Inside the world of dealing with someone who has died alone

When Neils Jansen* was discovered, he had been dead in his home for three months. A loner, isolated and emotionally erratic, he had long shunned the friendship of humans for that of a few horses.

The beginning of a long process: undertakers remove a body from a house in Ballarat. Picture: Jeremy Bannister.

The beginning of a long process: undertakers remove a body from a house in Ballarat. Picture: Jeremy Bannister.

His remains were discovered by a relative, concerned that he hadn’t heard from the 70-year-old for some time. He called the police, who came to the small farmhouse where he lived. 

What took place next is an increasingly common scenario in today’s society, where isolation and an ageing population have combined to leave rising numbers of our population at the risk of dying alone.

The Courier spoke to four people who work in the field of death; whose jobs involve dealing with the dead on a daily basis.

A police officer, coronial undertaker and two funeral directors all spoke openly about the growing frequency of being called to homes where someone has died alone and undiscovered, sometimes for weeks; sometimes months; occasionally years.

In some cases it’s a person who has no nearby or living relatives. In others, it’s mental illness. Sometimes it is suicide. Often they find themselves in the detritus of someone’s life: in the house of hoarder, or someone whose existence hasn’t changed for decades; the home of an alcoholic or a person who has lived in modern poverty.

Each of them describe with astounding detail and compassion the work that they do in these frequently difficult and distressing conditions.

A brief outline: what happens

  • Someone discovers a body, whether a relative or a stranger. Their initial response is usually to call an ambulance and the police.
  • Police attending will, having established to their satisfaction that no suspicious circumstances exist, call the deceased’s doctor or the Coroners Court, who ensure the police have finished their work. If the death is reportable, it must go to the Coroner’s Court.
  • The court assign a contracted funeral director to collect and transport the body for storage, either in the Victorian Institute of Forensic Medicine (VIFM) at Southbank in Melbourne, or to the mortuary at Ballarat Base Hospital, which operates as the coroners mortuary for two days a week and cannot accept badly decomposed bodies.
  • The police will formally advise any next of kin of the death, and meet with them to hand over any items of identification or other possessions they have secured. Meanwhile the coroner will ascertain when or if the deceased last saw a medical practitioner, and determine whether a preliminary examination of the body is sufficient or an autopsy is necessary.
  • After the coronial examination process is complete, and the next of kin informed that the body is available for burial, the family’s appointed funeral director will take over the process, including the application for a death certificate.

This is the simplest of outlines. What if there are complications – no immediate contactable family, or if an autopsy is required? What if someone is unidentifiable? Then the story becomes complex.

The police officer – “Everybody deals with death differently”

Coping mechanisms: Ballarat Senior Sergeant Stacey Glenister says Victoria Police have developed strategies to assist both officers and the next-of-kin deal with death. Picture: Lachlan Bence.

Coping mechanisms: Ballarat Senior Sergeant Stacey Glenister says Victoria Police have developed strategies to assist both officers and the next-of-kin deal with death. Picture: Lachlan Bence.

Ballarat-based Senior Sergeant Stacey Glenister has been an officer with Victoria Police for 20 years.

She says the initial police contact in a case where someone has died and not been discovered is often through a welfare check, which police conduct quite regularly.

“What happens is a neighbour or somebody might ring and say they haven’t seen a person for a couple of days or weeks and it’s a little bit unusual. Police will do a preliminary check – there might be a front light left on, accumulating mail, a car sitting there and accumulating mail in the letterbox. They might speak to the neighbours,” says Glenister.

If their concerns are raised, by perhaps seeing someone on the floor or in a chair not moving, the police have the power to enter the premises to establish if the person has in fact died. If that is the case, says Glenister, then the police will begin a process to establish foul play has not been a factor.

After they have satisfied themselves the death is not suspicious, the police will attempt to contact the deceased’s next-of-kin, perhaps through a mobile phone or and address book.

“Often with older people, they don’t have a mobile phone, so it gets a little trickier,” says Glenister.

“We might try the redial on the landline, or again check with neighbours to see if they know any relatives… quite often old people will tap into their neighbours – it doesn’t necessarily need to be an old person, any person might do this.”

The police will also attempt to contact a person’s doctor, who may or may not provide a certificate. If they do not, the body goes into the care of the coroner.

Senior Sergeant Glenister says it’s important to remember police officers are also people, and handling any death will affect them in different ways.

“Everybody deals with death differently,” she says.

“There are some members that are deeply affected; some members have different triggers. It could be when children die, or an elderly person, if the member has had a parent or grandparent die recently. Some are affected by the sight of someone who has been dead for a long time, because it is never pleasant.”

Glenister says Victoria Police have put measures in place to assist members who have been distressed by their experiences, and some members develop personal coping capacities.

“As a manager I will touch base with members who have been to these kind of jobs and see if I can assess their well-being, as well as giving them the tools to assess when they are struggling with the job – just talking about it can help.”

Police must also inform the next-of-kin. Glenister says this job can be as, if not more, stressful than dealing with the initial discovery.

“The members who attend to deliver death messages, they are also affected by the grief of the families involved, obviously,” she says.

“So we put in place the same strategies for those members who are talking to the families as for those who attend the death, whether it be at the scene or not.”

Glenister stresses that the police are deeply concerned about giving someone who has died, in any situation, the right to dignity.

“We will always cover up the body,” she says.

“Only people who need to see the body are allowed to see it, even (police) members. If a member doesn’t need to see the body, we recommend they don’t. When the family arrive, we offer them the right to see the body... and we try to prepare them for that, because it’s often not a very nice sight. People who have died do not look the same as when they are alive.”

The coronial undertaker – “Unidentified cases are incredibly rare these days”

Death in all its guises: Audrey Lake has worked in the Coroners Court, the Victorian Institute of Forensic Medicine and the funeral industry. Her understanding of what happens to the dead and the living left behind is comprehensive. Picture: Supplied.

Death in all its guises: Audrey Lake has worked in the Coroners Court, the Victorian Institute of Forensic Medicine and the funeral industry. Her understanding of what happens to the dead and the living left behind is comprehensive. Picture: Supplied.

Audrey Lake works for the Coroners Court as an undertaker, and worked formerly as a consultant to Bereavement Assistance Ltd, a not-for-profit funeral home. She was also a mortuary technician at the Victorian Institute of Forensic Medicine and a grief counsellor at the Coroners Court.

Her knowledge of the process of death and its attendant requirements is profound.

She says when the police have completed their preliminary investigation, they will contact the coroners office.

“Anything that needs to be queried will come to the coroner,” she says. If possible the coroner will advise any family of the initial admission and if a visual identification will be required.

The process of coronial investigation then begins with an external examination.

“Obviously if the process is not straightforward; for example if someone has been found at home and they have been there for a long time, then a dental or a DNA identification may be necessary,” says Lake.

The VIFM will extract the DNA, says Lake. It also has microbiology, histology and toxicology units, as well as Victoria’s largest computed tomography (CT) scan unit.

After the preliminary examination, involving blood, urine and other body samples and a CT scan, the coroner will direct if an autopsy is required.

“If that is required, then the coroner will ask how the family how they feel about it,” says Lake.

“There’s a legal requirement to wait 48 hours before scheduling an autopsy, to give the family time to object if they wish. If the family are strongly opposed, the coroner will meet with the pathologist again to see if they can agree on a determination, or if they need to proceed with the post mortem. And the only action against that direction is to apply to the Supreme Court.”

Lake says when a person dies who cannot be identified or who has no readily discoverable next-of-kin, they are usually retained at the VIFM for about three weeks, depending upon police investigations and the State Trustees’ funeral arrangements. (The State Trustees are one body responsible for helping organise funerals for those without means.)

“If the remains are skeletal they may stay at the Institute for years, because they are easily stored. A complete body will have DNA taken from it and then it will be interred,” says Lake.

“Those unidentified cases are incredibly rare these days.”

In her work counselling the bereaved, Lake says dealing with their desire to see the deceased was one of the more difficult aspects.

She says it’s a case of delicately explaining that there are sometimes better ways of remembering a loved one than seeing them after they have died.

“My approach – and it’s not easy to put into a soundbite – but if you have a scale of one to ten, you start at one and gently introduce the idea that, due to the period of time passed between when someone has died and when they’ve been found, there’s a process of deterioration that is a natural part of life,” she says.

“Ultimately people have the right to see someone and the process we undertook, particularly at the Coroners Court where some of the deaths are traumatic, was to start gently and as people resist you incrementally become more descriptive: maggots, bloating, bleeding, black skin. And some people will still insist, so we may cover the face, or show a hand.”

The funeral director – “Some people don’t get over a death”

Years of experience from both sides: Maree and Brian Harrison of Harrison Funerals in Ballarat. Brian Harrison was formerly with Victoria Police. Picture: Lachlan Bence.

Years of experience from both sides: Maree and Brian Harrison of Harrison Funerals in Ballarat. Brian Harrison was formerly with Victoria Police. Picture: Lachlan Bence.

Ballarat’s Brian Harrison of Harrison Funerals has seen the business of death from many angles. Working as a  full-time funeral director since 1987, his previous career was with the Victoria Police. 

“I’ve seen death from both instances,” says Harrison.

In the past he has worked as a Coroners Court’s contracted undertaker, although he does not at present.

The removal of the deceased is a fraught business, he says, dependent upon many conditions: the length of time a person has been deceased; weather and temperature; insect and animal ingress; exposure to the elements.

As a funeral director, he says an indication of the state of the situation is sometimes perceptible even before reaching the body. He recalls attending a death in Lydiard Street North, where a young man had suicided in a caravan behind the former National Bank.

“He wasn’t found for several months, and it’s rather unpleasant. You know there’s something wrong, because when you get called, you see all the police outside, some distance from the caravan.”

The physical process is straightforward for the director. The deceased is removed from the scene into a blue, fluid-tight bodybag made from much the same material as a plastic tarpaulin. The zip for the bag is not in the centre but rather on the side, so a person can be lifted, rolled or slid easily inside.

There are now powerful deodorants that immediately cover the smell of putrefaction, which are very helpful says Harrison.

Like Audrey Lake, he says the process of a body breaking down needs to be recognised as a natural part of life.

“We are a bit clinical these days; we like things to be clean and decomposition is a bit confronting for people,” he says.

“It’s the smell: that’s the first thing that really affects you... blowflies are an amazing creature, they can smell dead flesh from a long way away. And so nature takes its course.”

For Harrison, the impression that we are all more connected through social media and the internet these days can be illusive and lead to situations where members of society get left behind and are at risk of becoming lost.

He cites the practice of direct debit for such things as rental properties as one case where someone may die and not be noticed.

“Years ago, when they would collect cash for rent, it was easy. You had contact with someone all the time. Now life has become more automated, the opportunities to interact with people have diminished. But there are many different circumstances leading to where people are found alone.”

Brian Harrison says the nature of grief when a family member discovers another has died alone is different from person to person.

“There are many steps in the process of grief,” he says.

“People react differently, because we are all different, of course. Some people respond and bounce back really quickly. Other people struggle forever. Some people don’t get over a death; they simply adjust their life to cope with the loss. The facade of a person may change slightly, or it may not. Not everybody shares that internal story.”

In the past, says Harrison, those who died without family or money were buried for free, and the jobs were shared around the undertakers of a community.

These days, after changes made in the Funerals Act 2006, the State Trustees provide $2500 in essential care to cover the basic costs of providing an funeral for those unable to have a family look after the burial or cremation.

“The State Trustees prefer burial, in case family come along later. The problem for us is finding somewhere to bury someone for little cost. The Magistrates Court Act has some provisions to order a cemetery to provide a grave and a plaque. There has always been provision for the destitute. In Ballarat, I’ve been to many burials at Dowling Forest for people who don’t have any family, any friends, or any money.”

The funeral director – “We’re all equipped for different things in this world”

Personal knowledge: her father's death and the subsequent discovery of how he lived  led Pia Sims to advocate for services that care for those who are alone. Picture: Lachlan Bence.

Personal knowledge: her father's death and the subsequent discovery of how he lived led Pia Sims to advocate for services that care for those who are alone. Picture: Lachlan Bence.

Pia Sims is a funeral director with F.W. Barnes and Sons in Ballarat. She has also worked as a wedding and funeral celebrant. Her father’s death two years ago, when she was beginning in the funeral business, taught her much about the need for as much preparation as possible.

“He lived a very isolated existence. I was living a number of hours away; my sister was living a number of hours away. But we had phone contact every day, and when he gave me a call and said he’d called an ambulance because he wasn’t feeling too well… he was admitted into the emergency ward with elevated heart rate and respiratory difficulties. Within 14 days he’d passed away: stage 4 cancer in bladder, bowels, liver, lungs, pancreas,” says Sims.

Sims says her father was seeing a lung specialist and a GP, but he was never sent for additional scans. She feels that GPs and other doctors should make themselves more aware of a person’s living situation and offer them counselling services so that they do not suffer or die alone.

She cites the Red Cross service Telecross as an option that could be offered to those at risk.

Telecross is staffed by trained volunteers who telephone a person on their checklist daily to ensure their wellbeing, each day of the year. If the call is unanswered, the Red Cross says it will ‘take action to make sure you are OK’.

“If they try and call a number three times in one day and there is no response, they escalate it and it’s turned into a welfare check for VicPol. It’s a free service, and it’s terribly underutilised,” says Sims.

She also recommends those who may be at risk of finding themselves alone at the end of their life look at initiatives like ‘dying to talk’, a discussion starter about preparing for the end of life.

Dying to talk is promoted by Palliative Care Australia, a Commonwealth Government-funded body.

“We are all going to die, all of us. So let’s get affairs in order, so that when that time comes, on top of all the physical mess we’re left with, especially when someone is not living in less than ideal conditions, we don’t have to expend mental energy on thinking about what someone wants done with their body,” says Sims.

In her case, the conversation with her father before his death meant that his wishes were clear, including leaving $2000 to be put on the bar of his local sports club, “and there’s to be no light beer served.”

F.W. Barnes and Sons are the current Coroners Court contracted funeral directors in Ballarat. Sims says the jobs for the coroner need to be handled a little differently from the day-to-day work of the funeral home.

“There are details that need to be taken care of. I will always ask the size of the person – I was caught out once with another female director having to deal with someone who was 160kg,” says Sims.

“I’ll ask if they are on a particular storey of a building, what to plan for, what equipment we may need to do the removal.”

“When we arrive on scene we will introduce ourselves to the police officer contact given to us by the coroner; we get the name of the deceased and a case number. I’ll have a chat to the police, make sure they are finished. We’ll ask the police to remove any personal belongings. Sometimes they are a bit… ‘errrrr’, so I’ll put the gloves on and do it in front of them. Then we’ll address the case.

“I had one last summer… a drug overdose that had been in the car for a week-and-a-half. It’s very hard job – but I have a girlfriend that runs a childcare centre. I couldn’t work a day there. We’re all equipped for different things in this world and that’s a good thing.”

*Name changed for privacy