Rite on

Charles 4 Comments

Presently, more than 50 per cent of people who die in an NHS hospital do not receive last offices.

How did it come to pass that hospitals stopped performing last offices for dead patients? How was it that a ritual as old as time was so coldly abandoned? How did it come to be acceptable that funeral directors should collect corpses bagged with lines attached swimming in their own urine?

Good medics and nurses care like crazy for their patients. Good funeral directors care far, far more than people know for their dead. And in between, this hiatus where the body occupies the status of, I don’t know, so much disappointing carcase.

I’m not writing surefootedly here because I have never collected a body from a mortuary. FDs who read this blog will, I hope, feel inspired to give us informed information.

Having said which, the future is bright. At the instruction of the National End of Life Care Programme, all people who die in NHS hospitals will in the future have to be given last offices, and nurses will have to be trained to do it. Except it won’t be called last offices, it will now be called care after death because apparently last offices sounds too military.

People with ‘religious or cultural or requirements’ will be invited to participate. I really can see no reason at all why all people should not be invited to participate. They can always say no thanks.

New guidelines include: 


Jewellery should be removed in the presence of another member of staff, and staff should be aware of religious ornaments that need to stay with the body 


The body should be wrapped in a sheet and lightly taped, so as not to cause disfigurement 


People should never go naked to the mortuary, or be released naked to a funeral director 


The dead person should be laid on their back, with arms by their sides and a pillow under their head 


Eyes should be closed by applying light pressure for 30 seconds 


If a death is being referred to the coroner, intravenous cannulae and lines should be left in situ


I can see FDs nodding in approval of the pillow. Read more in the Nursing Times here. Read a nurse’s experience of last offices here.


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12 years ago

“I really can see no reason at all why all people should not be invited to participate.” I couldn’t agree more, Charles. Well, more or less. Actually, it is of course the family’s right to do this. The act is in fact the family’s property, and it is the staff who should be ‘invited’ to participate. But of course most people don’t realize this, or even think of it, and by the time you let them know of this axiom, it’s too late unless you have got to them before the person dies. So the moral is that the funeral… Read more »

Charles Cowling
12 years ago

Very good point, very well made, Jonathan!

11 years ago

great point i would like to family asked first than hospitals just rush in and do this they will never know what they have missed ,my daughter is a nurse and i would much rather her to prepare me , than a stranger

Charles Cowling
11 years ago

Yes, Jon; absolutely agree with you.