What should you do if someone (expectedly) dies in their sleep?

In My Humble Opinion
1

Suppose you are caring for a frail, elderly person with known health problems. One night you tuck them into bed as usual, and the next morning you find they have died. Like, there’s no question, no signs of violence, they are just laying there under the covers. Clearly their heart just stopped beating at some point and the body is now cold and stiff.

What should you proceed to do?

Do you call the police? Why?

Do you call for an ambulance? Why?

Do today’s GPs ever do house calls to pronounce someone dead?

Do you skip the intermediate steps and call a funeral home?

2

You call 911 because you are not qualified to officially determine death. 911 will determine who comes to the house; not you.

3

There are, erm… ways to make sure. Especially if you’re expecting an inheritance…

4

Bang! Okay, I verified that they are dead. Now what?

In reality, I agree that you call 911.

5

Then you should probably leave the scene before @StarvingButStrong calls 911.

6

I’m not sure that doctors ever conducted house calls solely to confirm that someone is dead. If the person was in home hospice , it’s possible that a doctor from the hospice organization will go to the home.

Where i live, you call 911 which will most likely send an ambulance unless the person is really obviously dead - like decapitated or decomposing. Someone in the EMT system ( either a paramedic or a doctor) will likely pronounce the person dead and call the police at some point , if the police aren’t already there.

7

I sure hope you wore hearing protection. You won’t be able to talk to 911 if you didn’t.

8

My parents are elderly and my fear is this happening especially when I’m staying over, though my brother points out that it’s not a bad way to go.

9

I was instructed, by both my mother and her doctor, when my mother was in my house in ill health near the end of her life, to call her doctor first if she died here. I’m not sure what the doctor would have done next; but I think the concern was that 911 would send EMT’s who would try to revive her, no matter how thoroughly dead she was – plus which she had a Do Not Resuscitate order and was worried that it wouldn’t be honored.

As it turned out, she died not in my house but in palliative care in a nursing home. Someone authorized to do so came in and checked and said yes, she was dead.

ETA: This was roughly 20 years ago. I don’t know whether EMT procedures have changed in the meantime; they might have.

10

Is there a better way? It’s the best way to go I can think of. The answer to the OP’s question is to call 911. They are trained to dispatch the appropriate team to the scene. It’s not your call.

11

And actually, in the case of my father, who is under the care of a home hospice agency, their instruction is to call them before or instead of calling 911. I think the understanding is that 911 might attempt extraordinary measures and that’s not needed or wanted at this point. (That was sort of in response to @thorny_locust’s post.)

12

When MIL died in our home, (after six years caregiving), I called her Drs office as he had instructed me to do so, on one of his house calls. His office is only 1+1/2 block from our home, so the nurse called me back immediately and said he’d come and do the paperwork, make the call etc.

After that the funeral home came.

I felt very fortunate that I had someone in my home, not a stranger, at such a really difficult time.

13

When my late wife was getting to the hospice stage one of the important messages they gave us was not to call 911 whenever she finally died. That would require the paramedics to come, attempt resuscitation, drag her to the ER, etc. All for naught.

Instead, once hospice was in place, we were to call them when she died. A doctor or nurse would come out, certify the death, then the funeral people would be called to pick up the now-officially dead body.

In the actual event, it eventually became clear she was dying imminently and we had a hospice nurse at home with us the last ~36 hours. When she finally did die, the nurse gave a report and vitals to an on-call doc, he said “yep, she’s dead”, and the body removal service (a subcontractor of the undertaker / funeral home) was called.

Different case:
My late aged MIL lived in an independent living facility. The sort of place where you have your own apartment and your own daily life but they check in on you every morning. She was old and raggedly but there was no particular reason to think she didn’t have a couple more years life left in her.

One night she died next to her bed. She was found that morning by the room-check person sitting on the floor. Presumably she’d gotten up to use the bathroom or whatever and had not quite made it to/from bed.

Their policy was they always call 911 as well as the family. Police and paramedics showed up and somehow she was declared dead. Paramedics left, and the police were still there awaiting the body removal people when I arrived.

Not sure what all that proves, but there’s two semi-recent experiences to choose from.


My advice:
If you have an elderly / frail person in your life, have a convo now with them and with their doctor about exactly this situation. Calling 911 is probably not the best thing, but in the absence of any prior planning it’s probably the only thing.

How exactly your local 911 service will react to your description of the decedent’s condition depends on their local procedures manual. Which might be not what you want or might be just the thing given the realities.

14

When my wife was dying, she was in hospice care. As others have noted, we were told to call the hospice when she died. He died about 4:00 a.m. I called the hospice and they sent out a doctor who arrived about 6:00 a.m. . He confirmed her death and filled out the paperwork. I don’t remember if it was he or I who then called the funeral home who came to take the body.

My understanding is paramedics are required to abide by a DNR/POLST order. We were told to keep the POLST order on the refrigerator, which is where they look for it first. So I’m surprised to hear this talk of paramedics ignoring a DNR order and attempting resuscitation.

These seem to agree that paramedics will not attempt resuscitation if they find a DNR, although each state may have different laws and procedures:

15

When is the next bulk trash pick up?

(I keed! 911, definitely!)

16

So my husband got home and I was able to ask him what happened when his mother died at home alone. His sister went to the apartment and found her mother on the floor - she called 911. The operator told her to try chest compressions as the body was not stiff. The paramedics and police arrived, she was pronounced and then the police stayed until someone from the medical examiner’s office showed up. There wasn’t any autopsy and it’s possible the ME’s office contacted her doctor to determine the cause of death - but I suspect a lot of details depend on what exactly “known health problems” and “expectedly” mean . Apparently in my city, the ME will be called for any death outside a healthcare facility. Which makes sense - just because I have heart disease, diabetes. cancer , COPD, etc. doesn’t mean I can’t have died from carbon monoxide poisoning or some sort of infection.

17

Maybe. As far as I’m concerned the only ‘good’ way to go is to be reduced to a fully ionized plasma in less than a nanosecond, so there is no possibility of your nervous system reacting.

Unfortunately that would probably imply either a nuclear bomb or an asteroid strike, which is a bit of a bummer in terms of collateral damage…

18

I think this

Because of the special nature of EMS, many states are now adopting a uniform, easily recognizable document the EMS/DNR (do not resuscitate) order.

and this

This writer has been confronted with a variety of patient directives, ranging from handwritten notes expressing vague wishes that “nothing special” should be done in case of imminent death to a 10-page document that it would have taken a law school professor to understand.

are probably the reason for talk of paramedics ignoring DNRs - standard , out of hospital DNRs haven’t been available all that long. And of course, another reason is that family present might insist on attempting CPR.

19

My father-in-law died from cancer, while in home hospice care, five years ago. This was exactly what we were instructed to do by the hospice team.

He passed away at around 2 a.m.; we called the hospice team, and they were there within 30 minutes, to initiate that process.

20

Seconding this. Talk about it if at all possible, with both the person and their doctor.

You also may need to make sure you – or rather the patient – has the right kind(s) of DNR. There is, or was in NYState 20 years ago, a non-hospital DNR which was not valid inside a medical facility; and a facility-specific form which the individual hospital or nursing home had to have on hand. I don’t know about hospice, at that time my mother wouldn’t have been declared eligible for hospice until it was too late to try to arrange for that.

When my mother was admitted to the nursing home (with a copy of her non-hospital DNR in her handbag), almost the first thing that happened when I got there was that they asked me, as her health care proxy, to sign the institution’s DNR form for her. They were very relieved when I did so without argument; they could tell by her condition that resuscitation would be a bad idea.

Again, talk to the doctor, who ought to know which forms are needed in which situation (and who also might need to sign the form in some cases).

Or, I suppose, been murdered. Though I don’t think they’re going to investigate in that fashion unless there’s some reason for suspicion.