What to do when death occurs in the family – an in-depth guide

Signs for caregivers that indicate end-of-life of patient

End-of-life patients may suffer from ill health due to age or terminal illnesses and cannot progress further. In this case, caregivers focus on palliative care to ensure the person’s needs are met as much as possible with the least pain.

When you care for an end-of-life patient, the experience can be very challenging and emotional. It is best to work closely with healthcare providers to provide holistic care as you prepare your loved one for death. However, as a caregiver, you might also be struggling to cope, and you might be in denial about the patient’s decline.

Therefore, the Agency for Integrated Care (AIC) recommends caregivers remain mindful of their own needs while caring for the patient. Doing so will help caregivers come to terms with and recognise the signs of a person’s end of life. These signs include sleeping excessively and moving less. They might also seem confused. Physical symptoms include cold hands and feet or more bedwetting.

When the person reaches their final moments, they might start to breathe differently, become unconscious, and the body changes colour. Recognising these signs can help you mentally prepare yourself for the final moments. The symptoms can cue you to discuss funeral planning when the patient is in a better state.

Seeing these signs can be distressing if you are not ready for it, so it’s helpful to look for resources about communicating or providing palliative care. The Singapore Hospice Council and National Cancer Council Centre offer more information.

When a death occurs at home

If your loved one has passed away at home, here are the steps you will need to take:

1. Contact a doctor willing to make a house call to certify the death.
2. The next of kin (NOK) will have to apply for a digital death certificate using his/her Singpass from the government site, My Legacy. The NOK will have 30 days to download the document.
3. After the certificate is downloaded, the family members may contact a funeral director who will take care of the process. This includes collecting the body from home and delivering the body to the wake.
4. With the certificate, the family can also apply for a permit to bury or cremate their late loved one at National Environmental Agency (NEA) e-portal. The funeral director can also be authorised to do so.
5. If a doctor cannot make a house call, the family members must call the police. Then, the body will be sent to Mortuary@HAS.
6. The police will then notify the NOK on when they can collect the body. The family members will need to bring medical documents and identification papers.
7. The family will view their deceased loved one with a coroner present, who determines if an autopsy is required.
8. If the coroner deems it a natural death, the coroner will inform them on when to claim the body. From here, the family members can engage a funeral director.

If the autopsy reveals that death is due to unnatural causes, the police will conduct further investigations. The family will also have to attend a coroner’s inquiry at the Subordinate Courts.

If the death occurs in a local hospital

A doctor will certify the time of death if your loved one has passed away in the hospital. A digital death certificate number will be provided by hospital staff. After downloading the digital death certificate, you can follow Steps 2 to 4 above.

If the death occurs overseas

If your loved one has passed away abroad, you must first register with the relevant authorities in the country where the death has occurred. This is so that you can obtain the death certificate.

You can obtain the death certificate with the help of Ministry of Foreign Affairs (MFA). MFA officials can also guide you on the procedures for repatriating the body or ashes back home to Singapore.

Repatriation of the body

If you decide to bring your loved one’s body home, MFA officers will put you in touch with funeral services in the country for the next step. Here are the key steps:

1. The body must be sealed in a casket and meet all requirements for cremation or burial in Singapore.
2. You will need to obtain the necessary documents, such as:

• A death certificate in English and a coffin export permit from the country where your loved one has passed on. A translated copy is required if the documents are not in English.
• A coffin import permit issued by Singapore.

3. You will need to Inform MFA of the flight date and time.
4. Once the coffin is imported, you will need to report this to the Singapore Registry of Births and Deaths at Immigration & Checkpoints Authority (ICA) building.

The above requirements will mean that a person in Singapore has to be available to register for the coffin import permit issued by Singapore. A funeral director can assist with this step with a letter of authorisation by the NOK.

If you are importing the body of a non-Singapore citizen back to Singapore, note that foreigners can be buried in Singapore only if the NOK is a Singapore Citizen or Permanent Resident. Nevertheless, cremation is permitted and the family can purchase niches from a private columbarium. Again, if you have engaged a service provider, the funeral director can manage this for you.

Bringing cremated ashes back to Singapore

If you have decided to cremate the body overseas, MFA officials will put you in touch with the relevant funeral services to do so. Here are key details to note when you are handling the funeral planning:

• The size of the urn has to fit the location you have chosen.
• Onlynon-metallic urn is permitted as it needs to be x-rayed at immigration checkpoints during security checks.
• You will need the death certificate and cremation certification in English. A translated copy is necessary if the documents are not in English.
• Once in Singapore, you will need to register the death at ICA. Then, to hold the necessary funeral services for cremation, you can engage a professional provider of funeral services.

You will also need to check with your airline whether the urn can be carried as hand luggage. While a permit is unnecessary, different countries may have various requirements when travelling with human ashes. The Singapore Mission overseas can help you with these rules.

When should you pre-plan for a funeral, and who should you include?

If you’re pre-planning a funeral for yourself, you can do so whenever you feel ready to handle these arrangements rationally.

If you’re married, your spouse, and your children should be involved. If you’re single, your or next of kin, such as your parents or siblings, can also be included.

While they might not be ready for such a discussion, you can initiate the conversation calmly so that they know you are being pragmatic about death.

For a loved one who is terminally ill, you’ll need to broach the subject only when they are ready for a discussion. However, if your loved one has not left a will, LPA, or AMD, it might be best to sound them out on how they would like to be remembered after they have passed on.

When you’re pre-planning a funeral, do consider engaging a funeral service provider as they can provide advice and guide you on what you need to do.

If you’re searching for one, look for a reputable and experienced company which is upfront and transparent about its pricing – like Empathy Funeral Service. Moreover, for those who require specialized services such as religious rites, it’s best to choose a company that can cater to those needs.

Other post-death matters

Although there is no specified time frame when to register the death to the Registry of Births & Deaths, the report is required for financial matters. These include account closures and inheritance matters.

Here are a few relevant parties that you might need to inform that your loved one has passed on:

1. Banks. You must close the accounts and resolve any automatic payments, including GIRO. Then, settle outstanding bills, mortgages, and loans.
2. Insurance companies. If the deceased has insurance, there might be payouts for the beneficiaries. Inform the insurers, and they will update you on how to follow up.
3. CPF matters. If the deceased were a CPF member, the nominated beneficiary or beneficiaries would receive the remaining CPF savings and any monies or assets. If the deceased has not made a nomination, the Public Trustees will handle CPF savings, other monies, or assets and distribute them to the deceased person’s family per the law. Here’s the comprehensive list of questions regarding post-death CPF savings distribution.

Besides the above, you might also need to settle any outstanding utility bills and close the accounts.

In instances where the deceased has drawn up a will, you would have to contact the solicitor or the executor of the will. The executor is the named person that carries out the deceased’s wishes in the will.

On managing grief

You might find it an emotional struggle while carrying out the administrative and financial duties. Know that it is human, and everyone handles grief differently.

You or your family members might experience shock or sadness. Some people might have bodily reactions such as feeling fatigued yet unable to sleep. Or they might feel breathless and oversensitive to their surroundings. Other signs include crying, attachment to the deceased person’s belongings, and social withdrawal.

If you recognise these signs of grief in your loved ones or yourself, you should seek out appropriate support. These might be of some help:

1. Try to have a routine to take your mind off the loss.
2. Be open to accepting help. If you are in a support group, communicate with others, especially if you face the same scenario.
3. Find creative outlets such as writing or painting, or rediscover activities that you have not tried.
4. Get help to go back to the workforce. If you’ve depended on the deceased financially or took time off work to care for an end-of-life patient, you might need professional guidance. Workforce Singapore can be your starting point.

Above all, know that if you need to seek professional help from doctors or counsellors, do it. With the right support, it can ease your grief and stress so you can carry forward the beautiful memory of your beloved without letting sadness overtake your life.

Empathy Funeral Service can ease the stress of funeral arrangements

Conversations about death are difficult. When caring for an end-of-life patient, it helps to pre-plan a funeral and involve them in the discussion. That way, you will also ease their anxiety. Further, it ensures that the funeral arrangement goes as the deceased wishes. Planning minimises the family’s stress and offers them a chance to honour the deceased properly.

Empathy Funeral Service can help with pre-planning and overseeing the funeral arrangements when you or your loved one passes on, easing the stress of planning a wake while grieving. Contact us to assist in your preparation.