In healthcare, the moment a patient transitions from life to death holds immense significance, as the responsibilities of the nurse continues beyond the patient’s passing. It’s important to learn the initial changes the body undergoes after death to ensure compassionate and dignified postmortem care. Nurses play a key role in this journey, providing not just physical assistance but also emotional support to both the departed individual and their grieving family members, navigating this delicate phase with sensitivity and care.
Post-mortem care, also known as after-death care, involves the procedures and practices performed to respectfully and hygienically care for the body of a deceased person. This process ensures that the body is properly prepared for viewing by the family, transportation, or further medical examinations such as autopsy.
Post-mortem care involves nurses tending to a patient immediately after death. Rigor mortis, the stiffening of the body, typically begins in the involuntary muscles, progressing to the head, neck, trunk, and extremities over about 2 to 4 hours, dissipating approximately 96 hours later. Algor mortis refers to the gradual decrease in body temperature after death, decreasing around 1℃ (1.8℉) per hour until reaching room temperature due to cessation of blood circulation. Livor mortis manifests as discoloration in dependent areas post-death, resulting from the breakdown of red blood cells due to ceased circulation.
Prepare the following supplies:
Nurses should regard postmortem care as an extension of the person-centered approach they provided during the patient’s life. To ensure that postmortem care reflects respect for the patient and their family, here are the following steps:
1. Verify the patient’s identity and death documentation.
Ensure the correct procedures are followed for the right individual. This step also meets legal requirements and prevents misidentification.
2. Notify the family members about the patient’s passing and provide them with time to grieve and say their final goodbyes.
Communicating with the family supports their emotional needs and provides closure. It also allows them to make necessary arrangements and decisions.
3. Wear disposable gloves, a protective gown, and a mask.
Protects the caregiver from potential exposure to body fluids and maintains a hygienic environment.
4. Position the patient supine and elevate the head of the bed by 30 degrees, or use pillows to elevate the head.
Elevating the head of the bed and placing a clean pillow underneath can prevent skin discoloration (livor mortis) of the face.
5. Remove all tubes, catheters, and medical devices unless an autopsy is required. Clean any insertion sites with antiseptic wipes.
Removing medical devices restores the body’s natural appearance and prepares it for transportation to the morgue or funeral home. Review institutional policies regarding autopsies.
6. Perform a thorough cleansing of the body using a gentle soap and water, and dry it properly.
Cleansing the body maintains dignity and hygiene, and prepares it for viewing by the family or for the next steps in postmortem care.
7. Place an absorbent pad under the patient’s buttocks.
Helps maintain cleanliness by absorbing any bodily fluids released due to the relaxation of the sphincter muscles. It also helps prevent soiling of the bed linens, ensuring a more hygienic environment.
8. Gently close the patient’s eyes and mouth, using slight pressure if necessary.
Closing the eyes and mouth provides a peaceful appearance, which can be comforting for the family during their final moments with the deceased.
9. Dress the body in a clean gown. Brush and comb the patient’s hair.
Dressing the body in clean clothing or family-provided attire respects the dignity of the deceased and ensures the deceased appears cared for and well-presented.
10. Cover the body with a clean sheet up to the chin with arms outside covers if possible.
Covering the body with a clean sheet helps maintain the dignity and respect of the deceased. This presentation also provides a peaceful and comforting image for the grieving family.
11. Provide emotional support to the family, offer time with the deceased patient, and answer questions.
Providing emotional support to the family allows them to process their grief and find comfort during a difficult time. Offering time with the body and answering questions helps fulfill their need for closure and understanding.
12. After the family leaves, pad the chin and fasten chin straps underneath, tying them loosely above the head.
Padding and securing the chin helps maintain the proper alignment of the head and neck, preserving the appearance of the deceased.
13. Pad the wrists and ankles, then tie them together using gauze or soft string ties.
Padding and securing the wrists and ankles prevent any potential movement of the limbs, ensuring a dignified presentation of the deceased.
14. Place the body in a body bag or wrap it securely in a shroud.
Prepares the body for transportation while ensuring hygiene and dignity.
15. Attach identification tags to the body as per facility protocol, including the wrist and toe, and any personal belongings.
Prevents misidentification and ensures that the deceased’s belongings are properly managed and returned to the family.
16. Complete all required documentation, including time of death, personal belongings inventory, and any other relevant information.
Ensures that all legal and procedural requirements are met and provides a record for future reference.
17. Inform the family and provide any necessary information regarding viewing, autopsy, or funeral arrangements.
Supports the family during their time of grief and ensures they are informed about the next steps.
Paul Martin R.N. brings his wealth of experience from five years as a medical-surgical nurse to his role as a nursing instructor and writer for Nurseslabs, where he shares his expertise in nursing management, emergency care, critical care, infection control, and public health to help students and nurses become the best version of themselves and elevate the nursing profession.
