Care of the deceased person (last offices) Policy
Nursing Homes have their own definitions of the “laying out” or “last offices” as it is sometimes called.
This can be done immediately after a suitably qualified member of staff or a doctor has confirmed death. In cases of uncertainty, it is wise to leave the deceased “in situ” till the doctor is satisfied as to the clinical cause of death.
“Laying out” refers simply to washing the deceased and putting on clean clothing, normally pyjamas for a man and a nightdress for a woman, in preparation for their removal to a Funeral Home. However as well as attention to basic hygiene, other simple procedures can be carried out which will not only help to ensure that the deceased goes on to the next stage of preparation in the best possible condition, but will also enhance the presentation of the body should relatives wish to pay their respects in the Nursing Home.
If the eyes of the deceased can be closed gently by a simple touch, all well and good. However, if the eyes are difficult to close or will not stay closed, then on no account should they be glued or the eyelids pulled. This causes damage to the delicate tissues, which can be difficult to disguise.
If the teeth have been removed before death, then it is advisable to try and re-insert them. This gives the face a more “lifelike” appearance. Again, as for the eyes, great care must be exercised so as not to damage the lips. The task may be made simpler if some Vaseline is applied to the lips before insertion of the teeth. This also retains moisture and so retards shrinkage of the lips due to dehydration. Alternatively, if difficulty is experienced, then it would be advantageous if a small pillow or amount of soft material is placed under the chin, resting on the collar bones to keep the lower jaw supported. This helps to prevent unnecessary stretching of the facial tissues.
As far as possible, jewellery should be removed and given to the family. If it is difficult to remove a ring, some Vaseline or suitable moisturising agent massaged into the area of the ring and over the whole finger may aid removal. If the ring is too tight, then forcing it may cause damage to the finger, and in this case, it is advisable to tell the family that the Funeral Director will remove the ring and return it to them.
Arms and hands, ideally, should be elevated so they rest on top of the chest or abdomen. If the arms will not stay in place, then a pillow placed under each elbow will help. This position enables good blood drainage, resulting in less discolouration due to “hypostasis” or the gravitation of the blood to the lowest dependent parts of the body with the cessation of circulation.
Care of the deceased person (last offices)
Unless Rigor Mortis is very pronounced it can generally be broken down by gentle massage and flexing of joints such as fingers, wrists, elbows and shoulders etc. The head may be supported and gently turned from side to side so it will lie in a straight position on a pillow.
Most importantly, in order to retard decomposition, the deceased is best kept under refrigeration or in cold storage. However as Homes generally do not have these facilities, it is recommended that the room in which the body is kept is not heated in any way, either artificially (i.e. radiators or fires) nor naturally (i.e. sunlight) It is also advisable to keep the windows and doors to the room closed. Particularly in hot weather, contamination can easily occur if a blowfly enters the room and lays its eggs on the body. This will result in maggots in as little as 24 hours. Cover the face of the deceased with a light muslin cloth until viewed to prevent flies entering facial orifices. Ensure that is removed prior to viewing to prevent distress for the relatives.
If the above points are observed you can rest assured that you will have done the best you possibly can for the deceased to ensure that the care you have given them in life is carried over into death and your efforts will be greatly appreciated by the receiving Funeral Director who will continue that care to facilitate the grief of their relatives. Most importantly remember to inform the funeral director if the deceased has a pacemaker.