What are the steps taken when a parent dies in a nursing home?

Hanging: Thank you for responding to my post. I'm sorry that you don't have the funds. Everything does escalate in price.

Hangingon61 ... By now, you have read many, if not all, of the suggestions. They are good ones (though we seem to have one unhelpful troll in this thread...just ignore that one).

When my mom died from Alzheimer's, I was the only one with her in the nursing home room. It was very hard one me. But, I can't tell you how relieved I was that I had gotten both her and me signed up for cremation years (decades) ago with the Cremation Society of Pennsylvania. I was in the room with my mom laying dead in her bed, and I was numbly packing up her belongings. I took a break to take some boxes down to my car. When I came back, the Society workers had arrived while I was gone and had already removed her. They are very professional at what they do, as they do this type of work every day of every week. See if there is a Cremation Society in your state and if they can help with the costs in any way.

But, like you say, you do not have much money. I can actually feel your stress, and I'm sorry you are going through this.

However, armed with FACTS (only) you can make good decisions. So, as many as these wonderful people on here have said, start with the Nursing Home (NH), and see if an administrator at the NH or even a doctor or higher-level nurse (e.g., RN) would have some advice for you. Most of these people have seen it all. Just be up front and honest with them. Don't just ask them in the hallway, ask them if you could speak with them in private for just a few minutes for their advice.

Simply move forward with coming up with a solution. You do not want to be at your mom's death bed and having to deal with this. Don't be afraid. Simply get the facts and take action. I know of a friend with a similar situation who put together a GoFundMe page. If things get desperate for you, you can even try that. If you go that way, private message me on here, and I will donate some.

Just believe that you can take care of this. I know you can. Believe in yourself! Everything will be fine.

Just a quick response to worriedinCali. My Mom had made all her arrangements prior to ever being in the position of needing Medicaid. I was just told by her caseworker that we would need to have all those arrangements made and paid for prior to her being eligible and was very happy to know that it had already been arranged. The reason she gave is because the state (NY) doesn't want to be stuck with the costs of a funeral. I really don't know how they "make" someone accomplish this if at the time of applying they haven't already done so and don't have the funds to cover it. They ignore the amount of money put into the burial trust and don't count it toward assets. Back years ago when my aunt died they buried her in Potters Field in an unmarked grave and the state did cover the cost.

Social services will take care if cremation. Just have the nursing home call a local funeral home. If the first one says no call the next. I'm sorry for your loss.

Hangingon: What had mom specified that she wanted when she was of lucid mind? Certainly she must have told you her wishes, right?

One thing you may not know, if mom would go to hospital with serious illness, hospital keep NH aprised of her condition, if chance for it to be fatal, NH will start discharge procedures.

Do what I did because I was in the same boat. Start the process right now and do a whole body donation and call the company, I did this the day my mother was dying and it took away my attention from her, it’s just much better to have this done and ready ahead of time. I ensured mine was a good company, I live in Florida so I looked at the website of the Anatomical Board of the State of Florida who governs whole body donations, but I used them to pick my source going on their website. I am using Science Care for me when I die, which will be a while, I am 54, but for my mother I used Medcure. You pay absolutely nothing. It’s about a 30 minute phone call because they get background information on your mother’s health and what kind of work she did for a living etc. - - those kinds of questions. You also want to use Hospice, as in the last days they will make your mother very comfortable with Morphine. In a nursing home, Hospice can come in there, I don’t know how often they will administer morphine, but in the dying stages, morphine is the ONLY thing that will keep her comfortable. I’ve read many many things and did alot of research when my mother was dying and what the whole dying process - what happens. Taking your mother to a good hospice place is the best place, here in Florida I used Avow, it’s a beautiful atmosphere, they play soothing music, they take care of them better than at the nursing home. But don’t let her die in the nursing home. Medicare pays hospice 100% as long as she continues to go downhill. If you do the whole body donation, everything is handled for you, as hospice will call Science Care or Medcur when your mother dies, a funeral home immediately comes to get the body and everything is handled from there, being that Science Care will come get the body from the funeral home - you do not go with to the funeral home when your mother dies, at least I don’t think so, my mother died 11pm. Whole body donation will cremate your mother for free and send her back home to you in an urn, or they will put her in a ossuary or disperse her at sea or a reasonable facsimile thereof - whatever choice you pick. You will get 1 free death certificate. She will be eligible for this program if she has no contagious diseases such as the top 5 I believe it was. But for someone with little income and my mother already signed off on this anyway 6 months before, this was an ideal choice as I always wanted to do this when I died as well. But start this process now. Can she sign her signature? If she can I can give you a form for her to sign, I don’t think it is needed actually, but I liked it because my mother actually signed off and was in agreement with all this. But with my situation being my mother’s friends are all dead anyway and to ship my mother back to her family in Canada was just too much money and I could not afford a funeral anyway, I am very pleased with what I did. My boss actually said he is going to do this as well - he didn’t know about whole body donation. Science Care’s # 1-800-417-3747. Everyone on here is saying it takes 2 yrs to get the body back, this is strange because it says on my forms it takes 6-12 weeks and a phone call to them confirmed this, maybe Florida is different? I called and right now my mother is being cremated and getting her ready to send to me. She died 3/2/19. https://anatbd.acb.med.ufl.edu/tribute/

Usually part of the Medicaid application process requires that all arrangements are made and prepaid for prior to Medicaid eligibility. At least with my mother that is how it is and was for any other friends or family that qualified for Medicaid. In my mother's case she went to the funeral home of her choice at the time of my father's death and made all of her funeral arrangements even choosing her own casket and paid for it all with money from Dad's life insurance. So when the time comes all I need to do is call or have the nursing home call the funeral home to come get her. Only arrangement left is putting the date on her head stone. Possibly all this has been prearranged prior to her receiving Medicaid and you just need to find out from them what and who the arrangements are with. My Moms is in an irrevocable trust with the funeral home so any interest earned on the prepaid funds are used to cover the increased costs that have occurred since the arrangements were made. Some of the things she arranged and paid for I wouldn't have had but it is her choice.

It may be different when the funeral home knows you don’t have money but take someone with you with a clear head and basically uninvolved to make arrangements and listen to what they tell as to keeping the cost down . My mother, me and my stepbrother went to make arrangements when my stepfather died. My stepbrother didn’t pay a single cent toward it yet kept adding things that upped the bill( he also added , without permission and against her wishes, double the people to the dinner afterwards and again , gave her the bill🙄🙄🙄) . My mother agreed to everything the director said would be “nice”. But every little thing costs $$$$$. Ie he was a Vet and that cost more to have some things due to that . Things we assumed were government paid but nope.

When my brother died in the ‘end of life’ hospice facility they requested that we provide the funeral home’s name so they could notify them to pick up his body immediately after his death.

I'm kinda surprised at all the people who have had to scramble to figure this out after the fact, naming the funeral home we preferred was part of the nursing home's admissions paperwork. I'll admit don't know how it is handled in AL, in my experience people living there would be less physically compromised and death often takes place off site in a hospital.

Go ahead and make some calls to get the cost of cremation. Some places are quite inexpensive and may let you start making small payments toward the cost. They may be able to refer you to financial assistance based on income. Also call your county courthouse and ask for a phone number for indigent burial information. Counties usually have funds to bury/cremate remains of those with no income. It will be beneficial to talk to them. If they can help, you would have contact information in advance.

When the time comes, the NH would assist you in making whatever calls are needed as far as pronouncing death (they have procedures in place for that) and you could give them name/number of crematory to make that call, too.

some may have issues with this, I know I would. But a friend of mine, although still middle aged, has arranged for he and his wife to be picked up by the medical school at a nearby university. Therefore not costs related to the body itself. Still may want a memorial service of some kind.

PS In response to another post, I will add that, yes, some people have donated their bodies. I have an Aunt & Uncle who did this. It was to the UT Medical school at Memphis around 25 - 30 yrs ago. Then my cousin had a memorial service at a local church soon after. My Mom had actually looked into this as an option for herself, but never followed through with filling out the paperwork and approving it, so it wasn't an option for us. I think the deceased has to approve it before passing.

If you could raise enough money to afford cremation prior to her passing, you would call the funeral home that would be doing the cremation to pick up the body. I think maybe some funeral homes may arrange payment plans or allow you to put it on a charge card. We had arranged part of my Mom's funeral prior to her passing and put down a deposit. When she passed (in Nursing Home Hospice), my sister was with her and she called the funeral home to come pick up the body. They started funeral proceedings and billed us the balance later. They should be able to arrange some sort of payment plan for you.

You have gotten some really good advive here. But I may offer one more tid-bit. You can call your local Funeral homes and ask them if they offer assistance for low income on cremations. In my city, we have a Funeral Home who will bury kids for free and they started another Funeral Home in 2004 for people of low income. For example, if you use their main Funeral Home for cremation it can cost $3000.00 to $4000.00, but if you use their smaller company for cremation it is only $1200.00 this included removement of the body. I know this because I have use them. You would be surprise on how some Funeral Homes have programs to help low income families.

Ask the nursing director - they have a process that they do & have been through this many times before - the funeral home will come during the night or at meal times so that other residents don't see & become distressed - the staff are your best source of info but talk to senior staff as they know more of the paperwork that you might have to sign -

I just went through this 2 months ago when Mom died at her apartment in assisted living. I'm sure that different states or counties have different requirements but here is my experience....
I knew Mom was dying and we have a doctor who makes house calls....yes they do exist. He went to see her and with the facility medical director, Mom's best friend, and me all present he examined her and asked her how far we wanted to take her care. (She had a DNR, living will and medical POA naming me as her POA). She clearly told him she wanted no invasive treatment, just keep her comfortable and free of pain. Then outside of the apartment, and away from her hearing, the doctor explained the process. He felt she would not last more than 2-3 weeks. The ALF nurse will call the coroner and funeral director of my choice. Because Mom was under a physician's care the coroner would not order an autopsy but had to be notified to release the body to the funeral director. Her physician would sign the death certificate which the funeral director would order for me as many copies as I wished. (It is cheaper to get them upfront rather than run out and have to order more.) Mom passed away around midnight and the ALF nurse called me to let me know and offered that if I wished to come see Mom, I could. She called the funeral home and they got an immediate release from the coroner so they picked up the body at about 2:00AM. I was getting ready to call the funeral director that morning but he called me before I could dial him. We met with him that afternoon to make arrangements. In Illinois, the funeral home notifies Social Security of the death so I didn't have to do that. I did need to meet with her bank as I was beneficiary of her IRA, and I was co-owner of her checking account. I notified her pension company and had to leave her checking account open so they could retrieve any pre-paid benefits deposited after she died. We did have money to pay her funeral bill but some states have a fund for indigent decedents that will pay for cremation. I also notified doctors and dentists with whom she had appointments scheduled.  I had already notified her priest that she was nearing the end so he was prepared when I called him.
I have to say the hardest part of the process for me was deciding who to ask to be pall bearers. She was 93 so many of the people she would have chosen had pre-deceased her. And once I made the decision who to ask, finding their phone numbers was a bit of a difficulty.

If her death is expected, she would probably qualify for Hospice, which is a Medicare benefit and can be given to people who live in nursing homes and/or are also on Medicaid. If she's on Hospice, the hospice social worker can do a lot to assist you in figuring this out.

Or if not, definitely the nursing home's social worker, who has dealt with this question a few hundred times before.

Donating a body to science can be the lowest-cost option. In a city location, transport can be free or very low-cost, and the receiving organization takes care of the rest. In most cases you can have the ashes returned to you later if you like -- probably in 1-2 years. A side benefit is that most medical schools hold an annual Memorial Service for their cadavers, which can be quite beautiful. Relatives are invited.

You can arrange this with a specific local medical school or other research organization in advance, by filling out their paperwork and giving a copy to the NH. There are also organizations that will do all of that for you with a simple form that she can sign while alive, in which case all you have to do is tell the NH that when she dies they are to call that number.

Direct cremation can also be very low-cost.

Many hospitals and NH's want the body out of the room within 3-4 hours. Some have a chill-room morgue where the body could stay for a day or two, but many NHs do not, so having transport arranged in advance will save a lot of hassle.

In addition to the great links from Autumn50, there's also the Funeral Consumers Alliance at www.funerals.org -- a network of volunteers with lots of info on cost-saving.

Losing a parent is difficult and adding another stress is not good for you. Here is some information that should help you.
1.     Talk with the social worker at the NH as they should be able to assist/guide to resources.
2.     Call Medicaid to ask if your mother can put away any funds for final arrangements.
3.     Here’s link to site with helpful information:  https://www.needhelppayingbills.comhtml/help_with_funeral_costs.html
4.     If your mom was on SS, check with them.
5.     If the estate, closest living relative and other next of kin relatives lack the funds to pay for a funeral, the person handling the death can sign a release form at the coroner's office. The form is a declaration that you are unable to afford to bury or cremate the family member. Once signed, it releases the body to the corner to handle the remains. If your family wishes to receive the ashes, a fee may be charged for their return. 
6.     https://www.funeralwise.com/2018/01/22/how-to-pay-for-a-funeral-when-there-isnt-any-money

I believe that if you donate the body to research they cremate the remains or return them to you. It would be your choice. If you receive the remains I would imagine you would have to go through a funeral home to bury them. Ashes you can keep. Hope this helps. I am facing a similar situation. I have an appointment with a funeral home to see what pre pay will cost. I know it will be a whole lot easier on me if I know what is going to happen ahead of time. It will be bad enough to lose my brother. I am doing it for myself also.

Some universities return the body to the family when they have finished with their research, as they do here. Make sure you ask the appropriate questions.

Select a funeral home near the nursing home. The funeral director will take care of everything else when you call upon your Mom’s passing. The nursing home might also be able to direct you in what to do. Cremation is probably the cheapest way. Since you will have to pay something (unless your Mom is a charity case), you should probably go with cremation. So many are choosing that today, in spite of ability to pay.

My mom is in a nursing home in Canada. The nurse asked us if we had any arrangements made when mom first went in at the same time she asked if we had a DNR signed. I've made arrangements for a funeral home to pick up and cremate her. I needed to make plans for my own peace of mind knowing I would not make the best decisions after 'the call'.
We're using a simple cremation as we want to take the ashes to England.

My husband and I got divorced about a year before my MIL passed away. He died just 5 1/2 months after our divorce. Her daughter had my calls blocked so the only way I had to contact her was via e-mail. The nursing home called me because they needed to know what to do with my MIL. I explained the situation to them. They tried to call the daughter and because it was long distance she wouldn't take their calls either. So I had to e-mail her to tell her that her mom was dead. I felt it was a horrible way to have to tell someone their loved one had died. But had no choice. She called the nursing home and took care of it from there. The weird thing was, she said she couldn't take any long distance calls because she might have to pay for them. She wasn't the brightest bulb in the pack if you know what I mean. Sometimes I wish I had just had my mil put in the space we had for her in Florida and not even bothering to tell her daughter. I was doing everything else for her mother (gladly as I did love the woman) so probably could have gotten away with it. But I know I did the right thing by figuring out how to contact her daughter. But back to your question, first step is talk to the nursing home. They will walk you through what you need to do.

I am terribly sorry to hear of your loss. It is a VERY stressful time for you and your family. My condolences.

I am wondering if I am missing some info from your post. When a resident died in a nursing home, it is the duty of the nursing home to advise you what your options are. You should not be left high and dry with no help. I agree with many posters on here that you should start with the NH’s social worker.

Again, my condolences for your loss.

Have you considered donating her body for science? Contact any major university that is close to you and ask if they have this type of program. Once they are done with the body, they pay for cremation and return the cremated remains to the family. All of this is done at no cost.

I would speak to the nursing home's social worker. I think there may be a small allowance from Medicaid or Medicare for funeral expenses depending on the state you are in. The social worker should be able to guide you in this, which funeral home to use, and how this process will work. Is your mom on hospice? The hospice staff may also know something about how the process will work. I wish you well.

Go talk to the NH's social worker. They'll help you.

Hi Hangingon

It is good you're asking this through a trying time. What will probably happen if you don't have a funeral home set up, the NH would call the county coroner to have her removed, since they probably don't have the means to keep the body from starting to decompose. You would then be dealing with them. Your mom could stay at the office until further arrangements could be made. Contact the city your where mom lives as well. They may have a contract a funeral home where the funeral home picks up the body, cremated it, and you're given the ashes in a box, at no cost to you (taxpayers pay the tab).