In times of Bereavement

Please find below information which may be of help to you. This ranges from the practical matters to emotional support and organisations that can help and support you. If you have any questions, please contact our Care Coordinator.

The Practical Arrangements

In the first few days after a death it is often the responsibility of the person who is most distressed to make the necessary practical arrangements. It is therefore wise to have a friend or relative to help you with these arrangements. Someone who can support you with the many things that need to be undertaken at this very difficult time.

Registering the death and obtaining the Medical Certificate of Cause of Death.

In September 2024, the law changed regarding how the Practice can issue the necessary paperwork to register a death.

Medical Examiners, who are mainly senior registered Doctors, have now become more actively involved with the process of issuing the medical certificate of cause of death.

Their role is to:
Determine the cause of death: The Medical Examiner ensures that the cause of death is accurately reflected on the medical certificate of cause of death and to improve the accuracy of mortality data.
Referral to the coroner: If necessary will determine whether the death needs to be reported to the coroner and explain the reasons why.
Addressing concerns: They will identify any concerns regarding the care provided to the deceased, whether raised by healthcare staff, the bereaved family, or observed during their review. These concerns will be escalated to the appropriate department or staff for further investigation.

When the Practice is notified of a death, information will need to be obtained to enable the GP to refer the death to the Medical Examiner office. A member of our Care Team will contact the next of kin to obtain details of the date, time and location of death along with the occupation (or last occupation) of the deceased and validate their contact details. In addition to this, there will be a discussion with the next of kin to establish whether they have any concerns and opportunity to ask any questions relating to the cause of the death or the care/treatment received by the patient. We acknowledge this is a very difficult conversation to have with our team, especially when someone is recently bereaved and incredibly upset. Our heartfelt apologies we have to ask such sensitive information.

Once this has been completed, the Practice will undertake a referral to the Medical Examiner who will also have a discussion with the next of kin to validate details provided. This could also include any information relating to recent hospital admissions or surgery.

The Practice will then be contacted by the Medical Examiner if they agree with the cause of death at which point the Medical Certificate of Cause of Death can be issued by the GP. The Medical Examiner will counter sign this and will contact the next of kin directly to make an appointment with the registrar to register the death which should be undertaken within 5 days of the issue of the Medical Certificate of Cause of Death.

No appointments should be made with the registrar to register the death until such time the certificate has been counter signed by the Medical Examiner.

There might be some cases where the Medical Examiner wishes to undertake an alteration to the information or may undertake a referral to the coroners for a particular reason. The Practice will cooperate with such requests in a timely manner as we do know wish to delay the issuing of the Medical Certificate of Cause of Death.

For further information regarding registering the death please visit

https://www.northnorthants.gov.uk/deaths/register-death

https://www.gov.uk/when-someone-dies

Contact a Funeral Director

Funeral directors can manage funeral arrangements and give advice and support. Most people choose to use a professional Funeral Director but some people prefer to make their own arrangements as they consider this to be more personal and less expensive.

Factors that may affect your choice of funeral director include:

The wishes of the person who has passed away
Location of the firm’s premises
The range of services provided
Cost
Recommendation of those who have used the service and trusted advisers
The way you are treated by the staff
Ownership – are they a large or small firm, a family business or company?
Advice or recommendation of family or friends

Most local companies are also listed in the telephone directory.

Before going ahead with any arrangements, it is advisable to check whether the deceased left a will and any instructions for the funeral. If you are not the Next of Kin (Nearest Relative) or Executor, you should check with them that you have the authority to proceed.

Member firms must provide you with a price list on request and cannot exceed any written estimate they give you without your permission.

Most people would probably require the funeral director to provide the following services as a minimum:

make all necessary arrangements;
provide appropriate staff;
provide a suitable coffin;
transfer the deceased from the place of death to the funeral director’s premises;
care for the deceased prior to the funeral;
provide a hearse to the nearest cemetery or crematorium;
arrange for burial or crematorium as appropriate.

Embalming, viewing of the deceased, or providing a limousine for mourners are optional extras. Discuss these fully with your funeral director and make sure you receive an itemised written quotation.

Funeral costs for the same services may vary considerably from one funeral director to another. It is advisable to get more than one quote to compare costs and services. Funeral directors should provide detailed price lists for you to take away.

Disbursements are fees paid to others, i.e. for doctor’s certificates, a minister, newspaper announcements, flowers, and crematorium. Ask the funeral director for a written quotation detailing all these fees.

In addition, it should be remembered:

when you arrange a funeral, you are responsible for paying the bill;
funeral payments are normally recoverable from the deceased’s estate;
check that the price includes what you require and whether there are any additional costs that will be added on.

Informing Organisations of the death

Telling people about a death is often difficult, and you may want to ask trusted family and/or friends to help you.

The registrar will discuss with you the Tell Us Once service, which enables one communication to be sent to various organisations. GOV: Tell us Once

There will be a number of people and organisations who will need to be notified about the death to ensure the persons estate is dealt with appropriately that can not be undertaken via the Tell Us Once service. Banks in particular should be told quickly to prevent against fraud.

It is useful to record the date, time, and name of the person you speak to when making calls. Additionally, if you send of any important documents, it is advisable to keep a copy of them and a note of when you sent them.

If you are using a professional (such as a solicitor) to deal with the estate, they will be able to help you with any legal requirements and advice you on benefits or other financial matters.

Grief

We offer some support which we hope will help you come to terms with the emotions of losing a loved one.

Whoever has died, your loss is unique to you, and you will cope with it in your own way. But although bereavement is a highly personal and often traumatic event, many people go through a range of recognisable reactions and emotions when someone they are close to dies.

Sometimes people are shocked and upset by their changing and emotions when they are bereaved. Realising that these feelings are quite normal may help.

Grief knocks you off balance emotionally, physically and mentally.

If the death had been expected, you tell yourself you should be able to cope, but you might not be able to and really can’t. You think you’re over it, and you’re not. It hits you when you least expect it and the emotions are so overwhelming. You think you should feel alright because you have family and friends looking out for you – but you don’t feel all right because no one can replace the person who has died. Sometimes you feel so alone in your grief.

Close family might see you as the “strong one” which can make dealing with your own grief so much harder.

When you are bereaved you have to cope with a life without your loved one. Some people lose their sense of identity. It is very difficult and extremely hard to adjust – you always want to turn to that person for a chat, pick up the phone, drive to see them.

In practical terms, your life may have changed dramatically. You may have much less money, or you may be better off financially. You may be eating and sleeping alone for the first time, or be faced with household jobs which you used to share with the person who died. Losing a close family member or an old friend can mean that you have no one who shares your childhood memories and family jokes.

At First…

you may be too shocked to feel anything much, even if the death had been expected. Many bereaved people say that, in their initial shock, they felt a sense of numbness and disbelief.

As you get over the shock and begin to grasp the reality of what has happened you may go through some of the most powerful feelings you have ever had, feeling high or excitable one minute, in despair the next. You may think you are going mad because you can’t control your emotions, can’t concentrate, can’t organise yourself to make a phone call or make a cup of tea. It may seem as though everything you knew has gone and that nothing will ever make sense again.

You may feel that you don’t care whether you live or die because the person who died was so important to you that you cannot imagine existing without them. Your loss may feel overwhelming and you are likely to be reminded of it constantly.

You are likely to find it hard to concentrate, and may feel confused and forgetful. Your thoughts may constantly return to the person who died, with painful questions and fears running through your mind. Alongside this, you may have a sense of relief if they died at what seemed the right time for them.

As you think more about the person and your relationship with them, as you talk about them and listen to what relatives and friends, you are likely to start building a fuller picture of them than you had before. As it grows, you will probably find this picture becomes a part of your life, a source of comfort which is more than just a memory.

Sleeping

You may have difficulty getting to sleep, and your sleep may be disturbed by vivid dreams and long periods of being awake. Night time can be the hardest for people.

You may feel restless, slow, exhausted (especially if you had been providing care for the person who died, or had been through an anxious time before they died). Try and keep to a normal sleeping pattern to enable you to sleep through the night.

Call the Practice if you need some help and a clinician will contact you.

Physical changes

You might lose your appetite whilst you are feeling so low. If you don’t eat properly and “fuel” your body, you may be more susceptible to colds or other infections.

Whilst it is incredibly difficult and you feel very unmotivated, take some gentle exercise if you can. A short walk could make all the difference.

Getting used to the death

Accepting the loss of a loved one and “getting on” with life is very difficult. Talking about the death of loved one can be easier than other occasions. Sometimes you will feel brave and able to talk about the death, other times you really aren’t able to cope. It’s OK to feel like this. Don’t fight it, allowing your feelings to come out helps and heals.

Your life will be different and it will take a very long time to find a way of living without the person alongside you.

Feelings of depression can hit you when the reality of the death begins to bite and you realise that the person who has died will not be coming back. And just when you think you have started to move on and are feeling better, you may hit rock bottom and life can seem endlessly bleak and empty. Depression is a natural response to a bereavement, and usually lifts of its own accord. But if it doesn’t, and life seems an endless, pointless struggle, you could be clinically depressed. Clinical depression can be treated and there are different ways of getting through periods of depression, both with and without antidepressant medication. Once again, if you feel this way, you contact the Practice as our Clinicians will be able to help you.

Some people feel very angry due to the loss. That’s ok, you feel hurt and unhappy. The important thing is don’t bottle it up, speak to someone if you can or just scream and shout.

You may feel guilty as you think back to moments where you might not have not been able to see the person, not been able to do something they asked or remember a disagreement you had. This is normal, very normal to have these feelings of regret and guilt. Don’t be too hard on yourself or anyone else. No one is perfect and most people try to do the best they can with the situation they are in. As hard as it feels now, you will reach some acceptance of the past.

At Abbey Medical Practice we support our patients and it is very important you reach out to us to help you.

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