Tuesday, July 15, 2008

Handling Death at Home in Singapore

Death and Its Issues

Death is often a painful separation. No amount of preparation can prepare one for the moment of loss. The hapless feeling of loss of a loved one is inexplicable and sometimes even traumatic.

Care givers or family members with elder relatives can use the following recommendations to tide through these difficult times.

Be Prepared

Upon discovery of the passing away of a patient or elder, family members would frantically call for a doctor to certify the death of their loved ones. Unfortunately, medical practitioners need to be able to inform the authorities what is or are the medical condition(s) that has resulted in the death.

Medical practitioners will have difficulty in identifying the cause of death from deceased with no recent review by doctors or no recent admissions to hospitals. As such, it is recommended that patients receive at least a regular follow up with the doctors once in every 2 months. Obtain a letter from the regular doctor that documents the diseases and tests done. The documents together with the test results would allow medical practitioners to ascertain the cause of death of the patient.

Get a Breather

With the passing of a loved one, initial emotions can be dramatic. It would be preferred for the family to take some time to stabilise their emotions before proceeding with the administrative tasks. There are many legal and ritual procedures to see through. Family members therefore do not have the time to imbibe in the event and accept the outcome. Some will need to express their pain through tears. Take some time for every family member to get over the emotion, including little ones who may find the adult behaviour out of proportion and become fearful.

CCOD - Certification of Cause of Death

This is a legal document issued by the doctor to the police to certify that a death has occurred as a result of certain medical conditions. It can only be performed by a registered doctor. The doctor may need to answer inquiries from the various disease registries, the Ministry of Health and Immigration & Checkpoints Authority. As such, medical documents from the various doctors and hospitals may need to be given to the doctor certifying the death for future reference.

Death Certificates

This is a legal document issued by the police from their police post to the relatives. Any person (above 21 years of age) can report the death. The person reporting must bring along their Identity Card, the CCOD and the deceased's Identity Card. The family must decide whether the deceased is to be cremated or buried and where the process is done.

Once the death certificate is given, please make a few copies as they will be required for uses such as making of insurance claims.

Certifying Cause of Death

Certifying cause of death is not simply a matter of certifying that a body is breathless and has no pulse. Any medical practitioner can certify cause of death provided there is a valid discharge summary from the hospitals, or records of diseases and tests (including test results) in recent months.

If there is no known cause of death, the doctor can only come to inform the relatives if the patient has passed away but will not be able to issue the CCOD. After confirming the death, the police will need to remove the body of the deceased to the mortuary for the pathologist to certify and sign up the cause of death. Not everybody will undergo autopsy and families and relatives can usually collect the body quite soon after the body has been examined.

Reporting of Death

There is a 24 hours grace period given for the reporting of death at home. However, it is easier to proceed with the various preparations with the death certificate.

Death Certification without Touching the Body

There are some religions that believe that the body should be left untouched for a few hours upon passing away. However, certain examinations have to be performed to ascertain that death has occurred. The doctor can be contacted in advance, but asked to arrive only after this time period is over.