Who Do You Call When Someone Dies at Home? A Step-by-Step Guide

If the death was expected and hospice was involved, call your hospice nurse first. If the death was expected but no hospice was in place, call the person's physician. If the death was unexpected — sudden, unexplained, or due to an accident — call 911 immediately.

Those three calls cover the vast majority of home deaths in the United States. The sections below walk through each scenario in detail, explain who officially pronounces death, what happens with the body, and what you need to do in the days that follow.

You do not need to move the body, call a funeral home immediately, or make any irreversible decisions in the first hour. Give yourself a moment to breathe. Then work through this guide one step at a time.

For what to do after the immediate crisis has passed, our guide on what to do when a spouse dies covers the emotional and administrative weeks that follow.

When Death Was Expected (Hospice Was Involved)

If your loved one was enrolled in hospice care, the process at death is the most straightforward of the three scenarios — because hospice exists precisely to manage it. Hospice teams prepare families for this moment and remain available around the clock.

Step 1: Call the Hospice Nurse

Every hospice provider operates a 24-hour on-call line. Call that number first. A nurse will be dispatched to the home, usually within 30 to 60 minutes depending on location. Until the nurse arrives, you do not need to do anything else. You can sit with your loved one. You do not need to call 911.

Step 2: The Nurse Pronounces Death

When the hospice nurse arrives, they will formally assess the patient and pronounce the time of death. This is a legal act — it creates the official record. Only a licensed medical professional (physician, nurse practitioner, or registered nurse with the appropriate authority) can make this pronouncement. The hospice nurse is trained and credentialed to do exactly this.

Step 3: The Death Certificate Is Filed

The hospice physician — not the attending family doctor — typically signs the death certificate for hospice patients. The hospice team coordinates this paperwork. The cause of death is the underlying illness (e.g., metastatic cancer, end-stage heart failure) that prompted hospice enrollment. There is no requirement for an autopsy when a terminally ill patient dies under hospice care.

Step 4: The Funeral Home Is Called

After the nurse pronounces death and the family has had sufficient time to be with their loved one, the hospice team will help coordinate transport of the body to the funeral home of your choosing. If you have not yet selected a funeral home, this is the moment to decide. The hospice social worker or nurse can provide a list of local providers if needed.

There is no rush. The hospice nurse can remain present, and the body does not need to be moved within any specific time window. Many families spend an hour or more with their loved one before calling the funeral home — this is completely normal and appropriate.

What to Expect Emotionally

Even when a death is expected, the moment it happens can feel shocking. Hospice staff are trained to support families through this. You are allowed to grieve openly in their presence. You are not expected to manage logistics while also processing loss. Let the hospice team carry the administrative weight in these first hours.

When the time comes to notify people, our guide on what to say when someone dies covers both what to say and what to avoid — helpful when you need to make calls to extended family or friends.

When you are ready to think about the days ahead, our complete funeral planning checklist walks through every decision you will face.

When Death Was Expected (No Hospice Involved)

This is the scenario that most guides overlook — and it is more common than people realise. Not everyone who has a terminal illness enrolls in hospice. Some families provide care at home with support from a palliative care team, a primary care physician, or simply on their own. When death happens in this situation, the process is slightly more complex than with hospice, but it is manageable.

Step 1: Call the Person's Physician

Call the primary care physician or specialist who was managing the patient's care. During business hours, call the office directly. Outside business hours, the practice will have an on-call number or answering service. Explain that your loved one has died at home and that you need a physician to pronounce death.

Some physicians will come to the home to pronounce death in person. Others, in states where it is permitted, may pronounce death over the phone and arrange for a registered nurse to attend in person. State laws vary considerably on what is permitted — your physician's office will know the rules in your jurisdiction.

Step 2: Do Not Call 911 Unless Directed

If the death was expected due to a documented terminal illness and there is a physician willing to sign the death certificate, you generally do not need to call 911. Calling 911 can trigger an emergency response — including paramedics who may be legally required to attempt resuscitation if no valid DNR is immediately available. If you are uncertain about the DNR status or the physician cannot be reached, call 911 and explain the situation clearly: "My mother has died at home. She had a terminal illness. We are attempting to reach her physician."

Step 3: The Death Certificate

The attending physician will sign the death certificate. If the physician was not actively treating the patient in the weeks leading up to death, they may decline to sign — in which case the medical examiner or coroner may need to be involved to determine cause of death. This does not mean an autopsy is required; it simply means an independent medical authority reviews the case.

Step 4: Call the Funeral Home

Once a physician has pronounced death and agreed to sign the death certificate, you can contact the funeral home. The funeral home will arrange transport of the body. Do not call the funeral home before a physician has pronounced death — they cannot legally take custody of the body until that step is complete.

When selecting a funeral home, be aware that flowers and tributes are part of the service. Our guide on funeral flower etiquette covers what is appropriate to send, what to expect, and how to communicate floral preferences to guests.

If you are managing the estate after this, our guide on how to settle an estate without a lawyer provides a practical roadmap for the weeks ahead.

When Death Was Unexpected

An unexpected death at home — whether from a sudden cardiac event, an accident, suicide, or any death where the cause is not immediately clear — requires a different response. The priority is to call 911 immediately.

Step 1: Call 911

Call 911 and tell the dispatcher that you believe someone has died. They will send emergency services. Depending on the circumstances, this may include paramedics, police officers, or both. In some jurisdictions, firefighters also respond to all 911 medical calls.

Step 2: Do Not Move the Body

Unless you are trained in CPR and are attempting resuscitation, do not move or disturb the body or the area around it. When the cause of death is unknown, the scene may need to be examined by police and potentially by a medical examiner. Moving the body or disturbing evidence — even unintentionally — can complicate the investigation.

Step 3: Police Will Respond

Police respond to unexpected home deaths as a matter of routine. This does not mean you are a suspect or that anyone is in trouble. Officers are required to investigate any death where the cause is not immediately known. They will ask questions, document the scene, and coordinate with the medical examiner's office.

If the police determine the death was due to natural causes (even unexpected ones, like an undiagnosed heart condition), they may clear the scene relatively quickly. If the circumstances are unclear or suggest injury, the investigation may be more extensive.

Step 4: The Medical Examiner or Coroner

For unexpected deaths, the medical examiner (ME) or coroner will typically assume jurisdiction over the body. They will determine the cause and manner of death. In many cases, this involves an external examination only. An autopsy is ordered when the cause of death cannot be determined without one, or when required by law (e.g., deaths involving suspected violence, certain types of accidents, or deaths in custody).

Step 5: The Funeral Home Comes Later

You cannot contact the funeral home until the ME or coroner releases the body. In straightforward cases, this may happen the same day. In more complex investigations, it can take longer. The ME's office will communicate directly with you about the timeline.

DNR Orders and Advance Directives

A Do Not Resuscitate (DNR) order is one of the most important documents to have accessible when a death is anticipated at home. Its presence — or absence — can significantly change what happens when emergency services arrive.

When a Valid DNR Is in Place

If a signed DNR order is visible and immediately accessible — typically on the refrigerator door, near the bed, or with the patient's medical file — emergency responders are legally obligated to honour it. They will not attempt CPR or other resuscitative measures. The person's wishes are respected.

The DNR must be a valid, signed document. A verbal statement that someone "did not want heroic measures" is not legally sufficient for emergency responders.

When No DNR Exists

Without a valid DNR, emergency responders may be legally required to attempt resuscitation — even if the family knows the person would not have wanted it. This can be distressing for families to witness. If your loved one has a terminal illness and is being cared for at home without hospice, ensuring a valid DNR is in place — and that it is visible and accessible — is one of the most important steps you can take.

POLST and MOLST Forms

Many states use a Physician Orders for Life-Sustaining Treatment (POLST) form — also known as MOLST (Medical Orders for Life-Sustaining Treatment) in some states. Unlike a standard advance directive or living will, a POLST is a medical order signed by a physician, nurse practitioner, or physician assistant. It is immediately actionable by emergency responders and medical staff. A living will, by contrast, requires a physician to translate the patient's wishes into orders — a step that may not happen in an emergency.

If your loved one has a POLST or MOLST form, keep it with them at all times. Do not put it in a filing cabinet — it needs to be findable in seconds.

For questions about what happens to legal authority after death, see our guide on power of attorney after death — including what powers survive and which do not.

Coroner vs Medical Examiner: What to Expect

The terms are often used interchangeably in conversation, but they refer to different roles — and understanding the difference can help you navigate the process with less confusion.

Medical Examiners

Medical examiners (MEs) are physicians — typically forensic pathologists — appointed to their position. They are found in larger jurisdictions and metropolitan areas. Because they are physicians, they can perform autopsies and sign death certificates. Medical examiner offices tend to be more systematised and often have dedicated investigators who visit scenes before the ME reviews the case.

Coroners

Coroners are often elected officials and are not required to be physicians in many states. They may rely on contract forensic pathologists to perform autopsies. Coroner systems are more common in rural counties. Despite the difference in qualifications, coroners hold the same legal authority over determining cause and manner of death.

When Is an Autopsy Ordered?

An autopsy is typically ordered when: (1) the cause of death is unknown or unclear; (2) the death was violent, accidental, or suspicious; (3) the deceased was young and otherwise apparently healthy; (4) the death may have involved negligence or criminal action; or (5) state law requires it for certain categories of death (e.g., deaths within 24 hours of hospital admission, deaths in custody).

When an expected terminal illness is the cause and a physician is willing to sign the death certificate, an autopsy is almost never required. If you have concerns or questions about whether an autopsy will be ordered, the ME or coroner's office will answer them directly.

Documents You Will Need

Gathering paperwork in the days after a death can feel overwhelming on top of grief. Knowing what you are looking for before you begin makes the process considerably more manageable.

Death Certificates

Order at least 10 to 15 certified copies. Most vital records offices charge between $10 and $25 per copy. The funeral home will file the initial certificate; you can request additional copies through the state vital records office at any time.

Identity Documents

Locate the following:

• Social Security card and number
• Birth certificate
• Passport
• Driver's license or state ID
• Military discharge papers (DD-214), if applicable
• Marriage certificate, if the deceased was married
• Divorce decree, if applicable

Financial Documents

• Will and/or trust documents
• Life insurance policies (name, policy number, insurer contact)
• Bank account statements and account numbers
• Investment and retirement account statements (IRA, 401(k), pension)
• Mortgage documents or lease agreement
• Vehicle titles
• Tax returns from the past two to three years
• Any outstanding loan or debt statements

Health and Benefits Documents

• Medicare/Medicaid cards and account information
• Health insurance policy documents
• Advance directive, living will, or POLST/MOLST form
• Employer benefits statements (pension, survivor benefits)

For a more detailed walkthrough of the estate process, see our guide on how to settle an estate without a lawyer.

Legal and Financial Steps in the First Weeks

The administrative tasks after a death can extend for months. This section covers the most time-sensitive ones — the agencies and institutions that need to be notified within the first few weeks.

Social Security Administration

Report the death to the SSA as soon as possible. If the funeral home reported the death to SSA on your behalf (common practice), confirm this happened. If the deceased was receiving SSA retirement, disability, or survivor benefits, those stop as of the month of death. Any overpayment must be returned. A surviving spouse or dependent children may be entitled to a lump-sum death benefit of $255 — ask about eligibility when you call.

Banks and Financial Institutions

Bring certified copies of the death certificate to each bank. If accounts had a named beneficiary, those funds pass directly to the beneficiary outside of probate. If accounts were held jointly with right of survivorship, the surviving account holder typically gains full access with a copy of the death certificate. Accounts held solely in the deceased's name must go through probate before the executor can access them.

Life Insurance

Contact each insurer by phone or online portal to begin a claim. You will need the policy number, a certified death certificate, and identification. Payment is usually made directly to the named beneficiary within 30 to 60 days, often faster. Life insurance proceeds typically do not pass through probate and are not subject to income tax.

Employer and Pension Benefits

If the deceased was employed, contact their employer's HR department about final pay, accrued leave, group life insurance, and pension survivor benefits. Surviving spouses of federal employees may be entitled to FEHB health coverage continuation.

Subscriptions and Recurring Charges

Cancel subscriptions and recurring charges to avoid ongoing billing — streaming services, gym memberships, magazine subscriptions, and any automatic bill payments drawn from the deceased's accounts. Review bank statements for recurring charges that might otherwise continue for months.

Voter Registration and Driver's License

Notify the state DMV and county elections office. This prevents identity fraud and ensures accurate voter rolls. Many funeral homes handle these notifications automatically — ask whether yours does.

For more on what happens to legal authority over finances and property, see our guide on power of attorney after death, and if the estate is complex, our overview of how long probate takes sets realistic expectations.