Dying at home

A wife, of one of our patients, informed me that a marketing person for a Hospice company told her if she doesn’t sign up (with them), her husband’s eventual death at home would be considered an “unattended death” and that their home would be turned into a “crime scene.” She was visibly upset. I tried to reassure her. I also decided to check some references. Here’s what I could re-confirm:

A death is considered “unattended” only if/when it occurs in the absence of a doctor/patient relationship at the time of death.

The physical presence of the attending physician is NOT necessary at the time of death.

A death may be considered unattended if it occurs more than 30 days after the decedent was last treated by a physician, EXCEPT where death was medically expected and is certified as such, by the attending physician.

The medical examiner will be notified when a person dies by accident or in any suspicious or unusual circumstance.

The medical examiner is also notified when a body is to be cremated, dissected, or buried at sea. There's no exemption from this requirement, regardless of the circumstances of the death (I was a community medical examiner in Virginia from 1986-1993. I have some great stories...maybe a blog entry for another day).

To summarize: a person who dies at home, who has a doctor/patient relationship at the time of the death and who did not die by accident or suspicious/unusual circumstances will NOT have their home turned into a "crime scene."