Last offices

The last offices are the procedures performed, usually by a nurse, to a dead person shortly after death has been confirmed. They can vary from hospital to hospital, and culture to culture.

Name

The word "offices" is related to the original Latin, in which officium means "service, duty, business". Hence these are the "last duties" carried out on the body.

Aims

The main goals of the last offices are:

• To prepare the deceased for the mortuary (a funeral home or morgue), respecting their cultural beliefs
• To comply with legislation, in particular where the death of a patient requires the involvement of a Procurator Fiscal aka. Coroner
• To minimize any risk of cross-infection to relative, health care worker, or persons who may need to handle the deceased

Procedure

Often the body of the deceased is left for up to an hour as a mark of respect. The procedure then typically includes the following steps, though they can vary according to an institution's preferred practices:

1. Removal of jewellery unless requested otherwise by the deceased's family. If left on, it must be documented in the patient's property list.
2. Wounds, including pressure sores, should be covered with a waterproof dressing. Tube insertion points should be padded with gauze and tape to avoid purging.
3. The patient is laid on his/her back with arms by their side (unless religious customs demand otherwise). Eyelids are closed.
4. The jaw is often supported with a pillow or cervical collar.
5. Dentures should be left in place, unless inappropriate.
6. The bladder is drained by applying pressure on the lower abdomen. Orifices are blocked only if leakage of body fluid is evident.
7. The body is then washed and dried, the mouth cleaned, and the face shaved.
8. An identification bracelet is put on the ankle, detailing: the name of the patient; date of birth; date and time of death; name of ward (if patient died in hospital); patient identification number.
9. The body is dressed in a simple garment or wrapped in a shroud. An identification label duplicating the above information is pinned to the wrap or shroud.
10. A stretcher drawsheet is placed under the body to enable removal to a trolley for transportation to the morgue. These trolleys may often be disguised to resemble laundry carts if transportation has to pass through areas where members of the public may be present.

By following these procedures, healthcare professionals can ensure that the deceased's body is treated with dignity and respect, while adhering to any cultural or religious customs, as well as legal requirements.