Who do I call here in California if my dad dies at home not under hospice care?

I don't know about California but here it would be investigated by police as an unexplained death in the home, avoiding that is one of the benefits of being enrolled in Hospice. Is there a reason your father isn't with a Hospice provider? You don't have to accept their full services, just having the paperwork and a nurse on call if needed would be valuable for you.

While not in California (Maryland), my mom's doctor said you don't have to call 911. Call the family doctor - making sure he has a copy of the DNR and MOLST form in chart - and then you can just call the funeral home. Ask the family doctor what to do in that case, as I'm sure all states are different.

When my mom was seriously ill before she went in to hospice, I asked her doctor what to do if she died at home and was told to call 911. Once you explain the situation to the dispatch operator they will decide which first responders to send and the police if needed. Since your dad does have a DNR make sure you have that ready to show the emergency team or they are obligated to begin life saving treatment (at the ER as well).

I'm in PA so maybe CA is different; now is a good time for you to call your dad's doctor and ask them exactly what you should do.

I would get him set up with hospice. He can have his wish of being home and dying in bed. They don't force you into a facility.

If you die in my state, not under hospice or a physician's care, it is an unattended death and there is an investigation. That can be simple, but they are always looking to determine if foul play was involved, so it could be unpleasant to go through at the same time as losing your dad.

Hospice will keep him comfortable and pain free, they can help bathe him, change his bedding and it is a phone call when he passes.

You need to be considered in this situation as well, hopefully you can convince him that you need him to be on hospice.

I am in California and you have to call 911 if he is not on hospice. They will send the police, fire dept and ambulance. You cannot call the family doctor and then the morgue. So I would suggest putting him on hospice that way if he gets his wish, all you have to do is call hospice and once the nurse comes out to pronounce the death, you can have the mortuary come out.

My father died in his bed in California while not on hospice, and everything happened exactly as Cali says. Police, fire dept., and ambulance all came; ambulance whisked my dad off to the closest ER; and my mom had to answer the questions from the police. My dad was pronounced at the hospital. Had my dad been on hospice, the whole experience would have been less traumatic for my mom.

I had a coworker whose mother had advanced alzheimer's and was living at home with her husband. She had a catastrophic stroke or heart attack and "died" at home, but because nothing was in place EMS revived her on the way to the hospital and she lingered another couple of weeks. That spurred me to make sure I had all the documents in place, with mom's DNR prominently displayed on the fridge door.

Ricky, they don't provide medical services per see, they offer support and oversight of the decline. So you can be assured that he will not get any pain meds daily, but you will have them in the refrigerator for the time he may need them.

He could be eligible for hospice or not, Medicare covers this service 100%. So he would not have any fees.

Can I recommend interviewing several hospice providers and find one that fits your needs and has a business model that you like, they are not all created equal. If you hire one and you decide that they are not a good fit, you can fire them and bring a different one in.

They helped all of us when my 52 year old sister was dying of cancer and refused any treatment. They helped us understand what was going on, what would most likely happen next and they treated her painful bedsores so she didn't suffer from those. She couldn't move because her back was broken from the cancer eating her spine away. I have been told that they are a sign of impending death and that they are painful when untreated.

I hope you find the perfect solution to your situation.

Ricky, I think you said several times that you don't see the advantage of having hospice on board, but the big advantage is that there won't be any investigation of his death at home if he's a patient on hospice, even if hospice is only providing palliative (comfort, not treatment) care services.

It was great for mthr to have hospice to call first when she fell instead of rushing to the ER to see if she had a brain bleed. If we made the decision to keep her home on our own, and she had the brain bleed and died in her bed, then there would have been an examination, head trauma would have been noticed, an autopsy performed, and then an investigation into why she was not taken in (negligence on caregivers) or was there elder abuse (active abuse). Neither of those are what you want to face when you are grieving a loved one and want to get everything tied up.

Hospices can provide palliative care as well which has a cost - it is my understanding that Medicare covers hospice 100% but not palliative care. With hospice someone has to be at home with the patient at all times, but with palliative care, the rule differ.

Ricky something else to think about. Does your city or county have crime watch or neighborhood watch Facebook groups? Or Facebook pages run by people who post police, fire and ambulance scanner traffic? Consider this......social media has turned us in to nosy neighbors. People see an ambulance at the neighbors house and go to their local Facebook group or page to find out what is going on. I personally find it intrusive. If I or my family member has a medical emergency, it is nobody’s business what happened. So consider this......should your dad pass at home without being on hospice, you will have the police, fire dept and paramedics at your house. Do you want the neighborhood or nosy passerby’s who want to know what happened, posting a picture of all the action on Facebook? Because that happens where I live frequently. And I personally would not be happy if that happened to me or my family. Would you want to open Facebook and see that reminder?

If your dad goes on hospice, which would be palliative care at this point, no one will know if and when he passes. The mortuary isn’t going to roll up to the house with a hearse. When my MIL passed, they came in a minivan that was backed in to the garage. Totally discreet and dignified.

For lack of a better analogy, my dad is like an elderly pet, requires assistance with some aspects of daily living, (meals, some mobility) takes a couple of maintenance meds (thyroid, heart), but still enjoys life. He doesn't need oxygen, or a hospital bed, help with toileting, special diet, etc.
I don't understand what service Hospice would provide, other than being on-call for pronouncing his death.
Please enlighten me.

I thought you had to qualify for hospice by having a 6 month-or-less life expectancy. It doesn't sound like Ricky's dad fits that requirement.

Before going on hospice, know what that means. People are saying he should go on hospice just to avoid a police investigation. While that's preferable, he would also be giving up any curative treatments. Hospice is all about making dying as painless as possible. Not curing any illness. So what is your dad's health? Is he actively getting any curative treatments?

Ricky, since you apparently have already contacted a cremation service for your mother, are you using the same one for your father?  If not, have you identified a funeral home?

They could probably offer suggestions on how best to approach the situation, since they're familiar with your particular area.  

None of my family died at home, so I have no recent experience in this aspect of caregiving.

This is a sad situation, having lost your mother so recently, and now facing your father's apparent imminently close passing as well.  

I respect your attempt to honor his wishes; my father also planned to die at home, but his last illness was too intense for home care.    I was fortunate to find a compassionate multi-level facility where he spent his last days, warm, cared for well beyond any level I could handle, even with the nominal assistance of hospice. 

I still regret that I couldn't honor that last wish but I know in my heart that he couldn't possibly have gotten the care he got with a group of people trained to provide various levels of care.   Had I kept him at home, I know that I would still be battling recriminations for not providing the level of care I thought best for him.

Still, this is his wish, and you're considerate to try to honor it.

Medicare hospice status is meant to help elders for whom no further "active" treatment of their illness is wanted. For instance, if the elder has congestive heart failure, no further active interventions will be done, such as trials of different medications, possible surgery, etc. If a cancer patient who wishes no further interventions like chemo, radiation, surgery, hospice will provide comfort measures like pain management.

Medicare hospice status is granted after his MD determines that he likely has 6 months or less to live. That is a medical determination, not something a caregiver "decides." And hospice status can be renewed again and again.

When on Medicare hospice status, all medical support, including help with ADLs if needed, are 100% paid by Medicare. You and your dad will receive no bills. The hospice service determines what services the patient needs and then provides them. The service is seamless and very worthwhile (based on two cases in my immediate family.)

It's up to you and your dad to bring up hospice with his MD. That MD can explain what it means in his case. It sounds like, if your dad is "declining fast," hospice may be helpful to furnish some services, including nurse visits to the home, and they handle notification of the correct persons when a death occurs. For all these reasons, talk to the primary care MD about the advantages and disadvantages (seems like none in this case,) of Medicare hospice status.

When my dad died at home, the funeral home was called. They came and removed his body in a very quiet and dignified way. He was under Hospice Care. No lights and sirens--all done professionally and w/o drama.

My grandma died at home, alone, NOT on Hospice and when my uncle found her, he simply called her dr. He came out, pronounced her gone and called the mortuary. She had recently had hip surgery and was not doing well.

We've had deaths in our neighborhood and having the whole fire dept along with the police come--it's awful. Kind of terrifying for little kids who witness all this...Hospice does things so gently IMHO, just having them on board, even if they are NOT providing day to day care, would be a boon to you. Takes away that possible drama.


Dad's hospice team was catered to HIS needs, toward the end they did provide a lot of support, Your dad could easily go from not needing much help to being very needy in a few days. I'd look in to it, just checking it out cannot hurt.

We called sc creamator cost way less than to call a mortuary

My mom was on hospice for 2 years and I used them as a home clinic. They were useful continuing mom's regular home meds and I got labs done. I took her to the Emergency Room a lot which is your right while on hospice. When mom forgot how to eat and drink I revoked her hospice, took her to the hospital, they put a permanent feeding tube in her, then I restored her hospice on discharge. No problem! She was very comfortable after the feeding tube was put in and she lasted a long time with it. Ironcially she died of liver cancer and liver failure, and not Alzheimer's. But she died at home and she was really comfortable. yes old age and Alzheimer's disease is incurable--BUT I still continued to treat mom for dehydration, UTIs, and her regular meds under hospice!

You have total control on the treatment plan while on hospice. I just could not take mom to the doctor anymore so this is how I dealt with this, even though old age and Alzheimer's are terminal conditions.

In California you can call 911, if he’s non responsive, they’ll ask you all that (and about a DNR) if he’s full DNR they will send a sheriff to deem him “passed of natural causes or illness” normally the coroner comes next to take him and you’ll be able to ask the coroner where he’s going and what the protocol is, assumably a morgue. Then any arrangements made or needing made will be with a funeral home if you’d like a service. But if I’m not mistaken the morgue handles cremation or holds him till funeral arrangements are made. We have a company called Neptune Society so when that happens they handle every detail that he’s established and I handle real property/assets only. I make 1 call and they carry out his preset decisions then send me 2 death certificates. It’s a burial insurance costing approx 4 grand with a rider policy for any dependents also covered till they’re 26 (god forbid) but it’s there.
I hope he remains not in pain, but hospice handles much more than pain meds so I would implement that to assist you and him... in my opinion.

When my mom was living with me I thought about this situation constantly, Ricky.

I can see how this is weighing heavily on your mind. I called up Council on Aging in my area to ask this very question. They informed me to call 911 and explain that my mother had died. They take care of it from there.

Many years my grandma died while visiting at my parent’s home. Her heart just gave out. Daddy called grandma’s doctor. An ambulance came and took her body to the morgue. Arrangements were then made for grandma’s wake, funeral Mass and burial.

Just call 911 & tell them you need to report a natural death of a family member. In most rural areas, the sheriff's dept. is also he coroner. The 911 dispatch operater will send a couple of deputies to confirm death. They may or may not send firefighter / emt.
When my father-in-law passed, only a deputy came out & then the funeral home was contacted ( it was the middle of the night) & they sent a couple of people to get the body. When my good friend passed, dispatch sent the EMTs ( in our area the firefighters are trained EMTs) & 2 deputies. One of the deputies called the morgue to come for her body.
In one of the larger cities I imagine it is still handled pretty much the same.

Call his doctor. Call your funeral director if you have chosen one. Call the police. If you explain that he has died they won't send all the bells and whistles.

we had a friend die at home. We called 911. the ambulance came and then the coroner. They coroner pronounced her dead. Then the funeral home picked up her body.

Call 911. They can declare deaths and fill out certificates. They will probably take him to a hospital for storage until funeral services can arrive.

My gram died in the car on her way to a doctor's appointment. My mom drove her to her doctor. The doctor said, "Yes, she passed." Mom had to take Gram to a hospital to get a death certificate completed and store the body until the funeral service could arrive.

I would start hospice immediately! I recently started it with my 86 y/o father. They have been wonderful! They drop his meds off at the door, a nurse comes once a week to check on him, and they are available 24/7. When he passes, I call them, and they handle it. No sirens or firetrucks. My cousin went through this with his older sister, and she said the one thing she would have done differently, was to start Hospice sooner!

911, in any state

Put him on hospice. Services can be minimal if pain management not needed

As long as doctor will initiate and hospice agrees he has the "need", it can be started. My understanding is that you can take or leave any care they offer, but still remain on it. They offer a lot of services, including any medications needed for current conditions (I think they'd also cover simple medical things like flu shots, antibiotics, medical equipment that might make him more comfortable, etc if needed, but if he developed another serious condition, they won't treat that - if treatment is desired, you have to contact them first and get him off hospice, then go for the ER/treatment. Cetude mentioned doing this for her mother. Then once he is stabilized, he can go back on hospice at home. Medicare does cover this.)

Given what everyone has said about avoiding the hoopla involved with an at home death, I would definitely look into it and sign up if possible! My mother is in a MC facility. Don't know what they do, but it won't impact me (no fire, emt, police, ambulance at my house!)

Call 911 if he's not on hospice and go from there. Even if he already died. EMS deals with dead people in their homes all the time.

I live in CA. Been through a LO passing at home. Call 911. Tell them he has passed away at home. They send paramedics and police. Either will pronounce the death. Then call mortuary. Police will stay outside until mortuary arrives. Let your father's doctors office know he passed. A doctor has to sign the death certificate.