2.Principles, Purposes and Standards 3&4

The Mungo Foundation
Death and Bereavement Policy
SERVICES AND DEVELOPMENT DEPARTMENT RESPONSIBLE FOR IMPLEMENTATION / ISSUE DATE:
REVIEW DATE:
October 2013
POLICY SECTION
Services & Development

Contents

Page No

1.Policy Statement3

2.Principles, Purposes and Standards 3&4

3.Specific Considerations 4-6

4.Roles and Responsibilities 7-10

5.Implementing the Policy 10-15

6.Relationship to other The Mungo Foundation Policies, Procedures16

and Standards

7.Further Reading and Resources 16-18

1.Policy Statement

1.1Introduction

When experiencing a significant loss in our lives we grieve. Grief can be emotionally and physically draining and it consumes a tremendous amount of energy. It is also a necessary process linking between loss and moving forward. We may grieve not just for the people who have died, but other losses.

1.2The Mungo Foundation seeks to provide appropriate services to all individuals we support. This invariably means that staff and volunteers will be involved with individuals at important points in their life and this will include times of death and bereavement with the resulting feelings of grief and loss.

1.3The policy will consider two different death events. The first is the death of anindividual and the second is the death of an important person in the life of anindividual. The focus of the first will involve support and procedures for family, friends, other individuals we support and staff. The focus of the second involves support and procedures for the individual. Whatever the circumstances, The Mungo Foundation will endeavour to monitor the needs of all those involved in the particular death, seeking to offer and provide the appropriate support.

1.4The policy recognises that death requires certain procedures and tasks to be carried out. However, it is also a process of grief and loss which is personal to each individual.

2.Principles, Purposes and Standards of this Policy

2.1In supporting individuals in the death and bereavement process The Mungo Foundation will, therefore, adopt the principles:

To treat people with dignity and respect;
To assist individuals to know about the range of choices available in relation to making death arrangements while recognising the legal considerations which must be taken into account;
To recognise and respect that grief and loss is an individual experience.

2.2The Mungo Foundation adopts the key purposes:

To help individuals to receive support during an important life event;
To assist individuals to make the necessary arrangements for the funeral;
To ensure funeral arrangements are consistent with the individual’s we support’s choice;
To monitor personal coping mechanisms;
To identify further support resources where these are needed and requested.

2.3Standards

The following standards are expected;

Care planning includes helping people to plan arrangements after death where appropriate;
Individuals are assisted to make wills;
Services are aware of the designated staff within The Mungo Foundation who are trained in bereavement counselling;
Proper procedures and protocols for notifying next of kin, health authorities and statutory authorities are in place;
Staff are aware of the resources available, which relate to death and bereavement;
Care plans identify cultural, religious or other preferences in relation to death and dying;
Emergency procedures are in place and easily accessible.

3.Specific Considerations

3.1Introduction

There are a number of matters to take into account in relation to this policy. This policy will cover the range of things to be done at, before and immediately after a death occurring. It includes:

Tasks to be completed in helping individuals prepare for death;
Procedures for dealing with the death of a person within the service;
Supporting individuals to deal with the death of a family or staff member.

3.2Sensitivity will be required to achieve the balance between support and what could be seen as interference during a distressing time. There is a process of grief and loss taking place, for individuals we support, but also for staff. This process can be identified and understood but is unique to each individual.

3.3The Changes People Experience during Bereavement

Prior to death the person who is dying, will be experiencing a range of emotions and will require patient and understanding support. Before, during and after the death of a person it is likely the bereaved persons will also be going through a period of changing feelings and mixed emotions. It will be important to recognise that this person will require patience and understanding at this time.

3.4Who is affected by the Death?

It is important to recognise that the particular death will have an effect on a wide group of people. Grief and the resulting sense of loss is a common experience to all people. This is related to the fact that the nature of our social care service stresses the importance of relationships and that death is a disruption to relationships. Also consider:

Common features of how it affects each person since each will be affected in an individual way;
Support focused on those immediately affected;
Support also for those on the fringe of the event;
Support that may be required by other individuals, staff members or family, some of whom will be observing the process from a distance, i.e. they do not have a role in the immediate activity but are nonetheless affected.

3.5The Process of Grief

Arrangements have to be made before and after death and these are an important part of the grief and mourning process. Making funeral arrangements, for example, is an integral part of this process. There is a widely recognised grieving process, often broken into stages of denial, anger, bargaining, depression and acceptance. People will go through this process in their own individual way and speed and each of these stages is considered a normal response to this life event.

3.6Ongoing Sense of Loss

There will be a very real sense of loss for those close to the person who has died. This will be equally true for the individuals we support, family members and staff. While the process of grieving can usually be worked through, the sense of loss may continue for a long time, if not forever. What may change is that the sense of loss may move from the conscious level to sub-conscious level. It is worth remembering loss is an experience that all of us have experienced in one form or another before. It may be associated with death but there are many other forms of loss experience common to us all e.g. separation, loss of hopes etc…For this reason the sense of loss may well trigger past feelings about other significant experiences.

3.7Ongoing Issues after Death

In an immediate sense, but more often in a more medium/long term manner, regrets may develop for individuals and staff in relation to the person who has died. These feelings can turn to guilt. These feelings need to be acknowledged and worked through if possible. It will also be important to support those who are grieving to celebrate the life of the person who has gone. Both these responses are healthy and normal providing they do not consume those who are grieving. Death and bereavement will also be associated with life change and life transitions.

3.8Referral to Outside Agencies

It is important to recognise that there may be times when the support which is required by someone who is grieving may need to come from a resource which offers a specialist service in relation to bereavement. This may be because of the particular issues in relation to the death or it may be the person who is grieving is becoming stuck in the grieving process.

3.9Legal Considerations

The Scottish Government have produced a booklet which gives guidance on what to do and advises on legal matters and other issues. It covers legal aspects including the Donation of Organs for Transplants, Getting a Medical Certificate, The Role of the Procurator Fiscal, How to Register a Death, Planning the Funeral, Cremation or Burial, Help with the Funeral, Paying for the Funeral. It also covers Possessions, Property and Children, the Will, the Executors, Small Estates, Distribution of Property and Possessions, the Home, Debts. The third section deals with Social Security and help for those who are left. See useful websites (pages 17&18).

3.10The Department of Works and Pensions also produces a booklet about arrangements required after death, set out in “What to do after a death” DSS leaflet D49S (for Scotland). It includes – Paying for the Funeral, Administering the Deceased’s Estate, help for those who are left and other leaflets and how to get them.

It may be that staff from The Mungo Foundation will not require to carry out these tasks but may play an important role in supporting family and/or friends to do these at a time when there is distress and confusion.

4.Roles and Responsibilities

4.1Introduction

When considering roles and responsibilities in relation to death and bereavement, there are two functions to consider. There is the need to complete the administrative tasks and these can, while personally challenging, be managed in the organisational structure (pages 8-10).

4.2However, the tasks of providing personal support will involve the grief and the feelings of the bereaved who may include individuals, staff and those outside the service, such as family members. This is a greatly increased personal approach to the event and will engender feelings that are more difficult to deal with in a planned manner, meaning that only general principles can be followed. Staff at The Mungo Foundation may, or may not, be the best people to deal with these individuals needs. The responsibility for this aspect of our service can, however be monitored in a structured way to ensure that these needs are acknowledged and met by the appropriate person.

4.3Roles and Responsibilities of all Staff

There are a number of responsibilities that are common to all staff and volunteers within The Mungo Foundation irrespective of their function within individual services and the wider organisation. These are:

To ensure they are aware of the importance of the Death and Bereavement Policy, good practice guidelines and their role in The Mungo Foundation’s operational procedures;
To ensure implementation of this policy;
To help create an environment where the issues relating to death and bereavement are dealt with in a supportive and caring manner. This will include alerting the appropriate person, usually the Project Manager to bereavement issues which occur for the person;
To alert your colleagues, particularly your Supervisor, to your support needs.
All Staff will:

For Self:

Act in accordance with 4.1 (page 7).

For Individuals we Support:

Be aware of The Mungo Foundation’s Policy on Death and Bereavement;
Respect the personal, cultural and religious wishes of the individuals we support as they relate to death and bereavement;
Be aware of the different resources available which relate to death and bereavement;
Be aware of emergency procedures within the service;
Deal with issues of death and bereavement with respect, sensitivity and legal propriety.

4.5The Key Worker will:

For Self:

Act in accordance with 4.1 and 4.2 (page 7).

For Individuals we Support:

If requested assist individuals in planning arrangements for death and bereavement;
If requested arrange legal advice on the making of a will;
Ensure the individuals’, carers and wishes regarding death, dying and bereavement are recorded in Support Plans;
Support individuals after bereavement.

For the Service:

Alert the Project Manager to concerns and support needs of the individuals we support;
Alert the Project Manager of the arrangements for the funeral and raise any concerns about these.
The Project Manager will:

For Self:

Act in accordance with 4.1 and 4.2 (page 7).

For Staff:

Ensure that staff are aware of the policy on death and bereavement and are trained and supported to implement it;
Ensure that emergency procedures are in place and that all staff receive ongoing training in implementation;
Oversee the implementation of procedures when notified of a death within the service;
Ensure that a dignified and appropriate funeral is arranged in accordance with the individual’s;
Ensure the availability of accessible information about the individuals’ we support’s rights to choose their own funeral arrangements;
Assist in arranging attendance at funerals as appropriate;
Ensure that the staff are supported throughout the period of bereavement;
Ensure that accident and incident reports are completed within required timescales;
Ensure that the critical incident de-briefing is undertaken as appropriate;
Ensure that all relevant agencies and statutory authorities are notified in the event of the death of anindividual or staff member;
Ensure implementation of this policy.

For the Service:

Advise the Service Manager of funeral arrangements in relation to anindividual;
Advise the Service Manager of any complications that arise from the implementation of this policy;
Identify where there is a shortfall in resources in meeting the needs of individuals we support and staff;
Advise the Service Manager of any needs which arise for individuals we support and staff in relation to particular death arrangements;
Highlight the training implications of this policy.

4.7The Service Manager will:

For Self:

Act in accordance with 4.1 (page 7);
Support the appropriate services in relation to any death.

For Staff:

Identify suitable staff to undertake bereavement counselling;
Prepare media statement in consultation with Project Manager and Director of Services and Development if the death is likely to attract media attention;
Decide on requests for funds to cover funeral costs;
Review the consistency of practice and policy implementation;
Ensure implementation of this policy on death and bereavement;
Ensure that staff are adequately trained and supported in death and bereavement;
Ensure that the latest research and good practice guidelines on death and bereavement are disseminated.

For the Service:

Liaise with other agencies who will provide specific services in relation to identified needs;
Advise the Director of Services and Development of any potentially difficult situations;
Report on the extent to which services audit the implementation of this policy, assess and report on the implications for policy and practice.

4.8The Director of Services and Development will:

For Staff:

Receive reports on the death of anindividual we support or staff member;
Make recommendations on issues of policy arising from the death of anindividual we support or staff member.

For the Service:

Deploy, implement, monitor and review this policy;
Report to the Board on the subject of death and bereavement as required.
The Chief Executive will:

Ensure deployment, implementation, monitoring and review of this policy.

5.Implementing the Policy – Good Practice Guidelines

5.1The Mungo Foundation Policy delegates to the Project Manager responsibility to implement the Death and Bereavement Policy. The person to carry out specific responsibilities will vary, dependent upon which part of the policy is being implemented and whether staff are operating in a planning or emergency situation. In general, the Key Worker or the person designated by the Project Manager will carry out planned duties. Un-anticipated or emergency needs will be allocated by a senior member of staff on duty or on-call.

5.2Planning for anindividual we support’s death

If the individual wishes to make plans of this kind, whether as part of the care plan or at other times, be willing to offer support. The rights of the individual we support regarding confidentiality must be respected at all times. The individual may wish to involve the family to help with these plans;
Bear in mind the various cultural and religious traditions regarding death. Acquaint yourself with any which may be of relevance to the individual;
Problems of intestacy are avoided by the making of a will. If the individual wishes to make a will, advice should be obtained from lawyers or appropriate agencies. Staff members are not allowed to be beneficiaries;
The individual may express wishes about the involvement of family members or friends who are not otherwise known to the service. Any such information should be recorded;
Other helpful information may include:

-The names of ministers, rabbis, priests and other religious representatives;

-The names and locations of places of religion, such as churches, mosques and synagogues;

-If there is a will, the names of the solicitors and executors;

-If there is a funeral bond or funeral arrangement, the name of the company and details of the contents;

-The location of the family lair, should one exist;

-The individuals’wishes should be recorded carefully and the individual should be asked to confirm by signature the accuracy of the record. This record may form part of the Personal Support Plan or be a separate record;

-The individual may wish to purchase a funeral bond from their own funds. Where the service lacks the capacity to decide on such matters, sensitive contact with the next of kin should be initiated by service staff.

5.3Procedures when anindividual we support dies within the service premises

Immediate Action

The staff member who finds the individual should first check that there are no detectable life signs, pulse, blood pressure or responses. If there is any doubt about death, resuscitation or other appropriate procedures, these should be followed by the staff member and any staff on duty with Nursing or First Aid qualifications. The emergency services should be called immediately if there is any possibility that the individual is still alive;
If the individual is assumed to be dead, the body should not be moved. Nothing else at the scene of death should be touched or moved. If necessary, the area should be cordoned off or isolated to support dignity and prevent distress to staff and other individuals we support;
Telephone the individual’s General Practitioner and arrange for a doctor to attend. Find out when the General Practitioner last saw the individual (if this was within the last three weeks, the doctor may agree to issue a Death Certificate);
Advise the immediate Project Manager. Call out the On-Call Project Manager who will in turn call out the On-Call Service Manager. The Project Manager should be informed of any death at the earliest possible opportunity and the Service Manager within 24 hours of the death (immediately if the Service Manager is available). The most senior member of staff available should take responsibility for implementing these procedures.

Action Thereafter

Check whether there is a record of the individual’s wishes with particular regard to whether a cremation has been requested (the doctor who attends will need to know this as a second doctor will then need to examine the body);
After the examination the body may be moved to a suitable place. If the doctor cannot give a death certificate or is not satisfied concerning the cause of death, the doctor can only pronounce life extinct and there will be an autopsy to determine the cause of death;
Check the record of the individual’s wishes to find out whether there are any significant cultural or religious factors that may affect the funeral arrangements or relationships with the family;
Inform the next of kin, other family members and close friends. A personal visit may be the best way to inform close relatives;
In consultation with the General Practitioner a decision will be made to contact the Police if required;
After the doctor has given permission, make contact with suitable local Funeral Directors who will arrange the removal of the body. Be respectful of the wishes of the family who may wish to be consulted and to play a part in the making of these subsequent arrangements. Inform the Funeral Directors if there are any particular cultural or religious considerations and if the individual made prior arrangements for the funeral through a funeral bond or by reference to a family grave;
Arrange for the death to be registered by making an appointment, within five days of the death, with the local Registrar of Deaths. The Registrar will require the deceased’s birth certificate, medical cared and the death certificate issued by the doctor(s) who attended the deceased;
Inform bank, building society, solicitor, insurance company, library, club or other organisations who had dealings with the deceased individual;
Inform any attorneys, guardians, tutors, curators, appointees, social work and health professionals if they have not already been advised by previous contacts;
Record the death and actions taken using the Accident and Incident forms with supplementary pages;
Take action to support staff and other individuals’ through critical incident de-briefing and other forms of support;
If the death is likely to attract media attention, a Media Statement should be prepared by the Service Manager in consultation with the Project Manager and the Director of Services and Development;
Continue to observe the individual’s rights of confidentiality after death while respecting statutory requirements for information.

5.4Procedures when anindividual we support dies away from the service premises