What to Do When Someone Dies: The First Hours and Days

When someone dies, the first call depends on where and how it happened: if the death was expected and they were on hospice, call the hospice number, and if the death was unexpected or at home without hospice, call 911. Almost nothing else has to happen in the first hour — you're allowed to sit with the person, call family, and breathe before any decisions get made. What follows is the order things actually unfold, so you can handle each step as it comes instead of carrying all of it at once.

What do you do when someone dies at home?

If the death was expected and hospice was involved, call the hospice agency, not 911. A hospice nurse will come to the home, confirm the death, note the time, and contact the physician and the funeral home you've chosen. There's no rush — hospice deaths don't involve police, and the nurse will guide you through everything, including disposing of medications. You can take hours before the funeral home comes if you want time to say goodbye.

If the death was unexpected, or the person wasn't under hospice or a doctor's recent care, call 911 even though it's clearly too late for rescue. Paramedics and usually police will respond, and the death will be referred to the county coroner or medical examiner — in Missouri, Illinois, and Kansas, unattended and unexpected deaths are reviewed this way, with most counties using an elected or appointed coroner and larger jurisdictions like St. Louis and Cook County using medical examiners. The coroner decides whether an autopsy is needed and when the body can be released to a funeral home. This is routine, not an accusation, and it may briefly delay funeral arrangements.

What happens when someone dies at a hospital or care facility?

If the death happens in a hospital, nursing home, or hospice facility, the staff handles the pronouncement and the immediate logistics. They'll ask you which funeral home to call, and that's genuinely the only decision needed right away — if you don't know yet, say so, and the facility can hold the body in the interim, usually for a day or more. Ask the staff for the packet of paperwork they provide and for any belongings, and get the name of the attending physician who will certify the death certificate. Hospital deaths are only referred to the coroner or medical examiner in specific cases, like surgical deaths or suspected accidents.

Who legally pronounces a death?

A death isn't legally recognized until someone authorized pronounces it — typically a physician, a coroner or medical examiner, or in home hospice deaths, a registered nurse where state law allows. The pronouncement establishes the legal time and date of death, which flows onto the death certificate, and nothing official can proceed without it. This is why you can't simply call a funeral home first after an unexpected home death: the coroner or a physician has to be involved before the body can be moved. Once pronouncement happens, the funeral home you choose takes the person into their care.

How do you choose a funeral home?

Unless the person prearranged with a specific funeral home, you get to choose — and you're allowed to shop, even in grief, even by phone. Under the FTC Funeral Rule, every funeral home must give you prices over the telephone and hand you an itemized General Price List when you visit in person, and you have the right to buy only the goods and services you want rather than a package. Prices for the same service can vary by thousands of dollars between funeral homes in the same town, so calling two or three is not disrespectful; it's sensible.

Know two more rights before you sign anything. Embalming is rarely required by law — the FTC Funeral Rule bars funeral homes from claiming otherwise, and direct cremation or immediate burial doesn't require it. You can also buy a casket or urn elsewhere, and the funeral home must accept it without charging a handling fee. If money is tight, direct cremation is typically the least expensive option, and it doesn't prevent you from holding a memorial service later, anywhere you like.

What should you handle in the first day or two?

If the person lived alone, secure the home: lock doors and windows, take out trash and perishable food, water plants, and arrange care for any pets. Collect or forward mail so an empty house isn't advertised, move valuables and important papers somewhere safe, and make sure the car is locked and parked legally. Look for documents as you go — a will, trust papers, insurance policies, a prepaid funeral contract, and any written wishes about burial or cremation, since those wishes may change the arrangements you make. If family conflict is possible, having two people present when gathering valuables protects everyone.

Start the notifications that matter and skip the rest for now. The funeral home will usually report the death to the Social Security Administration, but confirm they did, because benefits paid for the month of death or later must be returned; a surviving spouse or eligible child can also claim Social Security's one-time $255 lump-sum death payment. Notify the person's employer if they were working, and their life insurance companies, since claims can take weeks to process. Banks, credit cards, and subscriptions can wait a few days — nothing bad happens if those calls come next week.

What about the first week?

During the first week you'll meet with the funeral home to finalize arrangements, write an obituary if you want one, and order certified copies of the death certificate — five to ten copies covers most families, since insurers, banks, and courts each want one. In Missouri, copies come from the DHSS Bureau of Vital Records or any local public health agency; in Illinois, from the Illinois Department of Public Health's Division of Vital Records or the county clerk where the death occurred; in Kansas, from the Office of Vital Statistics at the Kansas Department of Health and Environment. The funeral home can order copies for you in all three states, and letting them is usually easiest.

Everything beyond that — probate, the house, the accounts, the belongings — belongs to the coming months, not this week. Big financial decisions made in the first days after a death are the ones people most often regret, so give yourself permission to move slowly. Accept the help people offer, write things down because grief scrambles memory, and remember that doing this imperfectly is the only way anyone has ever done it.