END-OF-LIFE DOULA SERVICES
Although the concept of a doula is usually associated with those assisting birthing women, this generation has witnessed an exponential growth of individuals trained in the emotional support of dying patients. End-of-life doulas (sometimes called death midwives) work in tandem with those offering medical care for the client, focusing on tending to emotional, spiritual, physical, and practical needs of the dying.
This in-person service provides ongoing companionship for the patient, while also supporting the needs of loved ones. In working with individuals and families navigating the end-of-life, my ongoing services may include the following:
- Assisting with the fulfillment of final wishes
- Supporting the completion of advance directives
- Planning for the death vigil
- Creating legacy projects for the client
- Offering support during the vigil
- Leading rituals and ceremonies
- Delivering respite support
- Caring for the deceased’s body
- Facilitating funeral or memorial planning
- Helping family members process early grief
Anyone who is at the end stages of life and those focusing on a life-threatening illness or are in hospice care are appropriate individuals for this service. Doula services are also available for those concerned about pre-planning for some future point when care may be needed.
An end-of-life doula serves as a complement to traditional hospice care. Whereas hospice workers tend to focus on medical-related issues around dying, a doula will concentrate on emotional and spiritual needs of the individual. Serving one patient at a time, the doula provides a special continuity of care.
Depending upon the stage at which the client is in the dying process, initial pre-planned appointments are made for routine visits, in consultation with the family. As an individual enters the end-stage processes, I will offer as much time as possible to be with the person until the last breath.
In the early phases of work, compassionate, active listening will help the dying person reflect on their life—accomplishments, lessons, relationships, regrets, and so on. The goal is to help the individual have a sense of completion about their life. As energy and desire allow, the doula may facilitate addressing “unfinished business.” Should the patient be interested and able, this search for meaning can yield a “legacy project,” such as created a memory book of letters to family members. These projects are not only meaningful for the dying person, but a treasured object for family members after the loved one’s death.
Vigil planning for one’s last days takes place as the dying person desires. In a time when the patient has lost much or all control in life, s/he is able to make determinations about what final days will look like. For example, one can make determinations about the location and physical surroundings of the dying process, therapeutic modalities for physical relief (Reiki, guided imagery, aromatherapy, etc.), as well as how the dying person wishes to interact with visitors. Vigil planning may include expressed wishes about any rituals performed immediately after death, too.
The vigil begins when it is clear that the person is in the final stages of the dying process. At which point, as the doula, I hold space for the dying person, honoring their plan for a “good death,” as determined by the decisions made in the planning process. It is my job to be alongside the family, with reverence, service, and love. It is important to offer family members as much insight and comfort around the physical process that is taking place.
Depending upon plans made with the deceased and family, a ritual may be performed to mark the sacred nature of the transition. The doula will hold space immediately after death, for the family to begin processing grief—families need not succumb to the impulse to immediately call 911 for a removal of the body; rather, taking in the sanctity of the event in a personal manner is often helpful. Ultimately, I am honored to assist the family in the preparation for a funeral or memorial if they wish.
I serve in home, assisted living, in-patient hospice, nursing homes, and hospital settings. I am willing to be in any location where my services are needed.
No. I work with one patient until the time of death, providing continuity of care should the patient move from one setting to another.
Although the primary focus of being a death midwife is supporting a patient’s transition, I am available to help loved ones should they experience a sudden, unexpected death, including a stillborn delivery or accident, for example.
While I am based in Manhattan and perform most of my work in the metro area, I am certainly willing to work with clients in the tri-state area. Likewise, I am available for online (Zoom) consultations for those beyond the region.
As an end-of-life doula, I meet with families three to six weeks after the death, to help in reprocessing the dying experience. It is at that point that many of the initial support systems, following death, start to wane. The hope is that the pause may allow family members to recollect on the moving, beautiful, and sacred moments of the dying process and what it meant to them.