Last Offices
•  Relates care given to a body after death
Healthcare Support Certificate
Palliative Care Module
Last Offices
Last Offices
•  Practice should follow local guidelines
•  These are developed to ensure the body is
treated with respect and practice is carried
out with regard to the wishes expressed by
the patient before death and the wishes of
their family following death.
Legal Issues
•  Nurses responsibility to a deceased
patient continues until the body leaves the
clinical environment
•  Death must be verified before last offices
commence
•  It is a process that demonstrates respect
for the deceased and is focused on
respecting their religious and cultural
beliefs, as well as health and safety and
legal requirements (Dougherty and Lister,
2004)
Health & safety Issues
•  The body, following death, must be
prepared for transfer to the mortuary or
funeral directors in a way that does not
compromise health and safety.
Involving family/significant others
•  Family members may wish to be involved
in the last office procedures – this may be
a religious or cultural requirement.
1
 Procedure
•  Provide support to family as necessary
•  Ensure that death has been verified and discuss
with senior nursing and medical staff any specific
legal and health and safety issues that may
influence last offices practice
•  Ascertain if there is any need for referral to the
coroner
•  Discuss with family any preferences they may
have or that the patient, in life, may have
requested that will influence last offices practice.
Last offices
•  Care given to a body, with specific regard to the
procedures involved in preparation for transfer to
a chapel of rest, mortuary or undertakers.
•  Nurses should ensure that last offices practice is
in line with organisational policy and local
guidelines.
•  These guidelines should ensure that the
patient s body is treated with respect, and that
the procedure is carried out with regard for the
wishes expressed by the patient before her or
his death, and the wishes of the family following
death.
• 
Professional Responsibilities
This procedure should be undertaken
only after approved training, supervised
practice and competency assessment,
and carried out in accordance with local
policies and protocols.
Procedure (continued)
•  Collect all equipment necessary
•  Ensure the area where the procedure is to be
performed is private and as free from
interruptions as possible
•  Remove tubes, lines and access devices as
agreed with senior medical staff
•  if lines are to remain, cut and spigot off any
large-bore tubes and cover with gauze and
adhesive dressing
•  Ensure that documentation alerts mortuary staff
to their presence
Cultural, religious and
spiritual influences
•  The UK is a multicultural and multi-faith
society.
•  This offers a challenge to nurses who
need to be aware of the different religious
and cultural rituals that may accompany
the death of a patient (Dougherty and
Lister, 2004).
Procedure
•  Apply gentle pressure over the bladder
area, if the patient is not catheterised,
allowing the bladder to drain.
•  This will minimise the risk of postmortem
leakage (Cooke, 2000).
•  Remove jewellery and any personal items,
unless requested or advised otherwise
2
 Procedure
•  Ensure that appropriate records are made of any
personal items left on the body or otherwise.
•  Attend to hygiene needs, paying particular
attention to hair, nail care and oral hygiene
•  If the patient has dentures place them in the
mouth; if this cannot be done send them to the
mortuary with the patient.
•  Attempt to close the eyes, using a small piece of
clinical tape if required.
Procedure
•  If a body bag is to be used, place the body in the
bag as per instructions, completing any
necessary documentation.
•  If a body bag is not to be used, enclose the body
in a sheet, securing it with adhesive tape.
•  Complete documentation (notice of death) as
per organisational policy
•  Document last offices practice, including
property and any specific requirements for
mortuary care. Attach identification labels
Thank you
Procedure
•  Attach identification labels/wrist bands
according to local guidelines and
organisational policy
•  Dress the patient in a gown/shroud or own
clothes, as required
•  Place an incontinence pad underneath the
buttocks to contain any soiling.
Procedure
•  Dispose of clinical waste.
•  Arrange for transfer of the body,
•  communicating any specific requirements
to portering/mortuary staff
•  Transfer property, patient records and any
additional items to the bereavement care
office or appropriate area.
•  Attend to hygiene needs, for example hair,
nail care and oral hygiene