End of life care and funeral arrangements....How much do new care home need to know?

Discussion in 'Middle - later stages of dementia' started by snowygirl, Oct 11, 2015.

  1. snowygirl

    snowygirl Registered User

    Jan 9, 2014
    151
    Hello TP'ers
    Dad has recently gone into a care home and we have been involved in setting up the care plan etc. One of the pages of the plan asks lots of questions about end of life care including if a DNR has been set up. I appreciate why the home needs to know this( the DNR) but why at this stage do they need to know if dad wants to be cremated or buried, where he wants this to be, what funeral director he wants to use and what he wants to wear? Surely when the time comes we will arrange where dad is moved to(as in the funeral directors) and then after that we will get on with the funeral arrangements. Why ask this now as currently we cannot answer these questions as surely they don't expect us to ask dad himself or our mum who herself has dementia. Isn't this something that the family will deal with at the time? Is this normal to ask these questions? Thanks for your help.
     
  2. Kevinl

    Kevinl Registered User

    Aug 24, 2013
    4,776
    Salford
    Hi Snowy
    The DNA is I guess a fair enough question to ask once it's on file everyone knows where they stand in the future, as for the rest of the questions I'd tell them you'll handle all the details when the time comes. Details like buried or cremated, what clothes and who the funeral directors will be are something you can sort out yourself.
    A good funeral director will take care of everything, when my mother died they contacted the church where she used to live and fixed a date on one of the days we agreed, booked the crematorium, took my mother from the hospital to their chapel of rest, sorted the music we wanted and even gave me a list of local venues for the wake having first checked they'd be available that day. I got a similar service from a different company when an uncle died, as it was in a home and there was an inquest it was complicated but they took care of everything flawlessly.
    As none of the questions have any relevance to the care home I'd tell them you consider it very insensitive and you'll sort it yourself.
    K
     
  3. Saffie

    Saffie Registered User

    Mar 26, 2011
    22,499
    Female
    Near Southampton
    There is a reason for the home needing to know these details and I was asked them too.

    The details regarding the Funeral Director you want to use are very relevant and they will also want to know his phone number.
    The home will need to contact the Funeral Director in the event of a death and and it is possible that they would not be able to contact the next of kin at the time to ask who this should be.
    In such a case, they would also need to be able to inform the Funeral Director of the preference for a burial or cremation. Some people of course do not even have a next of kin to be contacted.

    I was shaken when I was ask for these details when my husband entered his nursing home and the above was explained to me. The timing was upsetting but I understood the necessity for it as someone could die at any time.

    In actual fact, sadly it did happen to us as I was with my TP friends in Launde Abbey when my husband died suddenly. The home were able to contact the chosen Funeral Director without being delayed by my absence but they asked him not to come until after I had arrived.
     
  4. sleepless

    sleepless Registered User

    Feb 19, 2010
    3,223
    Female
    The Sweet North
    Reading Saffie's post reminded me that on one or two occasions my dad's care home have been unable to contact either myself or my sisters for several hours, so I can understand them needing this information.
     
  5. Lindy50

    Lindy50 Registered User

    Dec 11, 2013
    5,239
    Cotswolds
    I agree with sleepless and Saffie, I have given my mum's care home this information in case they were unable to contact me quickly at the relevant time.

    Not sure why they'd want to know what he should wear, that maybe seems a step too far....

    I can understand why you'd feel these questions were insensitive, but it could be vital for them to have this information (as Saffie says).

    Hope your dad is getting on okay.

    Lindy xx
     
  6. Lawson58

    Lawson58 Registered User

    It sounds to me as if the CH is trying to alleviate you of having to make some of these decisions at a time of deep grief and by making your choices known in advance they are going to be able to help you through a very sad time.

    And I think that in asking you about your dad's clothing is just part of the same process and I believe they are simply trying to be helpful at a time of great stress.
     
  7. Pickles53

    Pickles53 Registered User

    Feb 25, 2014
    2,475
    Radcliffe on Trent
    I wonder if there are legal or other requirements which mean (for example) that if someone dies and the family can't be contacted fairly quickly that the person cannot remain at the care home? Perhaps if no funeral director has been designated they would have to send the person to a hospital mortuary which might be even more distressing? I can't think why they would ask about clothes, except that people do often have very specific views about what should/shouldn't happen; maybe they are trying to anticipate your wishes and avoid upsetting you further at the time by making the wrong assumption.

    There's nothing wrong with asking why they need to know this now, and then you can decide how to answer. Although it was a shock when I was first asked these questions, I did find it helpful when the crunch came, especially as in mum's case the care home was near me but the funeral was back in her home town.
     
  8. Spamar

    Spamar Registered User

    Oct 5, 2013
    6,993
    Suffolk
    DNR, yes,the care home will need to know this.
    I can also understand why they want to know funeral director. In my case OH died relatively unexpectedly and they only asked for the funeral director a few hours before he died. Just as well, as he died at 03:00 and was collected by the funeral directors 2 hours later. Clothes etc, I did it all through the funeral director, who was wonderful. The clothes I wanted him to wear weren't even at the home, so they couldn't have dressed him anyway.
    Just tell them you don't know any details.
     
  9. sleepless

    sleepless Registered User

    Feb 19, 2010
    3,223
    Female
    The Sweet North
    #9 sleepless, Oct 12, 2015
    Last edited: Oct 12, 2015
    I think the question about which clothes is also to do with time constraints. Sometimes the deceased will need to be taken from the care home, then prepared for burial or cremation as soon as possible.
    In some cases it is not possible to make changes to what they are wearing for very long after this stage, so to avoid any distress or disappointment about this (if say the family cannot be contacted at the time,) it is as well that these wishes are known.
    I speak from just one experience when this was the case, and hope I have not upset anyone.
    In the particular case, it was not that family were out of contact, rather that we requested certain clothing when it was too late.
     
  10. Witzend

    Witzend Registered User

    Aug 29, 2007
    4,289
    SW London
    We weren't asked, but I do see why they do - in case for whatever reason there is nobody to ask at the time. My mother died in July at her CH (after nearly 8 years there) just a few days before the entire family was due to be away for at least a week each, for a wedding in France. They did have a mobile number, so if the worst had happened while we were all away they could presumably have asked us then. In the event we just used the family-run funeral directors closest to the care home, which happened to be next to the Register Office.

    However it is emotional enough to be asked after a death the sort of details like what someone would want to be dressed in, let alone maybe a long time before the event. My mother had never talked about such things, so we assumed she'd have wanted the same as she did for our father. I honestly don't think she'd have cared about clothing - I was stumped when asked but in the end just said a pretty dressing gown she'd always been fond of.

    If everybody happened to be away and out of contact at the time, presumably the home would at least want to know which funeral director to ring. I would have thought other details could wait, always assuming there was going to be anybody to ask later.
     
  11. Chemmy

    Chemmy Registered User

    Nov 7, 2011
    7,592
    Yorkshire
    I was asked these too.

    You can always change your mind re. clothes - I was asked again once Mum had died, but to be honest, I was glad I'd made some arrangements in advance as at least I had time to consider the options.

    Dad died very suddenly and I was in such a state of shock, it was just easier to go with the flow than make a considered decision. I have no idea what he wore.

    Nominating a funeral director is sensible. The body will need to be removed as quickly and as discreetly as possible, I should imagine, in order to minimise potential upset of the other residents.
     
  12. sleepless

    sleepless Registered User

    Feb 19, 2010
    3,223
    Female
    The Sweet North
    In our case, we couldn't have our relative put into the clothes we wished, a day or two after their death. So if it is important to anyone, re viewings, or for any other reason then I would advise stating it to the care home, even if it is just to say 'their own clothes' then something could be sent along to the funeral directors at the time the deceased was moved.
    It was upsetting to be told the reasons why our wishes couldn't be fulfilled, and I would not want anyone to go through that, when a simple instruction could avoid it.
     
  13. Chemmy

    Chemmy Registered User

    Nov 7, 2011
    7,592
    Yorkshire
    I'm sure the physical practicalities is the real reason behind the clothes question, but as you say, that's a difficult one to discuss.
     
  14. Saffie

    Saffie Registered User

    Mar 26, 2011
    22,499
    Female
    Near Southampton
    The clothes I wanted my husband to wear and which had special significance to him were not in the nursing home. I wouldn't have wanted him to wear the clothes he did have which were not what he would have usually chosen to wear at any time but were necessary for his life in the home.

    Fortunately , I was not asked anything as specific as this.
     
  15. snowygirl

    snowygirl Registered User

    Jan 9, 2014
    151
    Thank you to everyone for your replies. Having just put dad into a care home(he seems fine thank you) it just seems unreal to be talking about his death at this moment. Also, having mum still here but not 'here' all the time because of her dementia makes it hard to make decisions. My dad hated to talk about death and never wanted to make a will when he was ok so we just cant ask him this now but I'm sure we all know what he would want. I sort of assumed that the care home had contact with a funeral director and they would move dad if we could not be contacted which really would be highly unlikely as there are 3 of us siblings. I suppose its a 'just in case' scenario but at the time I felt like it was an intrusion on our private lives. I still cant get my head around others being involved in my dad's welfare but I guess I will get used to it.

    As a sideline to this I believe my dad will want to be cremated away from where he lives now so as to be near his mother and other family members. Would I have to put down a funeral directors where he lives now and another near where he will be cremated? I'm lucky to have only been involved in one funeral so far so I'm a bit naïve where this is concerned.
     
  16. Saffie

    Saffie Registered User

    Mar 26, 2011
    22,499
    Female
    Near Southampton
    The home will want the name of funeral director whom they will need to contact to come to the home to collect your father. That's as far as their responsibility will go.
    Obviously this won't be able to be carried out until the GP has visited your father and signed the death certificate.
    I'm really don't know what happens afterwards regarding a transfer to another funeral director. Could not the cremation take place where he is now and his ashes be interred near to his family?
     
  17. Spamar

    Spamar Registered User

    Oct 5, 2013
    6,993
    Suffolk
    Snowygirl, don't ever think it is too early. A friend and I were sewing labels on more clothes for OH only 7 days before he died. I certainly wouldn't be doing that if I had any idea what was going to happen so soon!
     
  18. Chemmy

    Chemmy Registered User

    Nov 7, 2011
    7,592
    Yorkshire
    I agree. If it's hard to deal with hypothetically, well in advance, believe me, it'll be much more difficult straight after a death, especially if sudden.

    I'd have a chat with your siblings and at least agree on a basic plan. You can always change your mind later down the line.
     
  19. nellbelles

    nellbelles Volunteer Host

    Nov 6, 2008
    8,472
    leicester
    I was glad I had sorted it all before hand, on the day, the care home manager contacted the undertakers and dealt with as much as he could.

    Leaving me and the family to spend time with Tom.

    Anything you tell them will not be fixed in stone, you will be able to change it.
     
  20. snowygirl

    snowygirl Registered User

    Jan 9, 2014
    151
    Its funny that I should feel like this being the one who is always trying to sort things out get things in order. I guess it just seems to be in haste but then again 2 months ago I didn't think dad would be in a home for another year!! We will all get together and answer the questions as far as we can go. And yes I don't know what I was thinking I suppose dad will be cremated where he is and his ashes can always be scattered somewhere else. Thanks everyone.
     

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