Losing a loved one is an incredibly challenging and emotional experience, and witnessing someone’s final moments can be overwhelming, especially if you have never been through it before. As a hospice nurse with years of experience, I understand the importance of providing guidance and support. In this article, I want to help prepare you for what to expect during the death visit and explain the role of the hospice registered nurse in the pronouncement process.
The Death Visit: What to Expect
When a terminally ill patient is nearing the end of their life, hospice care focuses on ensuring their comfort and dignity. Here’s a breakdown of what the death visit may look like from your perspective as a family member or caregiver:
Emotional Support
The hospice team understands the emotional weight you are carrying and will provide compassionate support throughout the process.
Take the time to express your feelings, share memories, and say your goodbyes. It’s okay to feel a range of emotions, and the hospice team is there to help you navigate them.
Physical Changes
As death approaches, the patient’s breathing may become irregular, and there may be pauses between breaths. This is a natural part of the dying process.
The patient may also experience skin color, temperature, and muscle tone changes. These changes are a result of the body’s natural transition.
Pronouncement of Death
The hospice registered nurse has the responsibility of pronouncing the patient’s death.
During pronouncement, the nurse will carefully assess the patient to ensure they have expired. This includes checking for the absence of vital signs such as pulse, breathing, and heart sounds.
Providing Comfort
The nurse will ensure that the patient is comfortable and peaceful. They may adjust the patient’s position, administer any necessary medications for symptom management, and provide supportive care.
Guidance and Assistance
The hospice registered nurse will guide you through the steps following the patient’s death, including contacting the funeral home or the appropriate authorities, if required.
They can help answer any questions and provide information on the next steps, such as obtaining the death certificate.
The Role of the Hospice Registered Nurse
During the pronouncement process, the hospice registered nurse plays a vital role in ensuring that the patient has passed away peacefully. Here’s what the nurse will be doing:
Assessing Vital Signs
The nurse will carefully monitor the patient’s vital signs to confirm that they have expired.
They will check for the absence of pulse, breathing, and heart sounds.
Documenting the Time of Death
Once the nurse has confirmed the patient’s passing, they will accurately document the time of death.
The registered nurse will also call the provider, who will sign the death certificate, to inform them of the date and time of cease-to-breathe.
The registered nurse will also call the funeral home. In some geographic areas, the county coroner must also be called, and if that’s the case, this is often done prior to calling the funeral home.
Providing Support and Guidance
The nurse will emotionally support the family and caregivers, allowing them to grieve and process their emotions.
They will guide you through the steps following the patient’s death, including contacting the appropriate individuals or organizations.
Ensuring Comfort
The nurse will prioritize the patient’s comfort and dignity throughout the pronouncement process.
They will make any necessary adjustments to ensure the patient is peaceful and comfortable.
You Are Not Alone
Remember, you are not alone during this grim time. The hospice registered nurse provides guidance, support, and compassionate care for the patient and the family. Contact them with any questions or concerns—they are here to help.
Allow yourself to grieve and remember that everyone’s journey is unique. Lean on your support system, and don’t hesitate to seek additional support from counselors, support groups, or other resources.
All the Blues in the Sky by Renée Watson – About a 13-year-old whose best friend dies on her birthday, exploring grief through counseling group experiences.
The Truth as Told by Mason Buttle by Leslie Connor – Chronicles a boy dealing with a friend’s death, learning disability, and community judgment.
The Year of the Rat by Clare Furniss – A 15-year-old coping with her mother’s death during childbirth and caring for the baby sister.
The Dougy Center offers extensive free resources, including activity sheets, tip sheets, and guidance for children and families. They provide age-appropriate materials and have partnered with Sesame Street on grief resources.
Winston’s Wish provides comprehensive bereavement support for children up to age 25, including online chat, phone support, and downloadable resources. It also offers specialized guidance for different types of loss.
Sesame Street Communities: Helping Kids Grieve features interactive videos with Elmo and other characters, activities for expressing feelings, and guidance for families. All resources are free and available in multiple languages.
National Alliance for Children’s Grief (NACG) provides educational toolkits, connects families to local support services, and offers professional development for those working with grieving children.
GriefShare helps locate local grief support groups for families and provides daily email encouragement for those processing loss.
Enhanced Online Resources for Teens
Specialized Teen Platforms
Talk Grief—Winston’s Wish operates this dedicated online space for teenagers and young adults aged 13-25. It features peer stories and professional support.
Teenage Grief Sucks – A teen-run website opening conversations about grief where teens can read candid stories and share their own experiences.
Actively Moving Forward – A national network specifically created for grieving young adults, addressing the unique challenges of this age group.
The Dinner Party – Young adults in nearly 100 cities worldwide meet for dinner, creating community for emerging adults who’ve experienced loss.
Comprehensive Teen Support Centers
The Dougy Center Teen Resources provide age-specific materials including tip sheets that acknowledge “grief usually does what it wants” and doesn’t follow rules or schedules. They emphasize that there’s no right or wrong way to grieve.
Hospice of the Valley Teen Resources offers specialized materials addressing how teens grieve differently than adults, sudden versus expected death, and losing siblings or friends.
Children’s Room Teen Program provides peer support groups and activities specifically for teens to connect around shared interests while processing grief.
Interactive Support Options
Winston’s Wish offers immediate support through live chat, helpline, and text services – no waiting lists required. They also provide one-to-one sessions with bereavement specialists for teens 13 and older.
HEART Play for Young Adults connects late high school and college-aged individuals, providing space to discuss challenges of graduation, leaving home after loss, and meeting new people.
Educational Resources for Teens and Families
The JED Foundation provides mental health resources showing teens how they can support one another and overcome challenges during the transition to adulthood.
Eluna Network offers grief resources organized by specific age ranges, including detailed developmental information and support strategies for both middle school and high school students.
National Alliance for Children’s Grief provides educational toolkits and connects families to local services, with materials specifically designed for adolescent grief.
