What do you do when someone dies a natural death in your house? Call an ambulance? Call somebody else?
Ok, I just called my mom (she works in a doctor’s office and I figured she might know the answer to this one). She in turn asked a co-worker/friend, who is a) a nurse and b) once came home to find her own elderly mother dead.
Friend Nurse says that she called the police, who told her to call the funeral home, and representatives of both showed up together to remove the body. Mom and Friend Nurse were too busy to elaborate too much, but my guess is that the police showed up to make it legal in some way? Perhaps it has something to do with getting a coroner’s report? I don’t know squat about the legalaties of what funeral homes can do, so I’m speculating there. Perhaps some legally inclined Doper can explain…
In many jurisdictions, only the county coroner or his/her deputy can make a declaration of death. Joe Public is expected to treat the appearance of death as a mere emergency, even if you happen upon a rotting corpse. Call 911.
Once EMS gets there, if they determine that the person is too dead for them to work on, they’ll call the coroner and get everything squared away.
This happened to my father a couple of summers ago. He went to his mother’s house to check on her and found her on the floor by her bed. She had obviously been dead for several hours, but he called 911 anyway. He told the dispatcher that she was dead, and the dispatcher sent an ambulance, who then radioed in to the coroner’s office.
The exception to Rasta’s answer is when a person is under home hospice care. In that case, calling the hospice nurse or doctor is sufficient and it saves the family the additional disturbance of having the EMTs show up with sirens blaring. Hospice workers will prepare the family for this eventuality.
If a person has an out-of-hospital DNR (Do Not Resuscitate order), you should call the doctor. (All hospice patients should be DNR, either in or out of the hospital.) If you call the ambulance, they will not attempt to resuscitate if you can show them the DNR papers. If a person does not have an out-of-hospital DNR (or you can’t find the papers), they must try to resuscitate even if it’s against the patient’s or family’s wishes, except for a few situations as follow:
If rigor mortis (contraction of the joints that occurs after death) or liver mortis (pooling of the blood in the dependent parts of the body after death) or putrification are present, you (or the paramedics) are not required to do CPR because it’s obviously a lost cause.
In the hospital (this is Texas, BTW) whenever any death occurs, the JP must be notified. He decides whether an autopsy should be performed. In a home setting, you can expect one of the medical team to call the JP for you.
Several years ago my Mom hired Mr. McConky to retile her shower. She left him alone in the house all day. My Step-Dad came home later in the day to find him dead in midjob. He called 911 and they sent the cops and an ambulance.
Mr. McConky’s partner finished the shower and it’s been known as the McConky memorial shower ever since.
Haj
Which doctor? The doctor of record? I’ve only had two doctors actually look at the person in question. Should I call one of them?
My mother died at home under hospice care provided by the hospital and those of us in the family. The nurse that last visited her told us that since she was under a doctor’s care, no autopsy would be needed.
We called the funeral home and they came in a van instead of a hearse. The two men removed my mother’s body very efficiently and discreetly.
The hospice then came by and removed all the medical equipment in a matter of hours.
If the deceased hadn’t been under a doctor’s care, I believe the coroner will need to be involved.
Are you telling us you are asking this because there is, right now, a dead body in your house?!?!?
Please don’t let that be the case!
Second.
furryman- umm, maybe we should have a few details about your specific case. Is this person terminally ill? Under the care of hospice? Why, exactly, is this person dying or dead? The manner of death makes a big difference, here.
This person has Parkinsons. He’s had it for years and refused to go to the doctor. He broke his hip approximately two months ago. We finally convinced him to go to the hospital. After returning from the hospital we managed to convince him to get an MRI scan. The Parkinsons diagnosis was confirmed. So, that’s a total of two visits to two doctors. We had to take him off medication because of a severe adverse effect. Now he barely eats enough to feed a bird. He is not under hospice care and as I said he has only seen two doctors. He doesn’t want extraordinary measures taken to keep him alive. This includes feeding tubes, ect. If he survives another six months I’ll be surprised. What should I do when he dies? Should I do anything now to prepare? Any advise in this matter would be sincerely appreciated.
As an EMT in new mexico, I have both witnessed death, and arrived after death had occurred.
If you intend to let this person die, get a out of hospital DNR for them. When they are beginning to die, you may very well get scared. Almost out of reflex you may call 911. This is perfectly fine. I have been on two DRN calls in the last year, watching the patient die in both cases. Our presence is more for the family. We can explain what is going on. Also, the DNR just means that we do not attempt to perform any lifesaving measures. It does not mean that we cannot offer supportive care. Anything that may make the patient more comfortable, we can do, and I have done. This even includes the use of morphine.
once the patient dies, outside of the hospital, we are required to contact the NM office of the medical investigator. They send someone out, they document the death. If the death is expected, or there does not seem to be any reason to suspect foul play, an autopsy is not required. The family can be assisted in contacting a funeral home from there.
furryman, kinoons’ advice is good. If this man does not want extraordinary measures to be taken, he must have an out of hospital DNR.
I’m also concerned about his quality of life now. Terminal illness doesn’t have to mean misery. Is he demented? Is he bedbound? Who feeds him and bathes him, etc.? Do you think he’d benefit from having hospice care? (Hospice helps the patient and family; do you think you’d benefit from their help?)
In New Mexico, you are allowed to inject morphine at the ** EMT** level??? No way!!! Mazel Tov on finishing up your Medic training, I’ve got my State Practicals and Boards in a few weeks here in NY for my EMT card. 
Now, I guess states differ. We’re allowed to not begin CPR on a corpse only after calling Medical Control- the Doctor at the designated local hospital under whose legal auspices all EMT’s in the area actually operate. We, in the field ( and this includes Paramedics ) are not allowed to pronounce a death. That is the purvey of a doctor, or Medical Examiner/Coroner. We can call Medical Control, inform them of the findings ( rigor mortis, obvious prolonged death period, lividity, etc.) and request that they release us from our responsibility to perform live-saving measures.
It’s not just ducking a bullet, it’s the law. And it shows that we had enough respect for the patient and their family to speak to a Doctor and have his authority supercede ours in the situation.
Furryman, I would beg you- BEG YOU- to arrange immediately for a ** Do Not Resucitate** order. It needs to be done while the patient is still enjoying a mental capacity that allows him to make all decisions FOR HIMSELF. The Doctor referred to is going to be the one who signed that DNR. It will be his or her legal authority that allows Emergency Personnel to NOT touch that patient, and instead allow them to expire without extraordinary means.
This site offers very comprehensive info and links on the entire area of DNR Orders. Peruse it.
I wholeheartedly support the idea and application of DNR’s. My Mom is a hospice nurse in Philadelphia, I’ve learned a lot about death and families from her.
I wish you the best of luck, Furryman. Here is what I might suggest:
- Find an attorney unless you have one already, to assist and prepare in protecting his estate. Whatever it is, prince or pauper- you want to make sure that his wishes and assest are both protected.
- Call Hospice, even though he is not yet near death. They do what is called an Intake Interview. They will meet you and the patient, and any other family members who wish to be a part of the process. It is an extremely inclusive thing. They will be of boundless help to you. **Holly is so very right on the money here- they’re here for you and your family as well as the patient.
- Find out what his wishes are regarding a funeral, cremation, etc. As coarse as this will sound, shop around in advance and allow for some rough waters here. Make sure you respect his desires even if they don’t coincide with yours. It’s his life, and his death. ( IMHO of course ).
Like my compadre Kinoons, I’ve witnessed death quite a few times. It is so varied. Sometimes agonizingly slow, sometimes traumatic and sudden. This one you are dealing with is anticipated, to a degree. It makes it no less tragic or sad for you and your family. It simply allows you to make use of Hospice, and other mechanisms to protect the wishes of your family member.
Cartooniverse
Nice coding, huh? Thank god my State Exam doesn’t include “Internet Proficiency”, right? :rolleyes:
Cartooniverse
Also, I’d like to add that even if a person doesn’t want any measures to extend his life, that person should not be allowed to suffer unnecessarily. For example, if this man is eating little and losing weight, he may soon require extensive nursing care to prevent bedsores. He will need to be turned at least every two hours and have a bed or mattress overlay that will help to reduce pressure points. (People can die from horrendous bedsores, and trust me: it is not a good way to go.)
He will become completely incontinent and will need someone to wash and change him several times per day. He will eventually need to be hand-fed food of a certain consistency and in a certain position to prevent choking. If he is in pain, he will require medications alleviate that pain.
The person’s spiritual and emotional needs must also be met; these are just as important as his physical needs.
Taking care of a bedbound person is a 24 hour job. Very few people are capable of doing it on their own. There are resources to help; it sounds like in this case, hospice would be a great help to everyone involved.
Several years ago, I learned CPR from a paramedic in Ohio. He said that in Ohio, the paramedics were only allowed to assume death if there was blood pooling, rigor mortis, decomposition, or decapitation, and that any other circumstances required an MD to declare death. He didn’t specify whether the MD in question had to be the coroner.
That’s hilarious HAJARIO.