Do I need a death doula?

I am excited to announce that I am registered for death doula training next month. 

​This is a relatively new term and career that is really just beginning to be heard in the mainstream.  Most people have heard of a birth doula and have a general idea what they do for new mothers and the support they provide for families.  

​A death doula is not dissimilar, and of course the name was borrowed from them.  A death doula provides support to the dying and their family.  If your first thought is that no stranger can help and you don't want a stranger in the way during this very intimate time, I totally understand.  If your first thought is being thankful that there are people out there to help with such a tumultuous time in your family's lives, I totally understand.  

​What do they do?  You certainly can't make a decision about whether you need a death doula if you are not sure what they do.  In the simplest terms an end-of-life doula, or death midwife helps to make the end of life peaceful.  They help create a legacy project and work through life meaning.  These two things are inextricably connected but have different meanings.  The legacy project is for the surviving family and the life meaning work is for the dying person.  There is also planning the vigil and helping with funeral plans, as well as being a calming presence for the family at the very end.  

​A legacy project could be a collage, a series of videos, letters, a journal, or anything else you can think of, the possibilities are literally endless.  Where as life meaning work may have a written component, it is more so work done by the dying person to help them reflect on their life and the impact they have left behind in the world and their families.  

​Why chose a doula to do this, especially since it sounds like something someone who has known the dying should be doing.  A death doula comes in with no preconceived notions of the dying person, they can listen to the stories from the dying person and the family without years of love and frustration coloring the story.  

​Sometimes having a third party listen they can infer a different perspective than those that have been in a relationship for years.  The boundaries of child, spouse, parent, etc. are hard to overcome when faced with end-of-life.  The emotions of losing your loved one can blur the past and make it hard to hear the true requests of the dying person.  Your role all these years is going to change forever and your own emotions are going to color how you hear what your loved one needs and wants.  At the end of life people are often coming to grips with what they see as their failures during life and as you watch your loved one deteriorate you want only to soothe and comfort.  Its hard to listen to them talk of how they wished they had done something different and want to explore what they see as a failure.  Someone who is removed can more easily allow this to happen and help them explore these memories and either address it or come to terms with the decisions they made at the time.  

​The legacy project can help make the family and the loved one feel like although they are dying (or losing a loved one) they are not excluded from the family after their death.   A project can look like anything, if the loved one was the family cook it can be a collection of beloved recipes with stories intermixed in.  It can be a living garden or a series of emails.  It is created by the family and the dying person so that the family has something to reflect upon after the death of their loved one.  

​The vigil starts when the person starts actively dying, this will be discussed when they are able to.  Does the dying person want the sound of their playing grandchildren in the background, Gregorian chants, or their favorite classical music?  Do they want the room flooded with natural light or candlelight?  Do they want to be dressed formally or in a favorite outfit?  The doula is there at the end to check in during active dying to be sure the family is handling the end well, active dying can look scary sometimes and since we have mostly taken dying away from the home most people have not seen anyone die before.  The infamous death rattle can cause anxiety for the family who have never heard it before.  The doula is there to explain when things are normal and when there might be a need for medical intervention.  70% of people would like to die at home and only 30% of people actually die at home.  Inexperience of seeing the active dying process can cause people to call for help during active dying instead of letting the person go peacefully at home.  

​So, do you need a death doula?  Only you and your loved one can determine that, but now that you know what they do, you can make an informed decision.