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After death care in the hospital, home, and hospice – cooling the deceased

Author: Simon Rothwell LL.B (Hons) MBA, Director of Flexmort
12 December 2013
  • Flexmorts CoverCool system
    Covercool can be used to turn any bed into a refrigerated bed and allows bodies to be cooled whilst in bed thereby preserving their appearance, condition and dignity
  • Flexmorts CuddleCot product
    The CuddleCot cooling pad is placed in any moses basket, crib, pram or bed; it is connected by a specially insulated hose and is quietly cooled using the CuddleCot cooling unit

In this advertorial, Simon Rothwell address the issue of after death care in hospices and hospitals, and introduces his company, Flexmort, which specialises in cooling systems that simplify the cooling of the deceased. Flexmort’s products are used in over 80% of hospitals in the UK, and are becoming increasingly used in hospices; already 12 children’s hospices and 15 adult hospices.

Introduction

All hospices have to deal with the difficult aspect of patient death. This is not only a difficult time for relatives, but also hospice staff. A question that is often asked is whether the deceased patient needs to be cooled? 2011 NHS/hospice guidance for staff responsible for care after death states the body of a deceased person needs to be cooled ideally within four hours. Historically this has only been possible through mortuary refrigerators or cold rooms, but the new guidance recognises the use of cold beds and blankets as an effective alternative.

So what are these new cold bed systems and how can they help? Flexmort are behind these innovative cooling products which overcome previous technological hurdles and now provide an alternative and simpler method of cooling.

Flexmort’s new technology - the history

In 2010, Flexmort was formed through a University of Warwick Science Park programme to initially address the problem of cooling bariatric deceased in NHS hospitals. The problem was that within NHS hospitals, patients were more frequently reaching 40-70 stone (250kg to 445kg) and they presented considerable manual handling problems when they died. Deceased patients could not be easily moved from the bed and were also too large to fit into mortuary refrigerators. Flexmort’s innovation was the development of the CoverCool system, which effectively cooled the deceased patient whilst they were still on a hospital bed.

View the video of Simon introducing Flexmort at the UK National Funeral Exhibition 2013.

Together For Short Lives (the leading charity for UK children’s palliative care) saw this CoverCool technology at a UK Funeral show and highlighted an opportunity for using the technology to cool deceased children (and also adults) within hospice beds or at home. At around the same time, SANDS saw the benefits of a very small system for cooling deceased babies. As a result, in 2011 Flexmort developed the CoverCool Mini system and CuddleCot.

These innovative products have made cooling of the deceased in hospices or in the home simple, and bereavement professionals have found they assist relatives in the bereavement process. But before we explore these new systems, let’s address the question of whether the deceased really need to be cooled in hospices?

Next - we look at the issue of cooling, and focus on how CoverCool works...

Should the deceased be cooled?

NHS /hospice guidance on dealing with the deceased states:“The personal care after death needs to be carried out within two to four hours of the person dying, to preserve their appearance, condition and dignity. It is important to note that the body’s core temperature will take time to lower and therefore refrigeration within four hours of the death is optimum…

“Many hospices have cold rooms that offer the family the opportunity to view the body beyond the time possible in other environments. In this facility, the room temperature needs to be kept below twelve degrees centigrade and preferably between four to eight degrees centigrade. This may not be tolerable for relatives who wish to be in the room for extended periods and there are now cold beds and blankets that can offer effective cooling systems.”(1)

However, although virtually all children’s hospices and most adult hospices undertake cooling, some adult hospices have no cooling facilities and leave cooling to the funeral director. The problem is that the deterioration of the deceased begins quickly post death but is not immediately visible (as starts in the gut). It is for this reason that the guidance states the deceased should be cooled within four hours. If cooling is not undertaken within the four hours, the result can be that families are unable to view their loved ones due to the deterioration of the deceased.

Traditional cooling

There are a couple of traditional methods for cooling the deceased; traditional mortuary refrigerators or the use of cold rooms. However, there are advantages and disadvantages to all cooling systems for hospices. A chilled room is very different to a cold room as the temperature is considerably lower in a cold room. For these rooms, the room must be properly insulated to prevent the cooling equipment from breaking down due to overwork, and also damp can occur within the walls. 

There are also a variety of other hospice considerations:

  • Operational Issues - Traditional cooling systems are fixed and require the deceased to be moved to the refrigerated area. This raises some manual handling issues as moving the deceased from the bed can be difficult.
  • Costs - Cooling a large volume of air requires a great deal of power continuously and repairs to air conditioning systems can be expensive.
  • Staff Considerations - Hospice staff (unlike funeral directors and hospital mortuaries) have formed a relationship with the patient. Therefore, placing a deceased patient into a cold mortuary refrigerator can be difficult for some staff.
  • Family Considerations - The family members of the deceased often prefer to view their loved one in the familiar, cosy, hospice environment rather than at the funeral directors. Furthermore, some families wish to stay with their loved ones for many hours, and grieving in a cold/chilled room is known to be unpleasant.

Together for Short Lives approached Flexmort as it believed the technology could address the above problems and make hospice cooling of the deceased much easier, with increased dignity for the patient. Therefore, as a result, Flexmort developed the systems further for use in hospices.

How CoverCool works

The CoverCool Mini system comprises a lightweight, portable machine which cools and circulates extremely cold fluid to a pad; this pad is placed directly onto the deceased and a cover placed over the top. The CoverCool CuddleCot is a smaller version of the same system for cooling deceased babies. These systems allow the deceased to be cooled in any room, quickly and easy. Furthermore, it makes it much more bearable for relatives who can stay with the deceased whilst the body is being cooled. Due to the benefits, these systems are now in use within numerous children’s and adult hospices as well as over 80% of UK hospitals.

Flexmort can provide impartial advice on cooling the deceased and can advise on which types of systems would be best suited to the hospice and some comments from hospices using the system can be found at www.flexmort.com

References

(1.) National End of Life Care Programme and National Nurse Consultant Group (Palliative Care). Guidance for staff responsible for care after death (last offices). 2011.

Next - hospice testimonials...

Hospice testimonials

"I would like to thank you and your colleagues on the fantastic service that you gave to us when we were in desperate need of a Flexmort. Nothing was too much trouble and we somehow received our Flexmort at 0715 on a cold Saturday morning at the ferry terminal, Ryde on the Isle of Wight, having only asked for it mid afternoon on the Friday, nothing short of a miracle! 

"The friendly 'can do' attitude meant so much to us and the help and advice helped us to manage the equipment easily and without complication. The Flexmort is compact and mobile and fortunately for us nurses really easy to put together! It absolutely did the job we purchased it for, was unobtrusive and allowed us to let relatives say a proper unhurried goodbye to their loved one. Great product."

Penny Turner, Lead Nurse for Clinical Quality and Practice Development, Earl Mountbatten Hospice

"We purchased a CoverCool Mini system from Flexmort which has been excellent and was chosen over the use of traditional mortuary fridges. Our other options included fridges but the CoverCool pad system is very beneficial for preserving the patient and gives the family a better post death viewing experience with increased dignity. The customer service provided by this company is second to none and I would certainly recommend them." 

Sue Carter, St Barnabas Lincolnshire Hospice

"The CuddleCot is simply fantastic and exceeded all our expectations. It preserved the body so well that the family were able to keep their daughter at home for the whole seven days before the funeral... I can see benefits for Flexmort’s cooling systems for Hospice Care at home for all families." 

Tracie Dempster, Head of Care at chYps (a UK children and young person's hospice)

"There is no doubt that the use of the system helped the parents cope with the bereavement."

Christine Forster, Service Manager at Naomi House & Jacksplace (hospices for children and young adults)

"As a hospice our core values are to deliver high quality, compassionate care to our patients through the course of their illness and end of life care. Our primary concern is always to treat our patients with dignity and respect. This commitment is just as important in our approach to the care of our patients after death.

"At Bolton hospice we feel we have enhanced our care after death by carefully cooling the patient within the hospice bedroom environment. We have found the Flexmort CoverCool systems have provided a simple and ideal means of doing this, allowing us to preserve the dignity and appearance of our patients. This has allowed families to remain with their loved one for longer periods and has improved the family bereavement experience. We feel we now have the time to complete respectful care after death and that patients can be removed to the funeral directors in a dignified way. We are confident that this system meets our needs and current guidelines for care after death." 

Leigh Vallance, CEO, Bolton Hospice

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