• Before Beyond

The first 24 hours after death occurs

Updated: Feb 25



People seldom talk about the moment of death of their loved one or the many arrangements they have to make in the days following the death.


For me, the minutes leading up to my mother's death and the moment of death itself would forever be etched in my mind. I remember feeling a thousand different emotions and thinking a thousand different things. Yet, surreal as it felt, practical matters came and swept everyone away in a flurry of motion.


This is the first article in the three part series on how to deal with post-death matters in the context of death from a terminal illness. It will provide information on the matters that needs to be dealt with within the first 24 hours of death.

Do check out the next two articles to find out more about the tasks that needs to be done in the days to weeks after death.



How to obtain a CCOD



Upon death, the next-of-kin will need to contact a doctor to certify that the death resulted from known and natural causes.


If the death occurs in a healthcare institution (e.g. hospital, hospice), the doctors in the hospital will certify the death. If the death occurs at home, you will need to contact someone to certify the death. Who you contact depends on whether the cause of death is known or not known.


If the cause of death is known and expected


This is usually happens for cases that have a known terminal illness and have been on follow up with a hospice or home care team for some time. There are two options on who you can contact in this instance:

  • Funeral director: If you have already chosen a funeral director, you can contact the funeral director who will contact their in-house doctor to visit your home to certify the death

  • 24-hour doctor on duty: Check with your family general practitioner if he/she provides house visits to certify death. Otherwise you can also contact the following numbers:

  • MW Medical (6250 0625)

  • Raffles Medical Group (6311 1555)

  • Speedoc (8180 8948)

  • The House Call GP (6247 9247)

  • Trinity Housecall (8223 4999)

Prepare the following while waiting for the doctor to arrive

  1. Clinical report from the healthcare institution that has been treating the patient (this will help the doctor identify the cause of the death)

  2. Identification card (IC) of the deceased

  3. Take note of the time of death (if possible)


If the cause of death is not known and/or unexpected


  • Call the police (you may consult the funeral director or the 24-hour doctor on duty if you are not sure; if there is doubt about the cause of death, they can advice you to contact the police)

The police will report the death of the deceased to the coroner. The body of the deceased will be sent to the Mortuary at Health Sciences Authority (HSA).


At the Mortuary@HSA, the family will view and identify the deceased's body in the presence of the coroner and handover the deceased's medical documents, medicine, and identification papers for review. The coroner will determine if an autopsy is required.


If any autopsy is not required, the family will be informed and will be given a time to claim the body for the funeral. If an autopsy is required, the procedure will be more complicated. Scroll to the bottom of the article to find out more about the autopsies.


If the cause of death is known and can be certified in the home setting, what happens next?


The doctor will then produce the CCOD in either a hard copy or soft copy. The costs of the CCOD will be approximately $200-250.


It would take approximately one hour for the doctor to arrive at the home to certify death from the time of activation. During this period, you may start to contact the funeral director to pre-empt them and decide if the body of the deceased should be cremated of buried.


Do noted that the funeral service can only collect the body of the deceased after the death certificate is obtained.



How to obtain a death certificate



The death of a person needs to be registered within 24 hours from the time of death. There is no fee for registering a death. Additionally, funeral arrangements can only be started after the death certificate is obtained.


To obtain the death certificate, you will to go to one of the following places (do check their opening hours before you head over):

  • Neighbourhood police centre

  • Manned neighbourhood police post

  • Police division headquarters

  • The registry of births and deaths (ICA)

If the body of the deceased is referred to the Mortuary@HSA, the death will be registered there.


You will need to prepare several items to bring with you:

  • Deceased's IC

  • CCOD

  • The IC of the person who is exchanging the CCOD for the death certificate (i.e. your IC if you are collecting the death certificate)


You will also need to decide if the body of the deceased will be cremated or buried as the police will require this information in order to furnish the death certificate.


When the death certificate is obtained, make several copies of it (ensure you have both hard copies and soft copies as you will need these in the coming days).


***UPDATE*** Starting from 29 May 2022, the Registry of Births and Deaths (RBD) will be streamlining the death registration process by switching to an electronic CCOD (eCCOD). Deaths will be automatically registered in the Central Identification and Registration Information System (CIRIS). This will remove the need for the deceased's family to go to a police post to register a death.


Next-of-kin must then log into My Legacy using the to download the eCCOD using the death certificate number provide by hospitals/medical practitioners. Downloading the eCCOD must take place within 30 days of the death and should be saved on a personal device.


The deceased's NRIC can then be destroyed (e.g. cutting it in half). The invalidation of the NRIC will be automatically done in Immigration and Checkpoints Authority (ICA)'s system.



How to get the funeral director on board (if applicable)



Inform the funeral director once the death certificate is obtained. They will begin the process of facilitating the funeral arrangements e.g. making the booking for cremation. Not every race and religion will require a funeral director to come on board.


While waiting for the funeral director to collect the body of the deceased, you can prepare the following

  • A set of clothes and shoes that will be the deceased's final ensemble before cremation or burial

  • Other items that you would like to have placed in the casket together with the body of the deceased prior to cremation/burial (if you cannot assemble all the items in time, do not fret. Most of the time you will be allowed time to place the items inside the casket before it is closed for cremation or burial. Do discuss with your funeral director on these arrangements.)

More information on how to plan a funeral can be found in this article: How to plan a funeral (Part 2: What to do when death occurs).



How to inform family and friends


Make a list of family members and friends to call or text to inform them regarding the death. Recruit the help of relatives or friends to help with informing the various groups of people so that it won't be too taxing on you to have to do all the calling yourself.


Most of the time, people will understand that you will have many things to settle and will offer their condolences and support. They will usually ask the following questions so have some answers prepared:

  • When and where will the cremation be?

  • When and where will the funeral wake be held?

  • How are you feeling?

Most of the time, you will not have the answers ready. But you can let them know that you will inform them once you have all the details ready.



What to do if your loved one is a organ/body donor


If your loved one has made a pledge to be an organ or body donor after death, contact the National Organ Transplant Unit (NOTU) transplant coordinator as soon as possible upon death (you can do this while waiting for the doctor to certify the death) so that they can advice on the necessary arrangements. NOTU will inform the assigned hospitals or university to make arrangement to collect the body from the location on the same day.


Most types of donations will need to happen within 24 hours in order to provide the most benefit. Brain donations should ideally be received within 24 hours of death (although tissues can still be retrieved up to 48 hours). Whole body donation used for surgical workshops will need to arrive at the right facilities within 8 to 10 hours.


After the transplant coordinator is notified about the death, the transplant centre will need to conduct some assessments to make the final decision on the suitability for donation.



What happens if an autopsy is required


If the death has occured suddenly without a clear reason and/or is suspected to be due to unnatural causes, the coroner will authorise an autopsy. No fee is charged for an autopsy requested by the coroner. However, if you wish to obtain a copy of the autopsy report, the approximate costs of the administrative fee will the $150-160.


If the autopsy reveals that the death is unnatural, the police will need to conduct further investigations into the cause of death. Once the investigation is completed, the family will be informed by the Police to attend a coroner's inquiry at the State Courts and to claim the deceased's body.


After the autopsy is completed, the deceased's body will be restored as best as possible. Do note that there may be cuts made on the body in order to perform the internal examination. However, these cuts will usually be made such that they are not easily visible.


You can also request for a private autopsy if you wish. As of the time of writing on 30 March 2021, the administrative fee for a privately-requested autopsy is $5927.80 and the daily charge for the storage of the deceased's body is $181.90 per day from the third day onwards.



Conclusion


The first 24 hours following death of a loved one can be a very hectic period for the next-of-kins. Mobilise the help of relatives and friends in order to relieve your burden if you are already feeling very emotionally overwhelmed.


Do check out the next two articles to find out more about the tasks that needs to be done in the days to weeks after death.

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