Guidelines for a Palliative Approach in Residential Aged Care

14.7 CARE AFTER THE RESIDENT HAS DIED
The aged care team needs to be familiar with the details of relevant legal requirements, which
vary among the States and Territories. The Therapeutic Guidelines: Palliative Care
[109, p. 106]
indicate that when a death has occurred:
• a determination must be made that life is extinct. This may be performed by a GP or an RN
in some states, or only by a GP in other states;
• a Certification of Death must be completed. This does not have to be done by the GP who
pronounced life extinct, but the treating medical practitioner is usually the one to complete
this document; and
• if there is uncertainty about the cause of death (e.g. if there has been a fall that may have
contributed to the resident’s death), then the coroner may need to be informed.
However, as the legal requirements do vary throughout Australia, each RACF should
formulate their own policies and procedures, depending on legal requirements and their
local circumstances. These should be developed with a view to being sufficiently flexible to
incorporate diverse cultural and spiritual issues. Policies and procedures might include:
• determining that death has occurred;
• notification of death (dependent on State or Territory legislation, cultural issues, and RACF
policy). This may also vary according to the RACFs proximity to an acute hospital and/or
other services. The procedure would include the order in which people should be notified
(e.g. GP, family, funeral director, senior management);
• notifying other residents, family members and the aged care team about the resident’s death;
• the role of the GP (e.g. in relation to signing the death certificate);
• care of the resident’s clothing and belongings;
• giving the resident’s family and the aged care team the chance to say their farewells before
the resident’s body is removed (cultural practices and personal wishes should also be given
preference). The need to provide formal debriefing for the aged care team should also be
included when drafting policies and procedures;
• how to care for the resident’s body after death, including acknowledging cultural sensitivities
and family wishes, removing equipment from the body, and removing the body from the
RACF (having first determined that the coroner does not need to be involved);
• funeral preparations; and
• evaluating outcomes of care delivery.
14.8 SUMMARY
There is no one approach to caring for someone whose death is imminent. Although various
strategies and interventions have been suggested, the circumstances will always vary. However,
with comprehensive assessment and a multidisciplinary team approach, residents dying in RACFs
can receive the best of care. This does not occur without advance planning and appropriate
170 Guidelines for a Palliative Approach in Residential Aged Care