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level of distress and worry for the deceased person’s relatives and friends. When communicating with bereaved relatives and friends it helps to be aware that: · They are dealing with a lot of people, all of whom are both providing and looking for information and decisions – this can be very confusing, particularly when grieving. · They are likely to be unfamiliar with COVID-19 guidance on the care of the deceased person and the funeral process, and may seek reassurance on many points. · Grief may make relatives and friends less mindful of the need to protect themselves from possible COVID-19 infection. They may also be less mindful of the importance of protection for you and your colleagues. Deceased people come from many cultural and religious traditions. Intercultural awareness is particularly important when working with the body of a deceased person, and communicating with their relatives and friends. The HSE’s Intercultural Guide offers specific advice for the time of death and its aftermath. It is available at interculturalguide/intercultur alguide.html. Caring for people who have died, and supporting their relatives and friends, can be very rewarding, but it can also be emotionally demanding. See section 10 for guidance on how to look after your general and mental health. 2. The risk of contracting COVID-19 from a person who is considered infectious at the time of death The exact length of time that SARS-CoV2 virus (the coronavirus that causes COVID-19) can remain infectious in body fluids and tissues in a deceased body is as yet unknown. To date there have been no documented cases of transmission of COVID-19 through handling the bodies of deceased people, even those who died during the infectious stage of the disease (see section 8.2.1). As a precaution, however, it is prudent to wear appropriate PPE during: · procedures that may involve the splashing of liquids (for example, while washing the deceased person) · moving and handling (such as when dressing the deceased person) · direct contact with the deceased person’s clothing, bedding or possessions · post-mortem examinations · removing cardiac implants · the process of embalming. 6 Any infection prevention and control procedures advised before death should be continued when handling the deceased person after death. However, if precautions related to COVID19 transmission were discontinued before death, they are not required afterwards. For more information on viral persistence, see https://hselibrary.ie/how-long-can-the-covid19-virus-exist-on-surfaces-what-role-do-contaminated-surfaces-play-in-the-chain-oftransmission-what-infection-control-precautions-should-be-implemented/ 2.1 Cleaning procedures Standard infection prevention and control procedures for environmental cleaning continue to apply during the pandemic. SARS-CoV-2 can persist on surfaces, such as plastic and stainless steel, perhaps for up to 9 days, depending on factors such as the type of surface, temperature, relative humidity and specific strain of the virus. It is important to clean surfaces thoroughly: · Use soap and water or a detergent to clean surfaces on which the bodies of deceased people have lain. · Then wipe the surfaces with household bleach (or a disinfectant with a minimum concentration of 0.1% sodium hypochlorite or 70% ethanol). For Information about washing or cleaning personal items belonging to the deceased person, see section 4. Follow the guidance of the Health Protection Surveillance Centre (HPSC) on infection control and precautions while the deceased person’s body is in your care. Visit www.hpsc.ie for the most up-to-date advice. 3. Care of the deceased person immediately after death This section deals with the period immediately after a death has taken place. For related information: · concerning handling the personal possessions of the deceased person, see section 4 · on verification and pronouncement of death, see section 5 · about completing the Death Notification Form, see section 6 · on the procedures for reporting deaths to the coroner, see section 7 · about practical end-of-life care resources, such as the End-of-Life symbol and drapes, see section 11. 7 The following guidance applies in all settings, whether clinical or residential: · The deceased person’s relatives and friends should be informed that the person has died, even if they are present at the time of death. Document this in the healthcare record. · Compassionate communication with relatives and friends is crucial. Take a systematic approach to keeping bereaved relatives and friends informed of what is happening. Guide them gently to useful information and sources of support (see section 9) and encourage them to contact a funeral director. · Enable access to preferred spiritual care, if requested. · Prepare the deceased person’s body (perform last offices) in accordance with local protocol and the person’s wishes, religious and cultural preferences. When carrying out these tasks: o If the person died during the infectious stage of COVID-19 (see page 5), wear a long-sleeved gown, gloves, a FFP2 or surgical face mask and eye protection, discarding the PPE afterwards according to standard procedures. If relatives or friends are present, explain the necessity for wearing this PPE. o For all other deaths, follow standard
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