managed and D.I.Y. Probate Solutions Calls are charged at standard landline rates. Calls from mobiles are included in inclusive call packages.

Published by RNS Publications © Tel: 01253 832400 R14