Can you not just used the deleted memory-resident table. e.g:
IF OBJECT_ID(N'tempdb..#T', 'U') IS NOT NULL
DROP TABLE #T;
CREATE TABLE #T (Name VARCHAR(5), Description VARCHAR(20));
INSERT #T (Name, Description)
VALUES ('a', 'desca'), ('b', 'delete');
MERGE #T AS t
USING (VALUES ('a', 'newdesca'), ('c', 'insert')) AS m (Name, Description)
ON t.Name = m.Name
WHEN MATCHED THEN
UPDATE SET Description = m.Description
WHEN NOT MATCHED BY TARGET THEN
INSERT (Name, Description)
VALUES (m.Name, m.Description)
WHEN NOT MATCHED BY SOURCE THEN
DELETE
OUTPUT $Action, inserted.*, deleted.*;
IF OBJECT_ID(N'tempdb..#T', 'U') IS NOT NULL
DROP TABLE #T;
The output of this would be:
$Action | Name | Description | Name | Description
--------+-------+-------------+------+--------------
INSERT | c | insert | NULL | NULL
UPDATE | a | newdesca | a | desca
DELETE | NULL | NULL | b | delete
field BEFORE?