If a death occupies or is pronounced in the presence of a doctor or authorized medical staff, the death is termed as attended. By definition then, a death occurring within the home or without the presence of a doctor or medical staff is unattended.
Unattended death situations always require some law enforcement involvement. The police have the job of actually establishing whether the death involves any foul play. In conducting an investigation, the police have to be very consistent even when looking into routine matters. Under the conditions of stress, crisis clients may become defensive and offended at the matter of fact tone of the questions being presented. In the event law enforcement has to appear in court for any reason they must be able to say that they handled every aspect of the scene identical to all others.
Obviously, a large majority of death calls do not involve foul play and the questions are routine. At an appropriate time but as soon as practical, the reason for this function must be provided to the crisis client. With an explanation the interviews will proceed much quicker and with less confrontation.
Prior to the creation of the crisis response function it was part of the function of the police to deal with stabilizing the crisis. For this reason crisis responders should follow the lead of the law enforcement officer on scene. As the department and personal relationship develops the crisis responder may perform some of the post incident functions such as establishing the deceased’s primary care doctor, next of kin, friends and family support systems for the crisis client and law enforcement.
It is important to note that if the circumstance at the scene does appear to be suspicious, crisis responders may supervise the crisis clients as instructed by the police but under no circumstances are any questions to be asked or answered until the client(s) have been interviewed by the on scene law enforcement agency. Discussions between crisis clients and or responders could become tainted with unintentional cross fertilization.
With the stabilization of the situation it is now time for the crisis responders to turn his or her attention to transitioning the deceased from the current location (home) to the next stage of making final arrangements.
If the deceased’s physician has agreed to sign off on the death certificate, the next step would usually involve assisting the crisis client(s) in the selection of a funeral home in the area. If warranted, by the authority on scene, an autopsy is to be conducted to determine the cause of death, the medical examiner would be contacted.
Upon the arrival of the funeral home or medical examiner it is more comfortable to have the family and friends move someplace out of sight of the removal preparation activities. There are often situations in which due to a lack of manpower, crisis responders may offer the assist the ME or funeral home staff. This is very much dependent upon the comfort level the crisis responder has with handling the deceased. Remembering the differences as to how different cultures deal with death, the family may require that they observe every phases of the process.
As the body is being prepared for removal the crisis clients (family) may be asked if they would like to say their good byes. If so, the crisis responder would ask the ME or funeral home staff not to fully cover the deceased’s head and shoulders. If they agree, invite the family to say their good byes the same as you would if the death were attended in a hospital room. At this point, the family should again be removed to an area where the actual removal of the body is not witnessed. Watching a loved one be “loaded” into the back of a van or the hearse can be very upsetting. Time now for a final prayer or expression of sympathy and a quiet exit made once the deceased has left.
For more information concerning the process of Crisis Response Management, see Lesson #8- Dealing With Death,– A Child Code.