A Loved One Dies in a US Hospital: What Happens Now?

Updated

Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

Most people prefer to die at home, but it doesn’t always work out that way. Unless your loved one is on home hospice, a sudden accident or other illness could mean hospitalization. Even on hospice, there could be a short-term hospitalization to get your loved one’s pain under control, and they could die at the hospital even though that was not you or your loved one’s preference.  

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Your plan may have been to treat your loved one’s condition and bring them home to die, but they worsen and die in the hospital. This experience can be heartbreaking. In many cases due to the pandemic, families are not even allowed to visit someone in the hospital in some communities. You can request a video meeting or Facetime with your loved one so you can communicate, as well as ask to bring that person home.

What Do Hospitals Do When Someone Dies?

When someone dies in the hospital, many of the details are handled by hospital staff. Upon admission to the hospital, you and your loved one will fill out a Medical Order for Life-Sustaining Treatment (MOLST) or a Physician’s Order for Life-Sustaining Treatment (POLST) form. These forms dictate your loved one’s wishes while they are in the hospital.

A couple of scenarios could occur. Depending on what the order indicates, the hospital staff will have tried to resuscitate and failed, or your loved one is allowed to die without intervention based on their wishes. 

If someone had advance directives that indicated full resuscitation, that directive would be superseded by a POLST or MOLST that states otherwise at the time of admission to the hospital. The reason for having this option is that sometimes circumstances change when someone is in the hospital, and their preferences may reflect a different set of wishes.

Next of kin is notified

Unless you are at the hospital when someone dies, the next of kin is notified. The next of kin is the person identified upon admission as the primary person responsible for the family member’s care. It could be the health care power of attorney or a family member who accompanies the person to the hospital.

Once the next of kin is notified, that person makes calls to the rest of the family to inform them of the death. The emotional responsibility of contacting other family members can also be intense. Delegate this task to someone else if you need to. You can take the time later to fill people in on details regarding any funeral arrangements and other details.

Declaration of death

In a hospital setting, the doctor that cared for your loved one or the one on call will have to certify the death.

This step is necessary to get death certificates later, which are required to settle the estate. In a hospital, this process is more straightforward than if your loved one died at home. 

Decide what to do with the body

If the family has not made mortuary arrangements, the hospital may move the body to the hospital morgue. The other deciding factor about how quickly the body is moved has to do with bed availability.

Many hospitals have bed shortages as a result of COVID-19, and there might be some urgency to free up that bed. Although the family may wish to spend time with the body, this may not be possible depending on the circumstances.

Assign a social worker

The hospital will assign a social worker to the family to assist with the process following death.

A social worker can help contact the mortuary, offer grief counseling, and other guidance related to the steps to take after death. Social workers also have resources available to help with planning once everyone has left the hospital.

What Are Families or Next of Kin Responsible For After a Loved Ones Dies in a Hospital?

Even though the hospital will handle many of the details immediately following a loved one’s death, the family still has decisions to make. Many of these decisions may have been made prior to death and are indicated in a living will or other advance directives. If those decisions were deferred, they will have to be made now. Pre-planning avoids having to make these decisions during times of stress.

Families often disagree about these responsibilities, and things can get complicated and contentious. While you may have an idea of what happens when you die, your family members may have additional questions, comments, and concerns of their own. Following a loved one’s death, family members might be very emotional, angry, or frustrated. Family conflict and disagreement are where the hospital social worker can help families try to do what is best. Reach out to the social worker to help resolve disputes if you are unable to make any headway.

Organ or body donation

Your loved one may have already decided that they were an organ donor before death, or perhaps wanted to donate their body to science. A social worker assigned by the hospital will talk with you about these options if they have not already been decided.

Organ and body donation decisions can be very emotional and disagreement among family members is common. That’s why it is best to make these wishes known as part of your pre-planning process.

Autopsy

Every state has different rules dictating when an autopsy must be performed. In general, autopsies are performed if there is a suspicion of foul play, an infectious disease concern, or unexplained death.

In a hospital setting, an autopsy is rare since the person was ill, to begin with. The family can request an autopsy if the state doesn’t require it. Sometimes people take comfort in knowing the exact cause of death. If your loved one had Alzheimer’s disease, they might have decided upon an autopsy to contribute to Alzheimer’s disease research.

Mortuary

The family or social worker can contact the Mortuary. If you have not selected one, you can just pick one and call. This scenario is more common than you may realize. Mortuaries prepare to deal with unexpected needs. Organize this information before calling:

  • Will there be an earth burial or cremation? If the family has yet to decide on this, the mortuary can still take the body and hold it until a decision is made. For an earth burial, you will need to decide on a cemetery. 
  • Will there be a funeral or graveside service? You do not need to decide about funeral arrangements right away.  It is just something to be thinking about as you move through the process. Due to COVID, more places are offering virtual funerals or memorial services. If the death was unexpected, a virtual service could be especially useful for out-of-town family members who may not be able to make last-minute arrangements. 
  • Talk with your family about an obituary
  • If there is immediate disagreement among family members about what direction to take, ask to speak with the hospital social worker who can help.

Think about your loved one’s home

Sometimes people go to the hospital quite suddenly and leave things unattended.

Once you have attended to the immediate aftermath of the death, think about your loved one’s home and what might need taking care of. Are there pets that need care? Delegate this task to another family member or friend until you can take over. Make sure the house is secure until such time you can deal with your loved one’s belongings and the house itself. 

Start planning to settle the estate

You will need to obtain certified death certificates through the mortuary or cremation service.  Not much can be accomplished without these certificates, and it is suggested that you request 10. You will need specific information for the death certificate, including their full legal name, date of birth, place of birth, father and mother’s name and birthplace, social security number, marital status, location, and cause of death (the hospital can provide this) and address. 

Death certificates aren’t issued to just anyone. Depending on the state where you live, they may only be given to immediate family or someone who can show they have a direct financial interest in the estate. You will need these certificates to contact all financial institutions, settle the will, and take care of any other obligations. 

Take care of yourself and your family

Losing someone takes an emotional toll, and grieving is a normal part of any loss. 

If you are the executor of your loved one’s estate, you will be very busy over the next few weeks. Make sure you take care of yourself and your family through this process. Rest, reach out to loved ones, and ask for help if you need it. 

Many people find it very helpful to reach out to grief counselors or their spiritual advisors during this time. Don’t hesitate to do so if you think it will help. Also, don’t forget your family. They are also bearing the brunt of this loss and your emotional response. Be mindful of their presence and needs as well.

What Happens When Someone Dies in a Hospital Without a Next of Kin?

Next of kin is a term most people may recognize as the closest living relative or relatives to the deceased. In the event of a person’s death, next of kin is also used to describe the person or people who stand to inherit the person’s estate.

Sometimes people die in the hospital, and there are no apparent next of kin available to take care of the body or make other arrangements. In some cases, sadly, people die without anyone to claim the body or take care of the property. The process from this point is dependent upon state law, but generally speaking, this is what can happen:

  • If the hospital has advance directives that indicate preferences for burial, then those are provided to the coroner’s office. 
  • If no friend or relative of the deceased can be immediately located, the body is moved to the office of the medical examiner or coroner’s office, where it is held for a specific length of time. 
  • The coroner’s office makes attempts to locate next of kin. How long this takes is up to state regulations. It is possible that a distant relative can be found, but they also have the right not to claim the body.
  • According to state laws, if no one comes forward to claim the body, the coroner's office must contact a funeral home to collect the body. If the person did not leave written burial preferences, then the body is most likely cremated.
  • Finally, if the deceased person has no assets, the county or the state pays for cremation and burial. 

In the event that the person who has died in the hospital has an estate but no will, a probate court can handle the distribution of assets. Whenever someone with an estate dies without creating a will, this situation is defined as dying “intestate.” A court-appointed administrator compiles any assets of the deceased and distributes the remaining assets to those parties deemed as beneficiaries.

State law establishes next-of-kin relationships and inheritance. The legislature of a state has authority over the distribution of property within the state. The deceased's estate becomes state property if no legal heir is identified. Depending on state law, there is a priority of next-of-kin lineage all the way down to very distant relatives. But, if authorities can find no relatives, the estate goes to the state where the person died. 

Hospitals across the country have chaplains to provide spiritual comfort to people who are dying with no next of kin. Hospital staffers know when a dying person has no immediate next of kin to alert the chaplain program to attend to the dying person. 

Frequently Asked Questions: Dying in a US Hospital

Dying in the hospital or at home can get complicated just when the family is coping with the loss of a loved one. Hospitals, of course, are very accustomed to people dying and have processes in place to guide you through the necessary legal steps. Many of these steps follow state laws and specific hospital procedures.

Do you still have to pay for care if a loved one dies in the hospital?

Someone has to pay for care if a loved one dies in the hospital. All costs associated with the care of your loved one are still due. Who pays those bills depends on the estate, an existing executor, and if the family can afford to pay. If the person who died has an estate, then the estate is responsible for paying for care, and those costs are taken out before the distribution of money to the heirs.  

Suppose the person who died was a Medicaid recipient. In that case, federal law requires your state's Medicaid program to try to recover from the deceased person’s estate all the payments they made for related hospital costs. Medicaid won't hold the survivors responsible for the hospital costs, but they will try and recover any costs from the remaining estate.

How long will a hospital keep a body after someone dies?

A hospital will not keep a body long after someone dies. After 24 hours, the body starts to decompose and would require embalming for preservation. Hospitals do have morgues to keep the body for short periods. As the next of kin of a deceased person, you have the right to bring the body home.

Most hospitals need the bed space and will encourage the calling of a funeral home to collect the body as soon as possible. If the person died of an infectious disease, there is the possibility that state law will require immediate cremation. 

What documents will you need from the hospital after your loved one dies?

The hospital can handle the creation of the documents you need after your loved one dies, but it is good to know what those are so you can ensure completion of those documents. When your loved one dies, a physician fills out paperwork for pronouncement of death. This paperwork will vary from state to state and hospital to hospital but includes the time, place, and cause of death.

These details are necessary to obtain legal death certificates required to manage all financial aspects of the estate. The physician paperwork goes to the local authority to register the death. At this point, the local authority issues death certificates to the family or executor of the estate. 

It Is Difficult (But Manageable) When Someone Dies at the Hospital

When a loved one dies in the hospital, the experience is traumatic. The death may be expected or sudden, but in either case, rely on the hospital staff to help you.

Your task is to lessen the emotional burden of the loss and deal with the details of honoring your loved one’s wishes.

If you need help tying up loose ends after a loved one's death, read our guides on how to notify the IRS of a death and how to cancel credit cards after a death.

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