What Happens When Someone Dies in a Nursing Home: Next Steps for Families

The phone call often arrives in a quiet moment—between errands, between work meetings, between the parts of life that still insist on continuing. A nurse introduces themselves gently, and the world changes in a sentence. Even when a death is expected, even when someone has been declining for months, families are rarely fully prepared for the moment it becomes official.

If you found yourself searching death in nursing home next steps, you are probably trying to answer two questions at the same time: what needs to happen now, and what choices can wait until you can breathe. The good news is that nursing homes have procedures, and most staff members are practiced in guiding families through the first hours. The harder truth is that there are still decisions only the family can make—especially around funeral planning, cremation, and what to do with the ashes afterward.

This guide walks through what typically happens when someone dies in a nursing home, and then gently connects that timeline to the choices many families face next: cremation urns, cremation jewelry, pet urns, and practical planning around keeping ashes at home, water burial, and costs.

The first hour after a nursing home death

In most nursing homes, the immediate steps begin with confirmation and documentation. A nurse will assess the resident and follow the facility’s protocol for a legal pronouncement. Depending on the situation and local rules, that pronouncement may be made by a physician, a nurse authorized to pronounce, hospice personnel (if hospice was involved), or another medical professional connected to the resident’s care. For families, the important takeaway is simple: you do not usually need to “do” the medical part. The facility handles it.

What you may be asked to do, sometimes sooner than you would like, is identify who should be notified and which funeral home or cremation provider the facility should contact. Some families already have this information in writing, especially if the resident preplanned or had a preferred provider. Others are choosing in real time, still processing the news.

If you are unsure what to ask for in that first call, Funeral.com’s guide to what to do when someone dies in the first 48 hours can help you orient quickly without turning grief into a project.

In many facilities, staff will also begin after-death care (sometimes called “post-mortem care”), which may include positioning, bathing, and preparing the resident to be transferred when the funeral home arrives. Families are often offered time to sit with their loved one privately. If being present matters to you, it is reasonable to ask how much time you can have and what the facility’s process looks like.

Release of the body, belongings, and paperwork you should expect

After pronouncement, the nursing home typically contacts the funeral home or cremation provider you choose, and the provider arranges transportation. If the death is unexpected, or if circumstances require review by a medical examiner or coroner, the timeline may change. Staff can tell you if any additional authority needs to be involved.

While the transfer process is happening, families often face a quieter, surprisingly difficult task: gathering personal belongings. Many nursing home residents have a small life contained in a room—photos, a robe, a favorite blanket, a pair of slippers that still look like “them.” Some families want to take everything immediately; others cannot emotionally do it in one day. Facilities vary, but it is usually possible to coordinate a return visit if you need time. If there is jewelry on your loved one that you want returned to the family, ask about the facility’s policy and the safest way to document what is being released.

Paperwork is the part that tends to show up in waves. The nursing home documents the death for its records, and the funeral home typically coordinates the death certificate process. You will almost certainly need multiple certified copies for banks, insurance, benefits, and legal tasks. If you want a practical explanation (and help deciding how many to order), Funeral.com’s guide to death certificates and how many copies to request is written for families who want clarity without jargon.

Funeral planning decisions that can’t wait—and the ones that can

In the days after a nursing home death, families often feel pressure to make “final” decisions immediately. In reality, only a few choices are truly time-sensitive. The urgent decisions are usually about care of the body and the type of disposition (burial, cremation, or another legal option in your state). Many of the memorial decisions—what the service looks like, where ashes will rest, how the tribute will feel—can be made at a more human pace.

One reason this moment feels so heavy is that cremation is now the majority choice in the United States, meaning more families find themselves navigating ashes and memorialization. According to the National Funeral Directors Association, the U.S. cremation rate is projected to be 63.4% in 2025, compared with a projected burial rate of 31.6%, and the cremation rate is projected to keep rising through 2045. The Cremation Association of North America also reports the U.S. cremation rate was 61.8% in 2024. These numbers don’t reduce grief, but they do explain why so many families are asking the same questions you may be asking now: what to do with ashes, how to share them respectfully, and how to choose a permanent memorial that feels right.

If you want a calmer, step-by-step overview of the broader sequence—arrangements, service decisions, paperwork, and the practical flow of a funeral—Funeral.com’s guide on how to plan a funeral in 7 steps is a helpful companion, especially when your brain feels foggy and you want a reliable order of operations.

If your family chooses cremation

Cremation can support a wide range of memorial styles, from a traditional service with a viewing to a simple direct cremation followed by a gathering later. The choice is not only about logistics; it is also about what your family can manage emotionally right now. Some families want a ceremony quickly. Others want time to plan something meaningful without rushing.

After cremation, the next practical question becomes the one people often whisper because it feels strangely “too real”: where will the ashes go? There is no single correct answer. The best plan is one that fits your family’s needs and reduces future stress.

If you are beginning the urn decision, a helpful starting point is Funeral.com’s guide on how to choose a cremation urn, which focuses on real-world considerations like placement (home, cemetery, columbarium), closures, durability, and the emotional “fit” that matters more than most people expect.

Choosing cremation urns for ashes without feeling rushed

Shopping for an urn can feel like trying to make an important decision while standing in a storm. Many families find it easier when they stop thinking of an urn as “a product” and start thinking of it as “the tool that makes our plan doable.” If your plan is home display for now, you can choose for beauty and security. If your plan is a columbarium niche, measurements and shape matter. If your plan is scattering, you may want something designed for that purpose rather than a permanent display vessel.

For families who want a broad view of styles, materials, and capacities, Funeral.com’s collection of cremation urns for ashes is an easy place to start browsing without forcing a decision.

It also helps to know the language families use when they are really talking about sharing grief across households. A full-size urn is usually intended to hold all (or nearly all) of an adult’s ashes. Small cremation urns often hold a meaningful portion (or, in some cases, all ashes for a smaller adult—capacity matters more than labels). Keepsake urns are designed to hold a small portion of ashes so more than one person can keep a connection without conflict or pressure.

If your family expects to share ashes among siblings or children who live in different places, it may be kinder to build that “share plan” into the memorial rather than trying to solve it later. Funeral.com offers dedicated collections for small cremation urns and keepsake urns so you can compare options that are designed specifically for that purpose.

• Ask the funeral home for the ashes’ approximate cubic-inch volume and whether they will be returned in an inner bag.
• If a cemetery niche is involved, confirm the niche’s interior measurements before purchasing.
• If you are sharing, decide whether you want multiple urns now or a “main urn first, keepsakes later” approach.

Those three questions prevent most of the common stress points families encounter: buying something that doesn’t fit the niche, buying something that cannot be filled easily, or realizing too late that several family members expected to have a keepsake.

What about pet urns for ashes and pet memorial options?

Not every nursing home death story includes a pet, but many families do carry layered grief. Sometimes the family pet was part of the resident’s identity—a dog they talked about every day, a cat that was “waiting at home,” a companion animal that anchored a routine. And sometimes the pet’s death has already happened, leaving the family with ashes and unanswered decisions they postponed while caring for an aging parent.

If your family is also navigating pet loss, pet urns are not a minor concern; they are often one of the few tangible ways to honor a relationship that mattered deeply. Funeral.com’s collection of pet urns for ashes includes a wide range of styles and sizes, and the Journal guide pet urns for ashes planning guidance can help you choose capacity, material, and personalization without guesswork.

Families who want a memorial that visually reflects a companion’s likeness often explore pet figurine cremation urns, while families sharing pet ashes across households frequently find comfort in pet keepsake cremation urns. The goal is the same as with human memorials: a plan that supports real family dynamics, not an idealized version of grief.

Keeping ashes at home and making it feel safe and respectful

For many families, the most honest answer to what to do with ashes is “not yet.” Choosing keeping ashes at home—at least for a season—can give everyone time to make decisions without rushing. It can also be a meaningful choice in its own right, especially when a loved one’s presence at home is part of how the family grieves.

Still, keeping ashes at home comes with practical questions: where should the urn be placed, how do you protect it from pets or children, and how do you handle differing comfort levels among family members? Funeral.com’s guide on keeping ashes at home walks through safe placement, household considerations, and respectful routines that help the urn feel like a memorial rather than an awkward object.

When families feel stuck, it is often because they are trying to decide a “forever” plan while grief is still raw. A practical middle path is to create a home memorial now, then revisit permanent placement later—especially if travel, family conflict, or financial constraints make immediate decisions harder.

Beyond the urn: cremation jewelry, cremation necklaces, and water burial

Modern memorialization often includes more than one form of remembrance. A primary urn can serve as the home base, while a small keepsake supports day-to-day grief, travel, or sharing among relatives.

Cremation jewelry and cremation necklaces

Cremation jewelry is a discreet way to carry a tiny portion of ashes (or another memento) close to the body. For some people, it provides comfort in the quiet moments after the service—on the drive home, at work, in the first wave of ordinary life that feels anything but ordinary.

If you want to explore options gently, Funeral.com’s cremation jewelry collection includes necklaces, bracelets, and other keepsakes designed for ashes. Many families begin specifically with cremation necklaces, since a pendant can be worn close to the heart and removed easily when desired. For a practical explanation of how these pieces work (including filling and sealing), Funeral.com’s Cremation Jewelry 101 guide is a clear starting point.

Water burial and burial at sea

Some families feel drawn to the symbolism of a water burial—a return to the ocean, a lake, or a place tied to memory. If your plan involves the ocean, it is important to understand the legal framework so the ceremony can feel peaceful rather than stressful afterward. The U.S. Environmental Protection Agency explains that burials at sea under the Marine Protection, Research and Sanctuaries Act include requirements such as conducting the placement at least three nautical miles from shore and notifying the EPA within 30 days.

Families often appreciate having a simple planning reference for the ceremony itself. Funeral.com’s guide to water burial planning can help you think through timing, biodegradable urn considerations, and the small practical details that matter on the day.

One important nuance for families who are also memorializing a beloved animal: the EPA’s burial-at-sea guidance specifies that the federal general permit authorizes burial at sea of human remains only, not pet remains. If both losses are part of your family’s story, a respectful approach is to keep them separate—honor a person’s ashes according to the rules for human burial at sea, and honor a pet’s ashes with dedicated pet cremation urns at home or in another meaningful setting.

How much does cremation cost and what families should watch for

Cost questions can feel uncomfortable in grief, but they are part of responsible care for your family. If you are wondering how much does cremation cost, start by separating two different categories: direct cremation (cremation without a formal service through the provider) and cremation with a viewing and funeral service. Those structures are priced differently and include different line items.

For a credible national benchmark, the National Funeral Directors Association reports a national median cost of $6,280 for a funeral with viewing and cremation in 2023, compared with $8,300 for a funeral with viewing and burial. Local prices and packages vary widely, so the most practical approach is to compare what is included (transportation, permits, crematory fee, death certificates, and service options) rather than comparing only the headline number.

If you want a family-friendly breakdown of the most common fees and ways to avoid surprises, Funeral.com’s guide on how much does cremation cost is designed to help you read pricing with more confidence.

Bringing it together: a plan that respects grief

When someone dies in a nursing home, the immediate steps can feel procedural—pronouncement, phone calls, transportation—while your heart is somewhere else entirely. It may help to remember that you do not have to solve everything at once. A workable approach often looks like this: let the nursing home handle the medical process; choose a provider you trust to handle transportation and paperwork; and then make memorial decisions in stages.

For many families, that staged approach becomes a kind of quiet kindness. It leaves room for a primary urn and a home memorial now, keepsake urns or small cremation urns as sharing becomes clearer, and cremation jewelry if someone in the family needs a more personal, everyday connection. It also leaves room for a future decision—whether that is a cemetery placement, scattering, or water burial—made when grief has softened enough that you can think clearly.

If you are navigating these choices in the middle of a loss, you are not behind. You are doing what families have always done: taking love and turning it into care, one decision at a time.

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