Rigor Mortis, Arranging the Mouth, and an Environment That Slows the Changes in the Body: Introduction to Angel Care (2)
In this free three-part series, we explain the content of the Angel Care Seminar that we hold for medical and care providers. Part 2 covers rigor mortis, the topic that draws the most questions in the seminar, how to arrange the mouth when it falls open, and how to create an environment that slows the changes in the body.
As we explained in Part 1, many changes in the body cannot be stopped once they have begun. Everything in this part is something you can do before the changes begin.
The timing and strength of rigor mortis cannot be generalized
Rigor mortis is said to be related to lactic acid in the muscles, but it is not clearly known how strongly or for how long it appears in which people. What is commonly said today is that the amount of muscle changes the strength of stiffening and when it begins and ends. Even among older people, however, it differs from person to person, and in practice it cannot be generalized.
For this reason, trying to prevent stiffening in advance, or waiting for it to pass, is not very realistic.
How stiffening passes: it is not like a tightly tied string loosening; it passes as the muscle cells break down. Stiffening that passes is therefore also a sign that the changes in the body are progressing
Seasonal differences: stiffening tends to pass sooner in summer than in winter
Order of stiffening: stiffening begins from the top of the body, so the jaw becomes stiff relatively early
Arranging the mouth when it falls open
A common question is, “What should we do for a person whose mouth falls wide open after death?” If stiffening has not yet begun, closing the mouth gives a better impression when the family sees the person.
The basic method: roll up a towel and place it under the chin to keep the mouth closed. This method, used in many workplaces, is fine
A little extra: lifting the whole jawbone upward brings the face closer to its natural shape. Rather than just placing the towel under the chin, place it as if wrapping it around the neck
On the other hand, when it is noticed late that breathing has stopped — in a facility or at home, for example — stiffening may already have begun. There may also be cases where not only the mouth but also the hands have already stiffened. It is best not to force any part where stiffening has begun, and to leave it to the funeral company.
Nokanshi (professional encoffiners) sometimes use an adhesive made for the deceased to close the mouth. It is a difficult procedure, so there is no need to force it on site.
Why we do not recommend chin bands
Some providers use a rubber band with frills (a chin band) to keep the mouth closed. Some may have received them from funeral companies. Basically, however, we do not recommend these bands.
If you put a rubber band around your arm and then take it off, the mark stays for a while. In a living body, it fades naturally with time. The body of a person who has died, however, does not recover. When a rubber band is pulled tight, the wrinkles and marks hardly disappear, and it is no exaggeration to say that this is one of the hardest points for nokanshi to deal with. To close the mouth, we recommend the towel method described above.
To slow the changes in the body: room temperature and drying
Room temperature and drying are very important in slowing the changes in the body. Based on cases that actually happened at funeral companies, here are points to watch:
Forgetting the air conditioning in summer: in some facilities, the person is moved to a room for the deceased. When the whole building is air-conditioned, you may not notice the heat when you open the door of a room without air conditioning, and forget to turn on the cooling
Direct sunlight: opening the curtains because the room feels dark, out of consideration for the family, can let direct sunlight fall on the body. A living person would turn over because of the heat, but a person who has died cannot move, so the sunlight keeps shining on the body and the skin turns red. This needs attention not only in summer
Heating devices in winter: some bed mattresses have a warming function. When a futon is laid on the floor, an electric carpet or an electric blanket may be in use. If these are left on, the changes in the body speed up greatly. This applies at home as well as in facilities
Leaving windows open: if you open a window on a fine, warm day to let in fresh air, insects can come in from outside and get into the body. There have been cases where large numbers of insects appeared
Pets: at home, a dog or cat may lick the face of the deceased. A cat’s tongue in particular is rough, so the weakened skin can peel. We understand the family’s feelings, but a word of advice to keep pets from licking the body is reassuring
All of these can be prevented with a little attention. Keep the room temperature low, avoid direct sunlight and warming devices, and keep the windows closed. This alone helps protect how the person will look until the farewell.
Key points of Part 2
The strength and timing of rigor mortis vary with factors such as the amount of muscle and cannot be generalized. Preventing stiffening or waiting for it to pass is not realistic.
Stiffening passes as cells break down, and tends to pass sooner in summer. It begins from the top, so the jaw stiffens early.
Close the mouth before stiffening. Place a towel under the chin as if wrapping it around the neck, lifting the whole jawbone. Do not force parts that have stiffened; leave them to the funeral company.
We do not recommend rubber chin bands, because they easily leave wrinkles and marks.
Room temperature and drying matter. Watch for forgotten air conditioning, direct sunlight, heating devices, open windows and pets.
In Part 3, we introduce how funeral companies cool the body, and points to watch in cotton packing, dressing, shaving, preparing for leakage of body fluids, and makeup.
Introduction to Angel Care (three parts)
Part 1: How does the body change after death? Early changes and why body temperature and drying matter
Part 2: Rigor mortis and arranging the mouth, and creating an environment that slows the changes (this article)
Part 3: How to cool the body, and points to watch in cotton packing, dressing, shaving and makeup
Read next: Angel Care in Practice (eight parts, published in Japanese on note)
Part 3: From confirmation of death to laying out: why the body is arranged before rigor mortis, and changes in the body after death (in Japanese): care to prioritize before stiffening begins, and time guidelines for rigor mortis and livor mortis
Part 4: The 10 basic steps (part one): preparation, oral care, closing the mouth and eyes, medical devices and the bed bath (in Japanese): the first half of the basic procedure, including closing the mouth and eyes
For an overview in English, see our digest, Angel Care in Practice: A Complete Guide.
Related training textbooks (in Japanese)
Training Textbook for Care Facility Placement Consultants, Volume 3: Advanced: basics of the body and medical procedures, major illnesses, hospitals and discharge support, end-of-life and palliative care
Senior End-of-Life Planning Business: Comprehensive Training Textbook, Vol. 9: basics of long-term care insurance, senior facilities and medical care (including end-of-life care)
Senior End-of-Life Planning Business: Comprehensive Training Textbook, Vol. 6: basics of funerals, graves, Buddhist altars and farewell gatherings
Related articles
The original Japanese version of this article is published on note as part of our free three-part series “Introduction to Angel Care” (read it on note, in Japanese). On note, it is collected with our eight-part practical series in the magazine “Angel Care in Practice (11 parts)” (in Japanese).
This article summarizes general approaches based on Next Co., Ltd.’s Angel Care Seminar. In actual care, follow doctors’ instructions, your facility’s procedures, and the latest laws and government guidelines. For training requests or inquiries, please use our contact form.
This is an English translation of a column originally published in Japanese by Next Co., Ltd.
About Next Co., Ltd. We support companies in Japan’s senior care and end-of-life planning (shukatsu) market through research, business development and training. Our English textbook, Senior End-of-Life Planning Textbook, explains the market from the big picture down to day-to-day practice, including senior housing and care facility placement consulting. See the English edition | Buy on Gumroad | Contact us
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