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Senility and death certification

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • Old age, senility

    • old age should only be given as the sole cause of death in very limited circumstances. These are that:
      • You have personally cared for the deceased over a long period (years, or many months)
      • You have observed a gradual decline in your patient's general health and functioning
      • You are not aware of any identifiable disease or injury that contributed to the death
      • You are certain that there is no reason that the death should be reported to the coroner

    • You should bear in mind that coroners, crematorium referees, registrars and organisations that regulate standards in health and social care, may ask you to support your statement with information from the patient's medical records and any investigations that might have a bearing on the cause of death. You should also be aware that the patient's family may not regard old age as an adequate explanation for their relative's death and may request further investigation. It is unlikely that patients would be admitted to an acute hospital if they had no apparent disease or injury. It follows that deaths in acute hospitals are unlikely to fulfil the conditions above. You can specify old age as the underlying cause of death, but you should also mention in part one or part two, as appropriate, any medical or surgical conditions that may have contributed to the death.
      • Examples:
        • Ia. Pathological fractures of femoral neck and thoracic vertebrae
        • Ib. Severe osteoporosis
        • Ic. Old age
        • II. Fibrosing alveolitis

        • Ia. Old age II. Non-insulin dependent diabetes mellitus, essential hypertension and diverticular disease

        • Ia. Hypostatic pneumonia
        • Ib. Dementia
        • Ic. Old age

    • how old is 'old age'?
      • when the Chief Medical Statistician first advised, in 1985, that old age or senility would be accepted as the sole cause of death in some circumstances, he recommended a lower age limit of 70 years. There is no statutory basis for this limit and some crematorium referees have set higher limits for accepting applications for cremation when the only cause of death is old age
      • some coroners ask registrars to report to them all deaths under the age of 75 or 80, or at any age, certified as due to old age alone. The average life expectancy at birth for men is now about 76 years and for women it is 80 years
      • after much discussion, the ONS Death Certification Advisory Group has recommended that deaths certified as due to old age or senility alone should be referred to the coroner unless the deceased was aged 80 or older, the conditions listed above are all fulfilled and there is no other reason that the death should be referred.


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