To highlight something about bereavement I had no idea about regarding certification

[OldQueen1969]

Hello all,

I have posted previously about my terminally ill Mum and had lovely supportive responsses for which I am grateful.

She passed relatively peacefully on Monday morning at home with us not unexpectedly and thankfully is at peace - I am coping okayish (I think) and obviously am starting to do the admin that such an event generates.

Mum moved about 4 weeks ago to our place after a brief hospital admission and safeguarding concerns that meant she couldn't live at home any longer and needed 24 hour care which we were more than happy to provide especially in the current climate.

During this time she was seen every other day for drainage by district nurses and of course was registered at our local GPs as soon as he moved. She had a lomg conversation with a new GP on the phone, and the DNs wanted a GP to come and look at her various signs of deterioration in person, but this was deemed unnecessary. Therefore my Mum hadn't seen, face to face, a GP for over a month.

On Monday afternoon the DNs rang to say that the GP needed to do the other bit of the death certificate, but her designated GP (not the one she spoke to) was off so I would be contacted on Tuesday. Obviously even though Mum's passing was expected, I am still a bit of an exhausted mess, so didn't think much when the call didn't come - I was functional enough to follow it up today.

Initially the receptionist I spoke to said I would really need to go back to her old GP, which seemed a bit confusing, then she said she would check with them and call me back. After a couple of hours the GP my Mum had spoken to did call back and explained that because my Mum hadn't been seen by a GP for over 28 days face to face, it would have to be referred to the coroner, who hadn't answered his call so he'd left a message and was hoping to hear back this afternoon. Thus far, I have heard nothing.

The GP was very nice, reassuring me that this was just a procedural thing and will hopefully be resolved quickly as it was an expected death witha pretty blatant cause, but I'm a bit miffed - I cannot register the death until the Coroner approves it, which has a five day dealine extended for a further nine under these circumstances, and having googled, the Coroner would be within their rights (although unlikely) to request a post mortem.

I'm a bit annoyed that a GP wouldn't come and see her face to face when the DNs requested it, and that because of this sorting out her (meagre) affairs will be a more drawn out affair than she wanted - she had done everything she could to make things straightforward for me and by God, I miss her so much.

My AIBU is really that none of this has been mentioned as a possibility - the impression given is that you get the death certificate and register in a straightforward manner in such circumstances and I thought Coroners were about unexpected / suspicious deaths. So I'm just posting this really to make others aware of this - although it could easily be I'm just crap and should have googled beforehand - I suspect that in these CV19 times this might be the case quite often as GPs refuse face to face appointments.

So another layer of virus related complication.

If ever there was a time when talking to my Mum would have been helpful, this would be it....... bloody typical........

Anyway, if it gives anyone a heads up in similar situation, I hope this post helps.

I’m sorry OP. Something similar although not exactly the same happened when a relative of mine died. He was elderly with a known condition and died at home. The GP had actually seen him that week but because he wasn’t expected to die that week, didn’t feel he could sign the death certificate. And so the Coroner requested a postmortem for an elderly man when everyone already knew the cause of death.

I hope it’s sensibly and quickly sorted so that you can say goodbye to DM.

The same thing happened with my dad - but although his body was taken to the hospital mortuary for the coroner, after the coroner talked to his GP he was satisfied nothing more needed to be done and the funeral directors collected him the next day.
As registration appointments are on the phone now, and all the normal forms are being transferred electronically, it is very quick now. My mum died early Sunday morning, the GP issued the medical form Monday morning, and I got an appointment to register her death on Monday afternoon.

A similar thing happened to me recently. The coroners were incredibly efficient and did their best to keep me informed.

So sorry for your loss in these tough times.

My FIL passed away in hospital with chronic kidney and liver problems and a suspected heart attack 6 weeks ago (just entering lockdown). For some reason his death has been referred to the coroner, we’re not really sure why. He had no cv19 symptoms and only the day before had been told no further treatment available. The only thing we can think of is that he died of something he wasn’t admitted and they want to make sure there is nothing suspicious.

Initially we were told a pm was required, then an inquest, but there is still no date available for the latter. Previously the coroner listed all inquests pending and date of hearing , but now the website is blank.

However...the coroner provided an interim certificate (basically confirming he had died but no cause) and gave permission for him to be buried. We held the funeral 2.5 weeks after his death .

Our theory is that because he died of something he wasn’t admitted for (heart attack) and doctors are busy , maybe the coroner Is the on,y one that can issue an interim certificate ? Really not sure but it doesnt seem to have delayed things too much.

Thank you for the responses and the kind words x @CMOTDibbler I am sorry for your loss too

On Monday Mum was taken by the funeral directors once the DNs had done their bit and left - she wanted a no frills direct cremation which we sorted almost straight away - have we done something wrong? The DNs said it was ok.......

I'm sorry to hear this. I can see that the rule originated probably to help prevent foul play, but it can cause a lot of additional upset to families at times of great stress. We had problems like this when both my parents died.
My Mum died just after a Bank Holiday weekend when she'd been seen by a locum GP, but he wasn't at the surgery when we tried to get the certificate. Amazingly the receptionist managed to track him down and even though he was working in another town he came back to do it. However there was a delay and we couldn't make any funeral arrangements til we had the certificate.
But when my Dad died he hadn't been seen by anyone for a few weeks. He was in a nursing home with a DNAR in place, due to his end stage heart failure. The coroner insisted on a post mortem. We were very angry and upset. No prizes for guessing what the post mortem showed.
I hope your coroner exhibits more common sense OP. Hopefully the number of people who are likely to be in the same situation will mean that they are a bit more sensible.
Both my parents had "good" deaths and had pre paid funeral plans so everything should have been very straightforward, but the problems getting the death certificates caused our family a great deal of distress. It still upsets me years later. My Dad's PM did nothing for anyone. It didn't help him, or us and I can't believe it advanced medical science or benefited the public in any way.

My Grandpa died aged 90 very suddenly, it turn out he hadn't seen a doctor for 18 months. He died exactly how he would of wanted quickly and painlessly no drawn out illness. He had to have a post mortem which our family felt was pointless given his age.
I'm sorry for your loss

@Tootles2 - Sorry you are going through this, I hope it gets resolved soon - it's all a bit odd and unsettling and I am fortunate not to have had to deal with this sort of admin before - my cursory searching around the practicalities before the event just didn't cover this and tbh felt a bit morbid when Mum was still here.

Ah well, it is what it is I suppose. Will just have to wait and see.

Sorry for your loss OP but this is not to do with Covid -19 (although I appreciate that might be the reason she wasn’t seen by GP).

Coroners are not just suspicious / unexpected deaths - there are lots of reasons including random checks, deaths after leaving hospital (even when expected).

I’ve posted on a few threads recently saying the General public would be surprised at how complex completing a death certificate is - so it’s horrible for you but could mean another Harold shipman being stopped in his tracks.

I'm so sorry for your loss, and I'm so sorry you have the added complication of it being referred to the coroner.
I am a registrar and this is all quite normal rules that have to be followed, it does often mean we have to refer cases to the coroner but most of the time they do not do a post mortem and they get the correct paperwork to us quickly.

I don't think you can have a funeral/cremation without the correct paperwork?
Normally direct from the hospital (for my dad) or from the coroner (for my mum) to the funeral director.
because my mum had not been seen by a GP for about 2 months or more, a pm had to be done before her funeral (cremation)
I know it's not easy.

It’s an added stress you don’t need right now but as a society we do need these checks and balances and it’s great that we have these safeguarding processes.

@MrsAvocet - I agree, there seems little purpose in such circumstances and I am so sorry to hear your story - thank you for sharing.

I am hoping that the Coroner will be sensible - Mum declined rapidly over the five days before her passing and she had extra DN visits to make her more comfortable so I hope there is no question or doubt regarding her passing - I'm a bit knackered, emotional and not great at trusting professionals (for genuine reasons although I engage normally with them) so am doing my best not to let this get under my skin.

Firstly I want to offer my sympathy for your loss. I lost my Dad a few years ago now and even though he had been seen by the gp the evening before he died and the gp had left a message for his Papworth consultant following Dad declining to go to a&e on the gp recommendation, and then the afternoon Dad died the GP actually being there and administered CPR, Dad still had to go to the coroner. I spoke to the coroner the next day and told them that Dad really didnt want a PM and if it was at all avoidable then please dont do it. After speaking with the GP and looking at Dads hospital records they decided that a PM wasnt necessary and the funeral directors collected him. It is strangely comforting, given they didnt do a PM (as I requested), that i feel like they were really sure there wasnt anything dodgy going on, like fresh eyes without the emotion at an emotional time. This was a good 4 years before COVID too

So sorry for your loss- my ma died unexpectedly in hospital but she had been in less than 24hrs when she passed.i had to wait two weeks for the coroner to get twists to sign a death certificate and for the coroner
to declare mum did not need a post mortem.i ended up having to cancel funeral date and get it moved.I was doing the admin like yourself-all at the worst possible time too- what I will say is the funeral directors are fabulous at helping and guiding you.We also had issues with dfil and dmil when they passed too- since new rules came into for e because the dr shipman deaths-it has become much more complicated.I hope from now on everything goes smoothly 💐

@OldQueen1969 thank you, we’re all ok as it really wasn’t good seeing him look worse every time we visited. My point I suppose is that other than a bit of (understandable) delay when lock down happened the lack of a formal (Full) death certificate hasnt posed a problem. If the Coroner is happy then you should get your full certificate, if not then an interim certificate and permissions should be available from the Coroner. So far all the ‘authorities’ have accepted the emailed ‘Interim certificate’ without a problem.

I think it would be helpful to have it more widely publicised that not seeing a GP for over 28 days in such circumstances would result in this scenario. One assumes that someone being seen at least every other day by HCPs would be equivalent - but as they say, assume makes an ass out of u and me - lesson learned.

Thank you for all your comments and sharing your experiences - it's helping greatly

I do recognise the need for safeguarding measures like this, especially when thinking about the Shipman case.

It's just a bit of a bolt from the blue when you're already off kilter and worried about getting things wrong.

I am so sorry for your loss and distress. These measures were put in place following the Harold Shipham case where he was found to have murdered possibly hundreds of elderly patients. Now a single GP is not able to sign a cert. Even if he had seen her it might not have been enough. There will be a delay for the coroner but our funeral director handled all that liaison for us. It is their job to help you with this. So sorry again but the rules are to protect the vulnerable elderly.

I think the Coroner is informed if someone hasnt seen a doctor in the last 14 days and maybe care home staff may ask for a review if someone is unwell to avoid this. My dear dad died at home without seeing the gp and was referred to the Coroner but he had a long medical history and they just did a very basic pm.

I am so sorry for your loss. In Scotland when you register the death you are advised that when they enter the death at that point the deceased may be selected for autopsy even if elderly and at end of life.

Sorry for your loss OP and all others .

I’m in Scotland too and as @Tarscout says we are advised as they go to enter the registration of the death “ literally press the button “ the deceased may be selected for PM even with a doctor having issued with cause etc
It’s safeguarding though obviously stressful at a distressing time .
Take care

What through us when my Mum died was the need for police presence. She collapsed unexpectedly and passed away whilst the paramedics were with her. We expected the need for a coroner's report and for her to have a post mortem. We just didn't realise that the police would be in attendance even before her body had been taken away. I have to say that he was absolutely lovely and very kind, we just didn't expect his visit.

I am completely aware of it. It’s why the data on the number of deaths outside hospital is different to the hospital data in terms of reporting. It’s been this way for a long time. It bugs me that people made a big thing about it. Even without the coroner involvement or a pm you are looking at 5-7 days to register the death.

The reasons are fairly valid. But it happens a lot these days especially with patients on end of life care who move into a home or alternative setting.

Oh, I'm really sorry to hear your mum has died.

You had already been through so much lately, it feels like a further indignity you now have to go through this too. (And it's understandable you've lost trust in professionals at this point - I'd have been surprised if you hadn't).

I'm glad your mum was at least at home with you.

It is a really horrible feeling in the beginning when you find yourself needing your mum to help you with losing her. It does gradually get less crap though.

Please don't be too hard on yourself. You are allowed to fall apart a little from time to time.