Nursing Care of the Dead (Postmortem Care)

Your job does not end when the patient dies. Postmortem care is the last thing you do for them, and how you do it matters to the family who is watching and grieving. It takes physical care of the body and steady emotional support for the people left behind. Knowing how the body changes after death lets you do it well.

What is Postmortem Care?

Postmortem care, also called after-death care, is the respectful, hygienic preparation of a deceased person's body for family viewing, transport, or examination such as autopsy.

You begin immediately after death. Rigor mortis, the stiffening of the body, typically begins in the involuntary muscles and progresses to the head, neck, trunk, and extremities over about 2 to 4 hours, dissipating roughly 96 hours later. Algor mortis is the gradual drop in body temperature after death, falling about 1℃ (1.8℉) per hour until it reaches room temperature once circulation stops. Livor mortis is the discoloration in dependent areas after death, from the breakdown of red blood cells once circulation ceases.

Equipment

• Protective barriers (gown, gloves, face shield)
• Bathing articles (water, towel, soap, washcloth, basin)
• Comb or brush
• Body bag or shroud
• Shroud kit
• Absorbent pad
• Bed screen if needed
• Containers for belongings (box or bag)

Procedure

Treat postmortem care as an extension of the person-centered care you gave in life.

1. Verify identity and death documentation. Right person, right procedure. This also meets legal requirements and prevents misidentification.
2. Notify the family and give them time to grieve and say goodbye. They need closure and time to make arrangements.
3. Put on gloves, a gown, and a mask to protect yourself from body fluids and keep the environment hygienic.
4. Position supine and elevate the head of the bed 30 degrees, or use pillows. This helps prevent facial discoloration (livor mortis).
5. Remove tubes, catheters, and devices unless an autopsy is required, and clean insertion sites with antiseptic wipes. Check institutional policy on autopsies.
6. Cleanse the body with gentle soap and water and dry it, maintaining dignity and preparing it for viewing.
7. Place an absorbent pad under the buttocks to catch fluids released as the sphincters relax and to keep the linens clean.
8. Gently close the eyes and mouth, using slight pressure if needed, for a peaceful appearance.
9. Dress the body in a clean gown or family-provided attire, and brush and comb the hair.
10. Cover the body with a clean sheet to the chin, arms outside the covers if possible.
11. Support the family: offer time with the deceased and answer their questions.
12. After the family leaves, pad the chin and fasten chin straps underneath, tied loosely above the head, to keep the head and neck aligned.
13. Pad the wrists and ankles and tie them together with gauze or soft string ties to prevent limb movement.
14. Place the body in a body bag or wrap it securely in a shroud for hygienic, dignified transport.
15. Attach identification tags per facility protocol, including the wrist and toe, and tag personal belongings.
16. Complete documentation: time of death, belongings inventory, and other required information.
17. Inform the family about viewing, autopsy, or funeral arrangements.