When Death Occurs

Stay calm. Breathe. Focus on a few necessary steps. Spending a quiet moment (or hours) with the loved one who has just passed may be the most meaningful first step.
Do not call 911 unless to report a crime or to invite emergency resuscitation efforts. Contact a doctor or hospice worker or nurse who has already been helping this person and could determine (and report) the cause of death; or call the local police business number for advice. Note: If the deceased was an organ donor, time IS of the essence; notify the attending physician immediately. If the deceased had signed up for body donation to a medical school, contact that Anatomical Gift Program directly and let them organize the transportation; don’t involve another funeral home. Other early contacts might be next of kin, a faith leader, or personal lawyer.

There are only 4 basic necessities or requirements for death care:

1. Regulatory paperwork

In Massachusetts, this consists of a death certificate and a transportation and disposition permit. For basic information about what must be done in Massachusetts see Issues to consider in preparing for disposition of decedents on the Mass.gov website. Here you will find what must be done from the time a death occurs through final disposition of a body or ashes.

2. Handling and transportation of the body

A transportation and disposition permit (also known as a burial permit) is required to move a body from the place of death to the place of final disposition. This includes movement to any temporary storage or crematorium. Although typically handled by a funeral home, this may be done by the family with a valid permit.

3. Disposition of the body

Disposition may be done by burial, cremation, donation to a qualified research institution or by burial at sea. Note: During the Covid-19 pandemic, see our Tips about the two simpler or “direct” options.

For more information on all these options please see menu under the “Options/Rights” tab.

4. Paying for all of the above

There are costs associated with the regulatory paperwork. If you use a funeral home, you must pay for their services to you. There are costs for a cemetery plot, and a fee for opening & closing a plot. Cremation also involves a separate fee (which may or may not be included in a funeral home’s bill). If a coroner is involved, you may have to pay for body bags, removal (transportation) fees and per-day storage charges. You may have to pay for transportation to the research institute where the body is donated.

Make Basic Decisions

For the person handling disposition arrangements (usually the next-of-kin), there are some decisions to be made first. Check for any instructions or pre-arrangements made by the deceased.

What level of help do you need?

At one end of the spectrum, a funeral director can make most of the arrangements, in consultation with the family.
At the other end, the family can opt for home death care where they manage all the arrangements themselves. These activities include moving and transporting the body and filing all the necessary paperwork including the attending physician’s information.
In between is family-managed death care with the help of a home funeral consultant or a willing funeral director.

Choose between burial and cremation

This must be done by a person who has the right to control the disposition of the remains. In Massachusetts, that right goes first to the deceased (for decisions documented in advance), then to a spouse, then adult children, then other next-of-kin as specified by law. For more detail, see Massachusetts law about burial, cremation, and funerals). Note: Unless previous arrangements were made, whole body donation may not be available at this point.

If burial is desired, consider choosing between a green or conventional burial. A green burial is a natural burial in simple box or shroud. A conventional burial is burial with a casket plus a concrete vault. Check with the cemetery about what is allowed. Also see Green Burial Massachusetts for more information.

Choose a final resting place for the remains

If burial is selected, this may be a plot in a traditional cemetery or green cemetery. If cremation is selected, ashes or cremains may be buried in a traditional cemetery, placed in a mortuary or scattered. There are no MA laws governing the scattering of cremated remains, but there are laws respecting property rights.

These are only the very basic and immediate decisions. There will be many more. The national Funeral Consumers Alliance website has excellent information to help get you through this process.

See our page of helpful Checklists.

Optional Activities

Other than making the basic decisions, everything else is optional.

Autopsy: autopsies may be required depending on the circumstances of death and the ruling of the coroner/medical examiner. Families can also request autopsies.
Funerals, or memorial services
Graveside services
Obituaries
Hearses, corteges, pall bearers
Flowers, music
Caskets, coffins, urns for “ashes”(cremated remains). Note that coffins or burial/cremation containers may be required by the cemetery or crematory, but are not a legal requirement.
Disposition of “ashes.”

Additional Tasks

If a funeral ceremony is planned, determine a date and location. Consult with clergy, celebrant, reader, or other appropriate persons. Contact musicians, pall bearers, speakers, caterers, and others who may participate in event.
List and notify immediate family, close friends, employer, and key organizations in this person’s life (e.g., union, church, synagogue, mosque, senior center).
Notify lawyer, accountant, and personal representative or administrator of the estate. The personal representative or a next-of-kin will manage other tasks later on.
Decide whether memorial gifts are preferred in lieu of flowers. If so, get correct name and address for recipient organization(s) and include notice in the obituary/funeral notice.
Prepare newspaper notice if desired. The newspaper is likely to want full name, age, place of birth and death, occupation, degrees, memberships, military service, outstanding work, survivors in immediate family, time and place of services, if any.
List distant persons to notify and arrange for letter or printed notice.
Keep list of calls, flowers, and notes, and arrange for their acknowledgment.
Make needed household arrangements, as for child care or hospitality for visiting relatives.