What is a ‘Death Doula’?
You may have heard the term “death doula” in recent years and intuitively understood that it was a growing profession of dedicated people who wanted to help the dying and their families with their end-of-life care. When women began to use birth doulas and midwives, their advocacy helped make changes in how hospitals dealt with pregnancy and birth. Similarly, “death doulas” work in the midst of a changing landscape around death care. But as a relatively new concept (though admittedly with ancient roots), there can be some misconceptions about what the role does and does not do for clients.
We reached out to Portland’s Evening Star End-of-Life Doula Services’ Christine Borchert to learn more about what support looks like for patients and families at life’s end.
What does the word doula mean?
The word “doula” is Greek in origin. We use it in the U.S. to mean “one who serves.” The terms death doula and end-of-life doula are interchangeable.
What does a ‘doula’ do for patients and families?
End-of-life doulas use education, coaching and role-modeling to bring a sense of empowerment to the experiences of one’s final months, weeks and days.
For example, we might coach the family on the value of creating sacred space. To what degree can we remove the trappings of “medical implements” and bring in scents, sounds and other sense engaging items that reflect the person who is dying. No one wants to stare at a dresser piled high with briefs, Chux (waterproof pads) and pill bottles once they become primarily bed-ridden.
What is the most common misunderstanding about your profession?
People often think we are only available during the active dying period. People also often ask if what we do is “like hospice.” We are a complement to hospice. Engaging with an end-of-life doula at diagnosis (often well before entering hospice) allows you to have one provider that knows your values through your entire medical journey. Your medical team may shift, but your end-of-life doula will be with you through every change.
What is a vigil plan?
A vigil plan is a blueprint or list of things the dying person would like their friends, family and care providers to think about before they enter the room. The last days and hours are precious. Energy is at a premium.
What backgrounds bring people to work in your field?
Though they come from many backgrounds, we’re seeing a common thread in the end-of-life doula seekers we meet with each month. They’ve had an experience where they felt very alive while supporting someone who is dying. For those of us craving true human connection, learning how to be with the dying informs how we live each day. At a fundamental level, the path to a better death relies on living a connected, open, in-the-moment, life. Some get to have time to prepare for that final breath. Others don’t. How challenging the after-period is for those left behind is informed by how you live RIGHT NOW.
How can your doulas help organize us to be ready for death?
As educators, we’ll be checking in with you emotionally and organizationally at every visit. Once we know what’s important to you we can support you in preparation. Want to die at home? Curious about a living memorial? Want to limit relational stress between loved ones?
We help you organize by: Building trust, exploring immediate concerns, identifying ways to leave a legacy and creating an end-of-life plan. Education, empowerment and stress relief all lead to a dying experience that has room for love, living in the moment, and healing.
Can I use a “Death Doula” while in hospice care?
Yes. The two services are not the same, though both are focused on providing comfort at life’s end. End-of-life doulas support emotional health by guiding the dying in the creation of a values driven vigil plan, bringing focus to legacy work, educating about choices and assistance creating the support team. Hospice help will be more centered on the medical care of your loved one, with access to social workers, chaplains and twice weekly bath aids.
If you are interested in learning more about Evening Star, you can find more information on the group’s website. Evening Star also hosts regular end-of-life planning sessions and other informational talks.
Photo by Di Maitland