After death

'I wish we'd spent more time preparing for his death. We knew it wasn't far away but somehow couldn't bring ourselves to discuss it with each other or anyone else. I think it would have been easier if we had talked about it. As it was, I had to make the decisions all at once, after he died.'

While the first part of the dying with cancer section is written for the person who is dying, this section is written for the partner, relative or friend. However, you may want to read this section together and discuss the plans well in advance. As with making a will, this will not speed up death, but will make things a lot easier for those left behind. To undertake advance planning of the funeral and financial affairs, and then, having done it, put it to one side, often enables a person to concentrate all the more on living.

Dealing with death

If you think the person you are caring for has died, try not to panic. However well you have prepared yourself it will still come as a shock. You may feel confused and bewildered. If you are inexperienced at feeling for a pulse, anxiety may make it even harder. If you are in a hospital or hospice, the nursing staff will be nearby. If you are at home, let your doctor know straight away. Your GP, or someone who is covering for him or her, will come as soon as possible. If you are alone, ring a friend or relative to come and be with you. You may want your minister or religious leader to be with you as well.

During the first few hours the loss of your loved one may seem very unreal, yet there are important actions which you need to take. However, it is important that you do not feel rushed to 'get on with things' if you want to spend some quiet time with the person who has just died. Many people like to sit and talk or hold hands, and value seeing their loved one at peace, especially if the last few hours or days have been a strain on you both. In many religions this is a time when there is much that those who have been left behind need to do to help their relative or friend to pass onwards. So please feel comfortable to let instinct take over, and do what you feel is appropriate.

You might then want to help to lay out the body. In a hospice or hospital the nurses will usually do this, but they will be happy to let you help. At home the undertaker will show you what to do. This process is different for different religions but may involve carefully washing and drying the body, closing the eyelids, and making sure the mouth is supported closed. The hair is tidied and sometimes washed.

Certification and registering the death

A doctor needs to certify the death. As soon as this has been carried out, you can go ahead and contact the undertaker. All undertakers provide a 24 hour service, although you may choose to wait until morning if the death has occurred during the night. You will find that your undertaker can answer most of the questions you have. You will need to wait until you have spoken to your own doctor and he or she has decided whether a post-mortem will be required (see page 33), before you set a date for the funeral or other service.

The doctor will usually issue a medical certificate of the cause of death, together with a slip of paper 'Notice to informant' which describes the information you will need to register the death. If a post-mortem has been arranged, a certificate may not be available until later. You need to take this certificate, together with the birth and marriage certificates, to the registrar's office in the sub-district where the death occurred within five days (eight days in Scotland). The registrar will ask you several questions about your loved one, and look at all the documents you have brought with you. He or she will then enter the details in a register which you will need to sign. A certified copy of the entry in the register, commonly known as a 'death certificate', will then be completed. NB This is different in France

Some registrars' offices now operate an appointment system, so check before you go. (You can find the number of the local registrar's office listed under 'Registration of Births, Deaths and Marriages' in the Business section of the ordinary phone book and it may be on the envelope containing the medical certificate). If you are not able to attend yourself, several other people could act as an 'informant' and register the death for you. Details of who can act as an informant are listed on the back of the 'Notice to informant'. These include a relative of the deceased who was present at the death or during the last illness, or a person who is not a relative but who was present at the time of death. Slightly different information is required when registering a death in Scotland, so read the details of the 'Notice to informant' carefully and make sure you have all the information before you go to the Registrar's office. If you cannot find some of the documents, you may be able to register the death and take them in at a later date.

Before you attend the registrar's office, it is helpful to know how many copies of the death certificate you need. These so called 'certified copies' (which are duplicate original certified copies of entry, not photocopies) can then be purchased at the time of registration. They cost £3.50* each and you will need to pay for them by cheque - cash and credit cards are not acceptable. They are more expensive and much harder to get at a later date. You will usually need one for each life insurance policy or similar which you need to claim. Other organisations, such as your bank, will just need sight of the original certificate, or will make a copy for their records. The executor, if there is a will, can help you work out how many copies will be needed.

The registrar will give you a green certificate to say that the death has been registered and that the funeral can take place. You need to give this to the undertaker. The registrar will also provide a form for Social Security purposes.

It is useful to have a copy of the booklet When someone dies (available from your local social security office) to consult, as this outlines all the important tasks you need to undertake at this time. The Consumers' Association publishes a book What to do when someone dies which is available in most public libraries.

Post-mortem

Although in most cases when someone dies from cancer a post-mortem will not be required, there are occasions when it is very helpful. For example, the cancer may have been diagnosed at an advanced stage and only the secondary tumours identified. A post-mortem may show where the cancer started. This may be information which you will want to know, to help you understand exactly what happened. People who die from a mesothelioma cancer need a post-mortem as this is an occupational disease. A post-mortem may also be required for anyone who has ever been a miner and for some other groups of people who are claiming occupational compensation. Remember that you can agree to a limited post-mortem, where only the relevant parts of the body will be examined. This may feel like a more acceptable option, yet it will still allow the doctors to get the answers needed. A post-mortem can usually be done within two or three days and should not delay the funeral.

Funerals and other religious services

We live in a multi-cultural and multi-faith society, and each group has its own traditions and ceremonies. Some people have no religious beliefs, while others will have lived their lives as humanists, agnostics or atheists. There are people within the various humanist organisations who will lead a funeral service or will give help in planning a humanist funeral. Sometimes those who are confirmed atheists or agnostics choose to have their funeral conducted by a religious leader out of respect for them as individuals. However, it is not necessary to have a religious leader to conduct a funeral. Your chosen undertaker will lead you through issuing the death notices, planning the funeral and arranging for you or other family members to view the deceased at their chapel of rest if this is what you and your loved one wanted.

If you and your loved one have not had the opportunity to discuss his or her choice of burial or cremation, and there is a will, it is important to consult the executor to see if the will provides this information. If you had the opportunity to discuss plans for the funeral before death, this makes it much easier to be sure you are arranging a service of remembrance which would have reflected your loved one's wishes. Some people also have strong views on what clothes they wish to be buried or cremated in. Do not let anyone, however well meaning, talk you out of what you have agreed.

ENGLISH-SPEAKING FUNERAL SERVICES

What happens in France?