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Death and Dying

This information comes from Australian Home Funeral Association who adapted it from Tender Funerals Australia and the Natural Deathcare Centre: https://www.ahfa.org.au/tender-ndc-resources. It has been adapted again for this website.
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The Dying Journey
Preparing for Death
Caring for the Dying Person
Expected Death
After Death
Autopsy
Funeral Directors
The Dying Journey
Death is the natural end of our lives, an ordinary and sacred experience. Being aware of and able to talk about death as a part of life can help you live more fully. Talking about death does not make it happen, just as not talking about it cannot stop it from happening.
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Being more informed and prepared may empower you to hold an attitude to death that creates greater freedom. Adjusting to the understanding and reality that you are nearing the end of your life, and your death is coming, is a unique experience for everyone. You may want to create some time in your life to think about what needs to be in place if you died tomorrow. Beginning the process of considering, recording and communicating these things can be an empowering and life-affirming act.
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Preparing for Death
Death can be sudden or expected, coming in its own time and its own way. A dying process may take years, months, hours, minutes or be instantaneous. Being prepared covers, among other things, legal, practical, medical, emotional, social and spiritual matters. These areas are often intertwined.
An expected death can offer an opportunity to connect and talk about what matters to you, but in the event of your sudden death, that opportunity is not there. Being prepared is helpful for everyone involved.
Whatever your circumstances, you may want to:
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Speak to the person(s) you want to be responsible for carrying out your wishes; ensure what you are asking of them lines up with their values and beliefs, and they will action it for you - if they are unwilling or unable, this gives you the chance to talk about it and rethink who you need to appoint
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Have as little unfinished business as possible for yourself, your relationships and your professional life
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Convey what you want to happen to your body after you die; what sort of funeral and disposal method you want – burial, cremation or no preference?
Bear in mind the Will is often only read after the funeral, so it cannot be relied on to provide this information.
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When preparing for death, pain control is important, as there is no need to suffer unnecessarily. If you are physically comfortable you can do things like relax into your dying, complete unfinished business, reflect on your life and your relationships with others and even find new meaning in your life. It may be a time of growth, emotionally and spiritually, for you and others. Your dying is uniquely yours; it is different for everyone and it has often been noted that people have tendency to die in a similar way to how they have lived their life.
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You can be active and live your dying, and your responses may change as you move through your process. Talking about things can provide relief or comfort to you and to all those involved.
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You could discuss:
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Your care needs, as a support network may need to be created
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How you would like to be cared for, to assist your carers and allow for the death experience you want
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Appropriate pain relief, if your priority is to remain as conscious as possible
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Any preference to where you die – at home, in a hospice or a hospital
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You may want to consider your emotions and feelings:
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Love – to express your love and to allow others to do the same
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Gratitude – to express your gratitude and allow others to express theirs
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Forgiveness – to forgive yourself and others, and ask others for forgiveness
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Regrets – to express any regrets and allow others to do the same
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Saying goodbye – to say goodbye to your loved ones, your possessions, the world and your life, and let others say their farewells to you
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Acceptance – that things are as they are and may not be able to be resolved
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Discuss with those who may be caring for you to clarify what is really important to you about the environment and atmosphere you will be in - who you want around, how much conversation and/or silence you want, whether you have access to nature and the space you are in - the art, photos, music, aromas, candles and lighting.
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Your psychological, religious or spiritual needs may also be important, and you should communicate what is required to meet them if this is the case. Share these needs with those around you so they are supported, and they can support you. Access social workers, counsellors, clergy, prayer, meditation, solitude, friends and family, as needed.
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Be as honest as you can with yourself and others about what you need to feel comfortable and supported. This may mean finding ways to express or release emotions as they arise. There are people who can help with this. If you need help, ask for help.
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Considering and talking about personal things could be new territory and difficult. You may have no experience in speaking about your feelings and thoughts. If this is the case for you, it may be easier to write letters or notes, or you may choose to just make peace within yourself. What you consider and do can be a journey of incredible discovery. It is your life and your death, so it is entirely up to you.
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Caring for the Dying Person
Being with someone while they are dying can be many different things: challenging, exhausting, heartbreaking, satisfying, expanding, joyful or liberating. Any or all of these, and more. Every death is a unique and personal experience for everyone involved.
Most people want to live, and will do all they can to stay alive, but their illness or condition may deteriorate, and they progress into their dying process. This can begin a period of more intense emotions and their care may become more demanding. The situation could need to be reconsidered and new decisions made, with advice and information from loved ones and health professionals.
As noted above, people seem to die as they lived; someone who has always shared openly is likely to continue to do so, just as a person who has been stoic, private or independent throughout their life, is likely to continue to behave this way. This is a time when religious or spiritual beliefs, fears and myths may help or hinder.
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There are many places to die – at home, in hospital, in palliative care or hospice, or in an aged care facility. A palliative care facility or a hospice is a place just for people who are dying. A hospital may have a specialist palliative care ward or they may only have general wards.
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Try to create an appropriate space and atmosphere. Check in with the person – their sensitivities and needs are paramount. Most hospitals will accommodate things like soft music, decoration, photos and favourite or meaningful things in the room, as long as they are not obtrusive or in the way.
Hospital and Hospice visitors are generally permitted to stay around the clock and are often allowed to sleep in the room. The dying person may or may not be able to speak, so someone may have to gauge who, how many and for how long people may visit. Common sense and kindness will be needed as death can fascinate and repel at the same time. People often want to be there for as little or as much time as they can. This happens for a range of personal and complex reasons.
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It is can be valuable to allow the dying person some quiet time, with no-one, or just one quiet person in the room. Silence and solitude can be a great gift to give. Imagine yourself ill – not even dying – with a room full of people, often talking to each other, being there all the time. It can be intrusive to your peace of mind. It is important to use your knowledge of the dying person to make these decisions. If you need to take time to sort anything, do try, but remember it is their journey; you cannot always make it happen as you want.
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If you want to care for someone so they can die at home, consider carefully your willingness, ability and support systems; the practical as well as the emotional. It can be a challenging time, as well as stepping up or becoming aware of new aspects of yourself. Sometimes the burden of physical care doesn’t allow for emotional care. Consider honestly whether you want to do it, and whether you can do it. This may take a village of support for the person dying and the primary carers.
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These decisions are individual and must be made in the context of individual circumstances. There is no right or wrong choice, and even though the person may want to die at home, it may be too difficult or impractical. Do not take on caring for someone out of guilt; you can only do what you are capable of.
https://www.verywellhealth.com/the-journey-towards-death-1132504
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The signs of approaching death may be a slowing down of the body's functions, a gradual or lesser interest in external things, like the world, politics, religion, community, friends and even family. They may be with their own thoughts and feelings. Check in with them.
Some signs of the body shutting down are:
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Less or no desire to eat, as the body does not need to be nourished; less or no desire to drink, as it becomes too difficult to swallow; therefore, little or no faeces or urine
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Cool, moist or mottled skin, continuous sleeping, rhythmic periods of not breathing and rattle-sounding breathing​
If it is true or appropriate, assure them of your love, presence, gratitude and of your ongoing well-being. It may or may not be appropriate or you may or may not want to kiss, touch, hold hands, say goodbye, speak, be quiet, cry, go outside, leave, carry on as normal and be with your own partner or family.
Those accompanying the dying bring their own lives into this moment. It can be anything and everything: a time out of time, many emotions – sad, fearful, anxious, excited, anticipatory or relieved. These, and others, are all common feelings. Feel it all and discuss them if appropriate, but remember you are there to accompany the other person. When life is extinct, especially if you have been caring for or attending on them, along with sadness, there may also be relief that their physical or emotional suffering is over. Seek support as needed.
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Expected Death
As we all know, death is certain, although the time and place are uncertain. If you find someone who has died and the death is expected, it can be beneficial to take some time to be with the body.
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If they are clearly dead and unable to be resuscitated, you may just want to be still. This is a time and an experience you will only have once. Consider what needs to happen next. Take some time to be with your own feelings and the reality of the situation. This may be minutes or even hours. Do not call anyone straight away, unless you want to. You may want family and friends to come and be there too. Continue to try to stay as present as you can and use the time as you feel to.
Depending on the circumstances, you might call the doctor or a funeral director. A Medical Certificate of Cause of Death must be completed by the doctor within 48 hours.
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After Deathcare
If you are using a funeral director, preferably chosen in advance, call them when you are ready. They can also organise the doctor. As noted above, do not rush; your time with the body is precious and cannot be had again. The funeral director will take the body away to keep it in cold storage and await your further instructions.
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Being with the body can be a very beneficial experience. If you want to keep it at home, it is legal in NSW and some other states to do so for up to 5 days. Often people will keep the body between 12-48 hours. It is vital it be kept cold. This can be done with ice, dry ice, frozen containers or a refrigerated cold plate. Highlands has Techni Ice that can be borrowed for this purpose. If you want to do this, find out more in advance so you know what is involved and where to obtain what you need.
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You can also wash and dress the body yourself before it is taken away. This may also include closing the eyes and mouth and watching out for any body fluids (though there may not be any). If you want to do this, find out more in advance so you know what is involved.
If a person is dying in hospital or an aged care home, tell the nursing staff if you intend to spend some quiet time with the body once death has occurred. You can also take the body home and care for it there.
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Did you know you can do any of these things?
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Keep, care for and keep cold a body at home
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Wash, prepare and dress a body yourself
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Bury in a shroud without a coffin
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Bury on private land
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Be cremated in a shroud (this needs to be discussed with the crematorium)
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Build and decorate your own coffin (must meet certain specifications so it can fit in the cremator or grave and be weight bearing)
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Have a cardboard coffins
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Line a coffin with a soft absorbent liner, rather than plastic
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Drive a body in your own vehicle from a home or hospital, to the funeral and crematorium or cemetery
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These things are all possible and nothing new; rather, they are the way things were traditionally done. There are state regulations that need to be followed. Click here for more details on NSW requirements.
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Once the person has died, the Will is now valid, and the executor of the Will has the legal right to make decisions regarding the body, funeral and disposal, though usually it is the next of kin who make these decisions.
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Autopsy
If the cause of death needs to be determined, the body may be taken by ambulance or funeral director to a hospital morgue and undergo an autopsy. This may take days or weeks to occur. In some cases, the family may be given a choice, and can request no autopsy.
An autopsy is a procedure where the body is surgically opened by the Coroner. The organs are removed and examined to work out the cause of death and usually placed back in, and the body is stitched back up. This can involve a cut to the hairline and through the centre of the torso. The body can still be viewed, but it is suggested you have someone explain the condition of the body beforehand so that you know what to expect. You could also have someone accompany you for your first viewing, allowing them to leave you as you get used to it and shock abates. You may want to ask for a chair so you can allow the shock to pass through and let your body be supported.
If there has been an autopsy, it may still possible to:
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​bring the body home
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wash and dress the body yourself
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sit, be with or hold a vigil with the body
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have an open coffin at the funeral
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Funeral Directors
It is important to understand the role and purpose of an funeral director to feel empowered in the consultation when making arrangements. They should assist, guide and empower you, not control or override your wishes, so you can be with your loss and your loved ones and have the best possible experience. A good funeral helps you process the loss at the ceremony itself and it can also mean a healthier bereavement.
Ask them to explain clearly the service they offer, what is involved in the process, what they handle, how much they will allow you to do and the costs involved. Take notes throughout the process of questions and answers, as it can be difficult to concentrate or retain details and the conversation. Also, explain to them what you want - don’t feel pressured or intimidated to sign anything until you understand what you are signing, and you are ready.
A funeral director usually collects the body, completes the legal paperwork required for burial or cremation, drafts optional death notices, cares for the body and keeps it in cold storage, prepares the body if required, places the body in the coffin, transports the body to and may facilitate the ceremony, and transports the body to the burial or cremation.
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Although most people use a funeral director, in NSW it is also legal and possible to do it all yourself. You can complete all necessary legal paperwork, care for and transport the body, build a coffin and hold the ceremony and deliver the body for disposal. Click here for more on Home Funerals.
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It is most beneficial to understand what is involved before your need arises. Well considered choices may provide a more satisfying ceremony and experience, meaning no regrets, better memories and a healthier bereavement.
Usually, if there is a Will, the executors has the legal right to the body and to organise a funeral, but often the next of kin makes the funeral arrangements. The person who authorises the funeral is liable for the account. When someone dies, the bank commonly freezes their accounts. The funeral account is the only expense paid from the bank account, until probate is granted. If there is no Will, then the next of kin or a ‘person responsible’ usually takes over. If there is no one, the arrangements fall to the State and a local funeral director will have the tender for destitute burials.
The Dying Process
Preparing for Death
Caring for the Dyng Person
Expected Death
Funeral Directors, Funeral Arrangements and Ceremonies
Autopsy
After Death
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