GARY TINDEL

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DEATH NOTIFICATION

• GARY TINDEL
• ASSISTANT CORONER
• MARIN COUNTY
• March 19, 2008
• PA, PG, PC Spring Conference
• Sacramento, CA

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Death Notifications

• Something everyone in the office wants to do,
  right?
• When one needs to be done, the department head or
  the assistant says, Let me go out and do that
  one for you. Right?
• Usually made by the deputy, investigator or
  perhaps the supervisor.

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Can you re-do an improper notification?

• Probably about as easy as

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NOTIFY IN PERSON

• Confirm Information to be given.
• Make sure you have the correct information for
  the deceased and the family.
• Reconfirm information as it is given to you.
• Who, Where, When, Family, Address
• How it happened
• Be absolutely sure that there is positive
  identification on the victim

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• Notify in person, not over the telephone
• It is important to provide the survivor with a
  human presence or presence of compassion during
  this extremely stressful time.
• Arrange notification for the person even if the
  survivor lives far away

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• Who Do You Notify?

Section 7100 HS Code Surviving Competent
Spouse Surviving Competent Adult
Child Surviving Competent Parent Surviving
Competent Sibling
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• Who Do You Notify? (cont.)

CA Family Code 297 Defines Domestic
Partnerships and who/what qualifies CA
Family Code 297.5 Registered DPs shall have
the same rights, protections and benefits
as granted to and imposed on spouses
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Clip from Dr. IsersonImproper Notifications
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Clip from Dr. IsersonWhat to Do
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Clip from Dr. IsersonProper Procedure
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• Plan the Notification
• Before the team arrives, decide who
• will speak, what will be said and how
• much will be said

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Other Items to Consider in Planning

• Cultural Diversity Issues
• Language Barriers
• Religious Rituals and Beliefs

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Cultures, Languages Religions

• How many different types of each are in the world
  today?
• How many are there in the United States?
• How many are there in California?
• How many are there in your County?

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A Need To Worry?

• Considering the variety of cultures and customs
  in California counties today, along with the
  various types of religions, coupled with all the
  different languages, do you think this may have
  any affect on the way you prepare for a death
  notification?
• I certainly hope so!

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Rituals and Traditions

• Prior to Death
• Immediately after Death
• Prior to the Funeral
• After the Funeral

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Races of the World

• Today, California DOJ Forms
• List Races as
• White
• Black
• Oriental
• Indian

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Languages of the World

• There are about 6,703 living languages in the
  world today
• The top 10 languages in the world are
• Mandarin Chinese 885,000,000
• Spanish 332,000,000
• English 322,000,000
• Bengali 189,000,000
• Hindi 182,000,000

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World Languages (cont.)

• Portuguese 170,000,000
• Russian 170,000,000
• Japanese 125,000,000
• German 98,000,000
• Wu Chinese 77,175,000

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Languages of the World

• Perhaps a concern about utilizing an interpreter?

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Religions of the World

• Top 10 largest international religious bodies
  (with at least 30 of world membership living
  outside the core country)
• Catholic Church 1,100,000,000
• Sunni Islam 875,000,000
• Eastern Orthodox Church 225,000,000
• Anglican Communion 77,000,000
• Assemblies of God 50,000,000

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World Religions (cont.)

• Seventh Day Adventists 16,811,519
• Jehovahs Witness 15,597,746
• Church of Jesus Christ
• of Latter Day Saints 12,275,822
• New Apostolic Church 10,260,000
• Ahmadiyya 10,000,000
• Bahai World Faith 6,000,000

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Religious Belief Autopsy Law

• Government Code Section 27491.43
• No autopsy if valid certificate is produced
• within 48 hrs. Must be 18 yrs or older, must
  state the autopsy is against religious beliefs,
  must be signed and dated by person and 2
  witnesses
• Not valid for deaths at the hands of another
• Not valid for deaths from contagious diseases
  that constitute a public health hazard.

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Religious Belief Autopsy

• If Coroner challenges certificate
• Must petition Superior Court for an
  order
• authorizing the autopsy or set aside
• certificate as invalid.
• Court can set aside certificate if it finds
• Certificate does not clearly state
  religious
• objection, or
• The cause is not evident and the interest
  of the public outweighs the objection

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Religious Belief Autopsy

• If the court accepts the certificate, the body is
  released to the person authorized to control its
  disposition. The coroner does not list a cause of
  death and states reason why by listing 27491.43
  GC
• If the court denies the petition, the coroner
  proceeds with the autopsy

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Jewish Beliefs

• Two principles govern the Jewish approach to
  death and mourning
• Kavod Ha-Met (Honoring the Dead). Must treat the
  body with respect and care from the time of death
  until burial
• Death is a Natural Process. It is a natural part
  of the life cycle and the body is returned to the
  earth whence it came. Decomposition follows,
  facilitating its return from ashes to ashes,
  dust to dust.

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Muslim Beliefs

• Followers of Islam.
• Death is not final, but a temporary separation
  from the beloved person, who will be brought back
  to life on the Day of Judgement and, if God
  wills, be reunited with his/her family once
  more.
• Muslims bury their dead. Cremation is not
  permitted.

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Muslim Beliefs

• Prefer to bury their dead quickly, traditionally
  within 24 hours.
• The body is ceremonially washed before burial and
  this is sometimes done at the graveside.
• Many new Mosques have a special section for this,
  although it requires special permission from
  local authority.
• It is not traditional to have a coffin.
• There must be only one body in the grave

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Muslim Beliefs

• Muslims request that cemeteries provide separate
  burial facilities for non-Christians.
• The grave needs to prepared in a particular way
  so that it is aligned towards Mecca, ie on a N/E
  to S/W axis.
• The body should be placed in the grave so that
  the head is at the S/W end, facing towards Mecca.
• The finished grave must be raised from the ground
  four to twelve inches, to prevent anyone from
  walking or sitting on it, which is strictly
  forbidden.

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Religions of India

• Buddhism
• Hinduism
• Islam
• Sikhism
• Christianity
• Judaism

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Hinduism

• Sudden death, accidents and murders, dont allow
  time for the person to prepare and full funeral
  rites are not performed
• Hindus traditionally cremate their dead

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Hinduism (cont.)

• At the moment of death
• cloth is tied under the chin and around the head
• thumbs are tied together as are the big toes
• Preparing the body
• Sesame oil is poured over the head
• The body is washed with water
• Puffed rice is placed in the mouth to nourish the
  deceased for the journey ahead
• Embalming and organ donation are not allowed

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Sikhism

• Sikh Temple- place of worship community
  centre-used for worship, celebrations of birth,
  weddings and funerals
• At death, body is washed in yogurt water
• Dressed in 5 Ks
• 1 Kirpan (sword)
• 2 Kara (bangle or bracelet)
• 3 Kesh (uncut hair)
• 4 Kangha (comb)
• 5 Kaccha (pair of shorts)

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Sikhism

• Men and women are treated equally. Cremation
  should occur ASAP
• Cremation- ashes- immersed in the sea or other
  body of water. Some are taken back to the
  homeland- Punjab, India
• Where cremation is not possible, the body should
  be buried at sea or in some other body of water
• Belief in Re-incarnation

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India

• Indian Punjab
• 61 Sikh
• 37 Hindu
• 1 Muslim
• 1 Christian

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Pakistani Punjab

• 97 Muslim
• 2 Christian
• Muslims- are forbidden to eat pork
• Pakistan Culture Issues
• Most elders are muslim
• Religion preference should be asked, rather than
  assumed
• Elders may not speak English, especially the
  women
• Older Pakistani women prefer to defer decision
  making to their sons or daughters

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Pakistan Culture (cont.)

• Talking about death may make it a reality
• People are reluctant to discuss death or make
  end of life care planning
• With-holding of food is forbidden- be sensitive
  to withdrawal of feeding tubes
• Elders feel that same sex persons should deal
  with care issues and with the dead body

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Hmong Culture

• Mainly from northern Laos, but also from China,
  Burma Thailand
• Those in the US came from Laos
• Language is Hmoob (Hmong in English)
• Organized in Clans
• Father is the head of the household
• Dont believe in autopsy
• Girls marry at an early age (13) and start
  families
• Youth have a tendency to be very violent

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Hmong Death

• Discuss the Hmong Deaf-Mute Parents from Merced
  County

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Mien Culture

• Originate in South-West China
• Most Mein in the US came from Laos
• Two religious beliefs Animism and Taoism and
  they sacrifice chickens and pigs
• Live in large houses with 20 or more family
  members- childbirth is mainly at home
• Men are the head of households- wives are
  property of their husbands
• Girls marry at an early age also 12-13 years old
• Youth have a tendency to be very violent

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Romani Gypsy Death Rituals

• Belief in the supernatural is fundamental
• Death is senseless, an unnatural occurrence that
  should anger those who die
• They worry about the possible revenge of the
  dead, or mulo
• They often plug the nostrils with beeswax or
  pearls to prevent evil spirits from entering the
  body

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Romani or Gypsy Rituals (cont.)

• Items are placed in the coffin that will be
  useful to the deceased during the journey
• Clothing, tools, eating utensils, jewlrey, money
• Following the burial, all material ties to the
• deceased must be destroyed, usually by burning
• Recent years, because of financial concerns,
  items are sold to non Romas

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Rituals and Traditions

• Cleansing of the body immediately after death- a
  wash down
• Rubbing the entire body with oils or other
  liquids
• Blessing the body with Holy water
• Plugging the nostrils, ears, mouth with cotton,
  fiber, etc to prevent good spirits from leaving
  the body or allowing bad spirits to enter
• Filling the mouth with various food items for the
  after-life

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Rituals and Traditions

• Is autopsy permitted?
• Organ donations permitted, yes or no?
• Embalming vs. No Embalming
• Cremation, permitted or not?
• Time allowed for viewing, 1 day to 1 wk
• Place of viewing, home or mortuary
• Preservation of body while viewing
• Time allowed until burial, 1 day to 2 wks

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Tradition at a Funeral
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• The ceremony will include trappings to
• honor death in the line of duty bagpipes, a
  21-gun salute and a horse with no rider.
• The rituals are steeped in tradition.
• The use of a rider-less horse originates
• from the days of Genghis Khan, when
• the horse was sacrificed at a warrior's
• funeral so the steed could continue to
• transport his master in the afterlife.

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Rituals and Traditions

• Cleansing of the body immediately after death- a
  wash down
• Rubbing the entire body with oils or other
  liquids
• Blessing the body with Holy water
• Plugging the nostrils, ears, mouth with cotton,
  fiber, etc to prevent good spirits from leaving
  the body or allowing bad spirits to enter
• Filling the mouth with various food items and
  money for the after-life

47
Rituals and Traditions

• Is autopsy permitted?
• Organ donations permitted, yes or no?
• Embalming vs. No Embalming
• Cremation, permitted or not?
• Time allowed for viewing, 1 day to 1 wk
• Place of viewing, home or mortuary
• Preservation of body while viewing
• Time allowed until burial, 1 day to 2 wks

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• Timely Notification
• Make notification within one hour of time of
  call
• Time of day or night doesnt matter

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Two Person notifications

• Whenever possible, two persons should make the
  notification, especially at night
• Ideally the persons would be a law enforcement
  officer, the coroner, or other civilians

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• Chaplain
• Support Services representative
• Family doctor
• Close friend that is well briefed in advance

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• The initial contact at the door
• Knock and introduce yourself
• Tell them you are representing your department
• Clearly identify yourself with your credentials
• Confirm that they are the person you need to
  talk to
• Ask to enter the home- do not make the
  notification on the doorstep

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• Get into a soft room

• Living room, family room, somewhere with soft
  chairs
• Get them in a chair where their knees are above
  their hips
• Ask the Next of Kin if there are other family
  members in the house
• Tell them that you have information they may
  want shared with others at the same time

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• Relate the message in direct words- Plain
  Language
• Begin with a caring and compassionate
  statement- this gives the survivor an important
  moment to prepare for the shock
• Speak slowly- call the victim by name, rather
  than the deceased, the victim, the body
• Do not make small talk
• Do not say that we are sorry or that we have
  bad news

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• Use the words dead and killed rather than
  fatally injured, eg. We are here to tell you
  that Phillip is dead
• Be specific but tactful at the same time
• But remember, once you use the D word, you
  are no longer in control of the situation.

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Conduct to Avoid

• Pass out news article on Burlingame Police
  Department

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When relaying the message

• Expect any type of reaction
• There are many immediate physical and emotional
  reactions that a survivor can experience after
  receiving a death notification

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Try to imagine what a person or family starts to
go through upon being told about the death of a
loved one.
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• Give only the facts
• Do not give opinions
• If you dont know the answer, dont be
  afraid to say so
• Offer to get back to the survivor when more
  information is available, and be sure to say
  you will.

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• Notify With Compassion
• Remember, your presence and compassion are the
  most important resources you bring to a death
  notification
• Listen to them with empathy, not sympathy
• Be empathetic, not sympathetic
• Sympathy requires a relationship and you
  are a stranger
• Empathy acknowledges that you know how they
  are hurting

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• Do not say, I know how you feel, because
  one person never knows how another feels
• Give no reasons for false hopes. If no other
  family members are present in the home, is there
  someone else who is local that we can call, so
  the survivor will not have to stay alone

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Notify with Compassion
Little Miss Sunshine
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• Who the next of kin is to contact
• If relaying a message from another agency,
  there should be a point of contact to be
  called, usually a family member/friend or
  other agency at the location of the
  deceased
• Give the point of contact information to the
  N.O.K.
• Ask if they would like you to stay while they
  telephone the point of contact and do so
  accordingly

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• Dont Rush Off
• Write things down- survivors have a hard
  time remembering details at this moment.
  Make a list of things to do or people to
  contact
• Help them to make telephone calls to other
  family members and friends, if they ask for
  your help
• Ask if there is a rabbi, pastor or priest you
  can contact for them

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• Leave with them resource numbers, etc., for
  support systems available to them
• Inform the survivor of any chance to view the
  deceaseds body
• Be available, or make arrangements to
  transport the survivor or representatives
  for identification of the victim if necessary
• Always leave a name and phone number with the
  survivors so they can contact you or someone
  in your department if necessary

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Interview with Dr. IsersonOverall summary of
D.N. Protocol
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• Debriefing Death Notification Volunteers and
  Professionals
• Members of the notification team should meet as
  soon as possible to debrief the situation
• Double check who is responsible for any
  follow-up tasks to help the survivors
• Share what impacted the notifiers most- what
  hit the team the hardest, what landmines did
  the notifiers experience (past deaths,
  notifications, critical incidents, etc.)

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• Be frank and honest. Share your thoughts,
  concerns, fears and feelings with each other.
  Others may be experiencing similar reactions and
  it is helpful to know that you are normal and
  not alone in your experience
• If further intervention is needed for the team,
  contact a peer trained in Critical Incident
  Stress Debriefing

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SUMMARY

• Principles of Death Notification
• In Person
• In Time
• In Pairs
• In Plain Language
• And with Compassion

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In Conclusion

• Your next death notification should be made in
  the same sensitive, informed and compassionate
  manner as you would like to have one received.

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CALIFORNIA CORONER TRAINING CENTER
IN ORANGE COUNTY PRESENTS
DEATH NOTIFICATION
August 18, 19, 20, 21 2008 8 AM to 5
PM California Coroner Training Center
1071 West Santa Ana Blvd., Santa Ana,
CA 92703
This newly designed 24-hour Death Notification
course will be presented to sworn public safety
personnel with death notification
responsibilities
Coroner, Medical Examiner, Sheriff-Coroner,
Police
This course will focus on
Body Identification  Locating
the Next of Kin Death Notifications
In-Line-of-Duty Deaths
Cultural Diversity Issues