Guidance for the "Immediate Next Steps" Section of Your Packet
It can be a paralyzing thing when you lose a loved one.
Here’s an hypothetical, realistic example: A woman's husband died peacefully at home—exactly as they'd planned. Natural and expected. He'd been in hospice for weeks. But when the moment came, she panicked and called 911. Within minutes, paramedics were performing CPR on a body that didn't need saving, sirens were wailing in the driveway, and neighbors were gathering on the lawn.
She knew better. They'd talked about it. But in that moment, her brain went blank and she defaulted to emergency mode.
Here's what would've saved her: a single page in his packet that said, "Don't call 911. Call hospice first. Here's the number."
That's what the "Immediate Next Steps" section of your End-of-Life Matters Packet is for. It's not about your funeral wishes or your bank accounts. It's about the first two hours after you die—when your people are in shock and need crystal-clear instructions.
Why This Section Exists
In Being Mortal, Atul Gawande writes about how modern death has become medicalized to the point where we've forgotten that not every death is an emergency. And in A Beginner's Guide to the End, BJ Miller and Shoshana Berger remind us that the immediate aftermath of death is when people need the most guidance and often have the least capacity to think clearly.
Your "Immediate Next Steps" section is your voice in the room when you can't be there. It's you saying, "I know this is terrible, but here's exactly what to do next."
What Your Packet Already Asks You
If you flip to that section in your End-of-Life Matters Packet, you'll see it's designed to answer the most urgent questions your loved ones will have:
1. Who do we call to pronounce death?
2. What funeral home should we contact?
3. Are you an organ or body donor?
4. Are there religious time requirements we need to know about?
Let's walk through how to fill each of these out so your people aren't guessing.
1. Who Pronounces Your Death (And Why It Matters)
Here's something most people don't know: your body can't be moved until a medical official pronounces you dead. That's not morbid—it's logistics. The funeral home needs that pronouncement before they can transport your body and before the state will issue a death certificate (which your family will need for everything else).
If you die in hospice care: Your packet should say, "Call the hospice company. They will handle the pronouncement and next steps." Include the hospice phone number if you're currently enrolled.
If you die in a hospital or care facility: Your packet should say, "Tell the nurse or staff. They will handle the pronouncement. You can request time with my body if you'd like."
If you die at home (not under hospice care): This is where it gets tricky. Your packet explains that you don't have to call 911 immediately—especially if your death is expected and natural. Your loved ones can take hours, even days if they keep your body cool, before calling.
Here's what to write: "My death is expected. Don't rush. Take the time you need with my body. When you're ready, call 911 and request that paramedics come without sirens."
OR, if you've pre-arranged: Check that box in your packet and write, "Do NOT call 911. I have pre-arranged for [funeral home name] to pronounce my death. Call them directly at [phone number]."
Pro tip: If you have a medical official (like a hospice doctor or your primary care physician) who's agreed to pronounce your expected death, write their name and number here. This can save your family from an unnecessary 911 call.
2. Your Preferred Funeral Home or Mortuary
Even if you haven't pre-arranged your funeral, you can still name a preferred funeral home. This saves your family from Googling "funeral homes near me" while they're crying.
Here's what to write:
Full name of the funeral home
Phone number (including after-hours emergency line if they have one)
Address (in case your family needs to go there)
If you've pre-arranged: Write "I have pre-arranged my funeral and body disposition with [name]. They are expecting my death. Call them at [number]. My arrangements are paid/not paid (leave payment details if paid).”
If you haven't chosen yet, and you have no preference, make sure that’s clear. Write, “Please choose one that feels right to you. I trust your judgment."
3. Organ, Tissue, or Body Donation
This is a simple checkbox in your packet, but it's critical.
If you're an organ donor: Check "Yes" and write, "I am a registered organ donor. If I die in a hospital, tell the medical staff immediately. Organ donation can only happen in a hospital setting."
Why this matters: Organ donation has a very short window. If your family doesn't know you're a donor, or if they're not sure whether to mention it, that window closes.
If you've arranged whole-body donation: Write the name of the organization (medical school, research facility) and their 24-hour phone number. Also note: "Body donation arrangements are already made. Do NOT contact a funeral home. Call [organization] immediately."
If you're not a donor: Check "No." That's it. No explanation needed.
4. Religious or Cultural Time Requirements
Some religions require burial or cremation within 24 hours of death. If that applies to you, your family needs to know immediately—not three days later when they're planning a service.
Why this matters: As L.S. Dugdale writes in The Lost Art of Dying, religious and cultural death practices aren't just tradition; they're often deeply tied to how communities grieve and process loss. If your faith community expects certain practices, name them clearly.
What Else to Include (Optional but Helpful)
Your packet focuses on the essentials, but here are a few other things you might add in the margins or on a separate note:
"You don't have to rush." Seriously. Write this. In My Father's Wake, Kevin Toolis describes how Irish families used to sit with bodies for days—not because they had to, but because it helped them accept the reality of death. Your family might need that time too.
"It's okay to touch my body." A lot of people are afraid to touch a dead body. If you want your spouse to hold your hand or your kids to say goodbye, tell them it's okay.
"Call [specific person] first." If there's one person who should be the point person for all of this, like your sister, your best friend, your executor, then name them. "Before you do anything else, call Sarah. She knows what to do." You’ll certainly want to note this in the following First Contacts section, but can also add the note in the margins of this section as well.
The Uncomfortable Truth (Again)
You know what's wild? Most people can tell you their Netflix password but not their funeral home preference.
But here's what to know, the people who fill out this section aren't more prepared for death. They're just more prepared to love their people well after they've gone.
Your family is going to be a wreck when you die. You can't change that. But you can give them a roadmap for the first two hours so they're not wrecked and paralyzed.
Your Next Step
Open your End-of-Life Matters Packet to the "Immediate Next Steps" section. Read through it. Then set a timer for 15 minutes and fill in what you know.
You don't have to have all the answers today. You don't have to pre-arrange your funeral or choose a hospice provider right now. But you can write down your preferred funeral home. You can check the organ donor box. You can write, "Don't call 911 immediately and take your time."
Because here's the thing: this section isn't about you. It's about the person who will sit next to your body one day, holding their phone, trying to figure out what to do next.
Prepare them here for what you’d wish you could tell them in that moment.
Questions to consider:
If you died at home tonight, would your family know whether to call 911 or your funeral home?
Have you told anyone that you're an organ donor (or that you're not)?
Is there one person in your life who could be the "point person" for immediate next steps?
Resources referenced:
Being Mortal by Atul Gawande
A Beginner's Guide to the End by BJ Miller & Shoshana Berger
My Father's Wake by Kevin Toolis
The Lost Art of Dying by L.S. Dugdale