Death in the Family Information You Might Need GEN-45 (10/2004)
TABLE OF CONTENTS Introduction... 5 General Information... 6 Matters for Immediate Consideration... 7 Confirmation of Death... 7 Autopsy... 7 Notifying Others Family, Faith Leader, Friends... 9 Organ and Tissue Donation... 9 Funeral Costs and the Matter of Payment... 12 Choosing and Notifying a Funeral Director... 12 Information Needed for the Funeral Director... 13 Financial Assistance... 15 Canada Pension Plan... 15 Veterans... 15 WSIB... 15 Ontario Car Insurance... 16 Families Without Any Financial Resources... 16 Life Insurance... 17 Organizations and Clubs... 17 Public Guardian and Trustee: Estates office... 18 Other Matters... 18 Car Ownership and Insurance... 18 Health Insurance Coverage... 18 Life Insurance Policies... 18 Employer... 19 Legal Aid... 19 Proof of Death Certificates... 19 Coping With Grief... 20 Community Resources... 21 Checklist... 22
INTRODUCTION As staff of The Ottawa Hospital, we extend our sincere sympathies to you and the rest of your family. We want to support you in any way we can at this time of loss. When someone close to you dies, it is natural to feel great shock. You may find yourself numbed, bewildered and unable to do any of the things you know you must do. The entire family may feel devastated, under great stress and disorganized. This booklet has been prepared to provide information and guidance through death related events, funeral arrangements and burial, and finally some of the post-death legal and financial matters. The staff extends to you their sincere sympathy. If you need assistance, please feel free to call us. The Hospital can put you in touch with a Chaplain or Social Worker. They will willingly assist and support you. Spiritual Care Services: (613) 798-5555 (ext. 14587 Civic) (613) 737-8899 (ext. 78126 General) Social Work: (613) 798-5555 (ext. 14711 Civic) (613) 737-8899 (ext. 78600 General) Note: Staff Chaplains at the Ottawa Hospital have been trained to assist grieving families from all religions and cultures. A Chaplain is available twenty-four hours a day. 5
General Information Following the death: Take your time. If you feel the need, contact: Spiritual Care Services at: (613) 798-5555 (ext. 14587 Civic) (613) 737-8899 (ext. 78126 General) or the Social Worker. You may ask the nurse to call for you. Feel free to ask the nursing staff what to do next. You may be asked to consider the donation of organs or tissues for transplantation. Ask the physician or nurse if you have any questions about this procedure. You may be asked to consent to an autopsy. Please ask the doctor or nurse if you have any questions about this investigation. If you have not already done so choose a funeral home and contact them. 6
Matters For Immediate Consideration Confirmation of Death A physician will confirm that the patient has died. The physician will complete a Medical Certificate of Death, which states the patient s name, age, date of death and cause of death. You may ask for copies of the death certificate from the funeral home. Autopsy The purposes of an autopsy are to determine the cause of death, the presence of any disease, and the effectiveness of medical diagnosis and care. You may request an autopsy, or you may be asked by the physician to consent to one. A consent form must be signed, usually by the next of kin or executor of the estate. It is best if all in the immediate family are aware of, and in agreement with, doing an autopsy. During an autopsy a specialist doctor, the Pathologist, will examine the patient for signs of disease by looking at the body s organs in a way similar to that at surgery. Samples of the organs will be taken and later will be examined with a microscope. A report will be prepared and sent to the doctors who cared for the patient. You may request a copy of the Autopsy Report through your family physician, who can explain the language to you. (Note - this process could take months.) The autopsy will not be detectable at the funeral even if an open casket is planned. The autopsy will usually be performed in the morning, and the Funeral Home will then take the body for preparation for the funeral. An autopsy does not usually delay any of the funeral planning. 7
In most cases, a complete autopsy is performed, looking at all organs. If you are uncomfortable with this, a partial autopsy may be performed looking at only certain organs. You may wish to discuss this with the physician. Some tissues, including some organs, are retained for more detailed examinations and preparation of microscopic slides after the initial portion of the autopsy is completed. These retained tissues are stored at the hospital for a variable length of time pending completion of the autopsy report and then cremated. If this retention is not acceptable please discuss this with the physician prior to consenting to the autopsy. If a coroner is involved with the case, you should know that the coroner s orders legally take precedence over all others and that he/she may order an autopsy (if the coroner doesn t request one, you may). We feel that it is important to perform autopsies to improve medical care. We sympathize with your all-too-recent loss and recognize the sensitivity of this subject. We encourage you to ask any questions you may have about this matter. You or your physician may phone the Pathology/Laboratory Medicine Department if you have any questions about this procedure (General Campus (613) 737-8899, ext. 72280 or Civic Campus (613) 798-5555, ext. 14344, or ask for the pathologist on-call for autopsies). After hours/weekends contact them through locating. The pathologist will be happy to speak with you or them. To obtain the autopsy findings, call Health Records, your family physician or the physician who was responsible for the patient s care while in hospital. If the coroner ordered the autopsy, contact the Coroner s Office at (613) 239-1251. 8
Notifying Others Family, Faith Leader, Friends You may want to notify other members of the family, your faith leader, close friends or a neighbor before you leave the hospital. The hospital staff, particularly the nurse, chaplain & social worker, will assist you with any immediate calls. He/she can offer warm, understanding support and comfort, and assist you with some of the difficult decisions you will have to make during the next few hours. Organ and Tissue Donation The death of someone you love is the beginning of a very painful time in your life. As you struggle to find a meaning in this, it may help to consider organ and/or tissue donation. Some people find comfort in the thought that their tragedy has brought life to others. Some deaths occur when the heart stops. Death can also take place when blood flow to the brain has stopped due to a severe brain injury. When brain death occurs, your loved one can no longer think, feel, hear, or see. Their skin will feel warm with the heated blankets. Their chest will rise and fall as long as they are connected to a breathing machine. They may appear to be in a deep sleep. Only artificial means can sustain the body, for a period of time. Two physicians, who are not involved in the donation or transplantation process, independently assess each possible organ donor. Different clinical and diagnostic tests are used to absolutely determine brain death. Organs such as the heart, lungs, liver, kidneys, pancreas and small bowel can only be transplanted if the heart is still beating at the time of donation. Tissues, such as corneas, bones, and heart valves can be donated up to 24 hours after your loved one has passed away. 9
Most religious groups support the concept of organ donation. They consider organ donation to be a gift of life from one individual to another. A member of our Spiritual Care Team is available to assist you in any spiritual needs you may have. These are some questions that families often wonder about at this time. Will we still be able to have an open casket at the funeral? Yes. The donation surgery is very meticulous so very little evidence of the surgery will be apparent. Why is the coroner involved? The coroner is called for many reasons, one being that he/she is called whenever there is a sudden and unexpected death. The coroner may request an autopsy. Why are we asked a lot of questions about our loved one, now that he/she has been declared brain dead? Obtaining medical/social history from each donor is part of the routine screening process. Numerous blood tests will also be performed as part of this process to ensure safe transplantation. How long will the donation process take? Once the initial declaration of death has been obtained, the process can take up to 24 hours. Many tests will be done to determine the health of each organ. Recipients for the organ you consent to donate will be found. The retrieval of organs will take place in the operating room. 10
When can we say good-bye to our loved one? The nursing staff will ensure that you can spend as much time at the bedside with your loved one as needed. Often families choose to say goodbye to their loved one once consent has been given for donation, others choose to stay until the retrieval. How do we know what is happening after we leave the hospital? You will be given a contact name and phone number of an organ donor coordinator. He or she is available to offer ongoing information and support. When do we make the funeral arrangements? If no autopsy is required, final funeral arrangements are usually made after the donation is complete. Should an autopsy be required, it is performed as soon as possible after donation, and should not delay the funeral. The donor coordinator will maintain communications with the funeral home of your choice to facilitate the timing of the events. Who will know about the donation? The Trillium Gift of Life Network Act ensures confidentiality for both donor and recipients. Release of information regarding the donation is at the discretion of the immediate family. Will we ever find out what happened to the organs and/or tissues that were donated? Yes. A few weeks following the donation, we will send you a letter with information about the recipients of the donated organs. We cannot give you the identity of the recipients but we can let you know a little bit about them, such as their age and sex. Thank you for considering organ and tissue donation at this difficult time. 11
Funeral Costs and the Matter of Payment The cost of the funeral may be a matter of great concern to you. You may be surprised and relieved to learn of the financial resources available to your family. Funeral directors who are members of the Ontario Funeral Service Association have information about funeral plans and benefits that may be available to you. Funerals do not need to be elaborate or costly. You can express your love for the deceased with a simple, dignified funeral. Choose those services you want and can afford. The funeral costs can be paid in several ways. Be sure to discuss costs and payments before you make your final decisions and arrangements (See Section Re: Families Without Any Financial Resources). The funeral director can assist you by providing a list of the services he/she provides, and the costs. The Funeral Information Society is a non-sectarian, non-profit organization in support of simplicity, dignity and moderate cost funerals. It is one of more than 200 such societies in Canada and the United States. The Society has agreements with several funeral directors to provide its members with simple arrangements. Funeral Information Society Telephone: (613) 828-4926 Choosing and Notifying a Funeral Director It is best to choose a funeral director near your home, or one who others (family or close friends) recommend as a person in whom they have confidence. Funeral directors are familiar with the rites, rituals, and customs of all religions and cultures. The funeral home chapel is available for funeral or memorial services. If you wish, the funeral director will arrange for a faith leader if you have no individual whom you prefer. Call the funeral home, tell them that you would like them to take care of the funeral arrangements and that the body is at the hospital. Be sure to tell them if an autopsy is to 12
be performed so they can arrange to pick the body up as soon as the autopsy is completed. At the earliest convenient time, you and/or members of your family will have to go to the funeral home to complete arrangements. Plan and decide the type of funeral and burial you want before you proceed to make final arrangements. It is important that you plan a funeral that you can afford and one with which you feel comfortable. It is important to get help from someone you trust (family, friends or faith leader) when making these funeral plans. In some cases the deceased may have pre-planned and arranged his/her funeral, or indicated to you his/her preferences. If so, you will want to consider your loved one s wishes when you are making your plans. Information Needed for the Funeral Director surname and given names of the deceased permanent address citizenship province/state/country of birth date of birth social insurance number trade/profession/work if retired, date last worked at this occupation marital status if married, widowed or divorced, name husband or maiden name of wife name of father maiden name of mother birth place of father birth place of mother 13
This information is required for the funeral director to complete the Statement of Death form so the death can be registered and a Burial Permit issued. If you wish, the funeral director will arrange newspaper notices. He/she will need additional personal information about the deceased, and any other information you would like included in the notices. The cost of newspaper notices will be added to the funeral bill. 14
Financial Assistance You may be eligible for financial assistance to help pay some of the funeral costs. Canada Pension Plan Human Resources Development Canada A lump-sum death benefit s payable to the estate of a deceased person who contributed to the Plan for at least the minimum qualifying period. Contact your local Human Resources Development Canada office for further information. The telephone number is: 1-800-277-9914 Veterans Contact your Veterans Affairs District Office as soon as possible for additional counselling or possible assistance with funeral and burial expenses and a grave-marker. Survivor benefits for veterans receiving a disability pension or War Veterans Allowance will also be explained. The counselor may be also able to put you in touch with a support group in your area. (613) 998-9460 / 1-888-998-9460 In Ottawa the office is at: Mailing Address: 2323 Riverside Drive P.O. Box 8476 2nd Floor Postal Station T Ottawa, ON K1A 0P5 Ottawa, ON K1G 3H9 Workplace Safety and Insurance Board (WSIB) Survivors benefits are money and other services provided by the Workplace Safety and Insurance Board (WSIB) to the surviving spouse, dependent children or other dependants when a worker covered by the Workplace Safety and Insurance Act dies as a result of a work-related injury or disease. A survivor must apply for these benefits and services within six months of the worker s death. There are 15
four kinds of benefits and services that survivors may be eligible to receive: 1. Payments of money. 2. Assistance in entering the labour market, if it is requested within a year of the worker s death. 3. Bereavement counseling, if it is requested within a year of the worker s death. 4. Burial expenses and, in some cases, transportation costs for the body. Toll free number at 1-800-435-8980 (English) or 1-800- 661-6365 (French). Ontario Car Insurance If death was the result of a motor vehicle accident contact the car insurance company as soon as possible. Under Ontario s no-fault insurance program a payment will be made to cover part of the funeral expenses. Contact the motor vehicle insurance company of the person who has died. Families Without Any Financial Resources Social Service Departments across Ontario and Quebec provide assistance and payment for burial in cases where the family of the deceased person lack financial resources. Call the Regional Municipality of Ottawa-Carleton at (613) 560-6000 or the Gatineau area office at (613) 772-3694. This office will also be able to tell you which local office is appropriate if you live outside the Ottawa-Carleton area. The person applying for financial assistance should take along the deceased person s Social Insurance Number and bank account book(s) 16
if they exist. The funeral services provided will be limited, simple yet dignified, with burial in common ground. It would be better if arrangements for financial assistance are made before contacting the funeral home. This type of funeral is provided below cost by funeral directors as a service to the community. In the event that the funeral home is contacted before applying for financial assistance, it is important that you do not sign a contract with the funeral home. Instead let the funeral director know that you are planning to request financial assistance from Social Services. Life Insurance If the deceased had life insurance, contact the insurance agent or local representative for assistance with claim forms or you may contact the insurance company on your own accord. In the case of the death of a school-aged child, check the insurance policy you may have purchased through the school insurance program. Organizations and Clubs Many organizations, lodges and social clubs provide a death benefit payable to the estate of the deceased member. You should let the funeral director know the names and addresses of all the lodges, clubs and associations to which the deceased belonged. He/she will know which organizations offer a benefit to which you are entitled, and assist you in applying for them. Public Guardian and Trustee: Estates office If the deceased left no will, has an estate over $5,000 and the next of kin are unsure of what to do next regarding the estate then the Estates office of the Public Guardian and Trustee should be called. 1-800-366-0335. 17
Other Matters You or a member of your family can probably look after the following matters: Car Ownership and Insurance If the deceased owned a car, you must notify the Ministry of Transportation, and the insurance company as soon as possible. If death was the result of a car accident contact the car insurance company as soon as possible. Under Ontario s no-fault insurance program a payment will be made in the event of death of the insured person, spouse or dependent. Health Insurance Coverage If insurance was in the deceased s name, notify the insurance companies in writing. Ontario health insurance office is listed in the Blue pages of the telephone directory in the Government of Ontario section, under Health Insurance (Ottawa (613) 783-4400). When calling have the health insurance number available. For the addresses of other insurance plans, check any brochures, policies or cards issued by the companies. Life Insurance Policies Contact your agent or local representatives, or notify the company directly. They will send you the appropriate forms to complete. 18
Employer Check with the Human Resources Department to determine whether the deceased was enrolled in a pension plan, life insurance, or was eligible for some type of termination pay at the time of death. Legal Aid You may find your self having some legal questions and may not be able to afford a lawyer. You may be able to get some assistance from Legal Aid if you live in Ontario and qualify. Legal Aid (Ontario) (613) 238-7931 Proof of Death Certificates In many cases, a Proof of Death Certificate must accompany applications for benefits or claims. This form is available free of charge from your funeral director. You may obtain as many copies as you require. For some claims, a Certified Copy of Death document is necessary. Applications for a Certified Copy of Death may be obtained from your funeral director, or by writing directly to: Office of the Registrar General PO Box 4600 189 Red River Road Thunder Bay, ON P7B 6L8 Tel: 1-800-461-2156 Enclose the appropriate fee for each certificate requested. 19
Coping With Grief The death of a loved one brings about profound changes in the life of the bereaved. Grief and mourning are normal reactions to death. You may experience many emotional and physical changes a profound sense of loss, loneliness, desertion, anger, guilt, fear, depression, restlessness, disinterest in life around you. You may lose your appetite and energy, and be unable to sleep. Don t attempt to hide your grief, or try to deal with it alone, or pretend that nothing has happened. Crying and expressing your grief openly to a sympathetic listener will help you to grieve in a healthy manner and to adapt to the loss of your loved one. A sympathetic listener may be a friend, your faith leader, or your family doctor. Your family doctor will also be able to recognize signs of physical illness resulting from the stress you are experiencing. Any person with whom you are able to share your innermost feelings, and who can listen sympathetically, will help you to cope with your grief and to function more effectively. Please feel free to call: Spiritual Care Services (613) 798-5555 (ext. 14587 Civic) (613) 737-8899 (ext. 78126 General) Social Work (613) 798-5555 (ext. 14711 Civic) (613) 737-8899 (ext. 78600 General) They are concerned with your welfare and will be as helpful as possible in assisting you to adjust to the changes in your life. They can, if you wish, also refer you to a bereavement support group in your area. Some of these groups specialize in supporting grieving families sub- 20
sequent to the death of a young child or when the family member has died by suicide. Appropriate referrals can also be made for children experiencing the loss of a parent or other relative/friend. When you feel up to it, you are welcome to come back and visit us. The hospital staff who cared for your loved one will welcome your visit and are always interested in hearing how you are adjusting and coping. Community Resources Here is a list of some counseling services and support groups that may provide some help. Bereaved Families of Ontario 567-4278* Catholic Family Services 233-8478 Family Service Center Ottawa/Carleton 725-3601 Jewish Family Services 722-2225 Ottawa Distress Center 283-3311 St. Paul s University-Pastoral Counseling 782-3022 Widowed Support Group of Ottawa Carleton 723-0010 * All the phone numbers of the resources mentioned above are in the (613) area code. 21
The following checklist may be helpful for you to keep track of the people and/or organizations you have or need to inform regarding the death of your loved one. Completed Date/ Contact List of People and/or Organizations to Notify Lawyer/Legal Aid lawyer will assist the executor to fulfill the terms of the Will and arrange probate. This may not be necessary if it is a simple cash settlement and the executor is informed. Banks/Credit Union The deceased s bank(s) should be contacted and provided with Proof of Death Certificate so that the accounts may be closed. The manager or accountant will assist regarding safety deposit boxes. Employer/Union as well as pension plans, many companies have life insurance coverage as part of their employee benefit package. Other Life Insurance Companies or Private Pension Plans Canada Pension Plan 240 Sparks St, Level C3, Ottawa, ON, K1A 0K9, 1-800-277-9914. A lump sum death benefit may be paid to the estate. In addition, surviving spouse and dependent children may be eligible for a monthly pension. Application has to be made. Call the 1-800 number to make an appointment. 22
Old Age Security 240 Sparks St, Level C3, Ottawa, ON, K1A 0K9, 1-800-277-9914. The estate is entitled to a cheque for the month in which the individual died. Ontario Health Insurance Plan (OHIP) 75 Albert St., Ottawa, ON, K1Y 5Y9, (613) 783-4400. Notify in writing of the death, including a copy of the death certificate and the health insurance card. Credit Card Companies ie Master Card, Visa, Sears, The Bay, etc. Ministry of Transportation if the deceased person owned a car; also the automobile insurance company Cancel deliveries, service calls, subscriptions, appointments, etc on behalf of the deceased. Department of Veteran s Affairs If the deceased was a veteran of the Canadian Armed Forces, you may be eligible for some type of dependents benefits in addition to death benefits (In Ottawa, call (613) 995-6467). Fraternal Organizations/Service Clubs to which the individual belonged. Revenue Canada Income Tax Return for the deceased must be filed by April 30th of the year following the death. Please Note: The Ottawa Hospital provides the above checklist for your convenience. They may not cover all sources from which you may determine benefits or from which your involvement may be required. 23
Copyright: This booklet has been produced by The Death Policy Committee of The Ottawa Hospital.