Updated: Apr 30, 2019
Humans have been supporting humans in dying and death for thousands of years, yet the role of the modern-day death doula is relatively new. Families look to end of life doulas to fill in the gap in supportive care that is non-medical in nature, to provide guidance or to be companions when they aren’t available. They are searching for information, advice and assistance with navigating medical care and reviewing options in order to make informed decisions with and for their loved ones. End of life doulas are heeding the call and gearing up to help people find meaning and make sense of life. Dying with a complete sense of inner peace is the ultimate goal.
End of Life Doula Care is Not a Trend
When we hear of new trends of any kind, we think, ‘here today – gone tomorrow’. The Greek derivative of “doula” is “female servant”. In modern times, birth doulas have been recognized for their contribution since the early 1970s. The death positive movement that began in the early 2000s, shone a spotlight on the need for a doula in dying and death. While the role of “doula” remains an unregulated occupation, there are organizations that offer education to prepare individuals to support others at end of life and training that underlines the necessity to develop core competencies and work within the parameters of a clearly defined scope of practice.
While we cannot minimize the tremendous advances in medical sciences, as a society, we have lost sight of what is required to die. Innovative medical interventions and seemingly miraculous life sustaining measures can sometimes give us the false sense that we may even avoid dying and death. When our loved one’s life is lengthened, even briefly, we are thankful for the knowledge and service from medical care providers at every level. We are grateful when science and technology; equipment, tests, procedures and medicine afford us or our loved ones the opportunity to experience more life. We tend to rely wholly on knowledgeable, cutting edge medical leaders, for their ability to minimize suffering and decrease physical pain. We place all our hope in their hands and in doing so delay or avoid the emotional and spiritual suffering that is an essential part of dying and death. This reduces the opportunity for transformation and healing for the dying person and the people at his/her side.
A century ago, the industrialization of funeral homes kept death behind doors, shrouded in mystery, causing in increased fear. Within a decade or two the emergence of public hospitals meant that people no longer spent their dying days at home being cared for by loved ones. The effect over time, has left a gap in the collective hearts of humanity. Individuals and families require information, education and support to better care for their overall needs, within the medical model of care and in the community. End of Life Doulas are the “key to the door,” guiding and supporting people along the path toward the end of their human journey. For many people, finding the loving presence of a doula is the most valuable piece of support they need (especially for those who don’t have family, or loved ones aren’t available, or simply need human connection that doesn’t exist within their support group). Every person deserves to have someone available to meet their emotional and spiritual needs. No person should die alone.
Birth and Death Transitions are Similar
The role of the birth doula has evolved tremendously in the past 50 years. A doula is responsible for educating and providing evidence-based information and resources so mom-to-be may decide which approach is best for her. A birthing mom wants to know what to expect during each trimester of pregnancy, during the days leading up to labor/delivery and immediately following birth. The presence of a doula during pregnancy encourages mom-to-be to take time to plan and prepare so that the fear associated with labor can be minimized. Once the expecting mom feels ready to put a plan into place that best fits with her values and choices, the inter-disciplinary team endeavors to ensure that her needs and desires are brought to fruition, with the goal of a safe and positive birth experience. She collaborates with her care team which includes her doula, a doctor or midwife, nurses/midwife assistant, her partner, other designated support people and other care providers as necessary. During labor and delivery, the doula’s role is to provide compassionate, respectful, nurturing care to the mother and her partner. In the same way, dying and death require planning and preparation and along with the continuous nurturing support and presence that a doula provides, the associated fear is minimized.
The Circle – Birth to Death
The similarities between the role of the birth and death doula are evident. The commonality – those who choose to become a doula are willing participants during the most important life transitions of other humans, in ways that are deeply fulfilling. They choose to be with pregnancy and birth or dying and death because for many, it’s an instinctive human response. Doulas find joy in participating in the sacredness that is inherit in each transition. Many have a craving or yearning to be ‘more’ in their community, and to experience life in a way that gives them a sense of purpose and fulfillment. Although it’s taken more than half a century, Increasingly, birth doulas are gaining recognition for their presence at birth, which is paving the way for death doulas.
Death Phobia is a Real Thing
As a society, we focus on living healthfully and value a long and prosperous existence. While we turn our attention toward finding ways to be happy and healthy, we avoid aging and ignore thoughts of dying and death. We don’t want to talk about death, and we rely heavily on our medical infrastructure to take every measure to sustain life at any cost, attempting to convince ourselves that death may even be avoidable. The ending of life has become a legitimate fear, for many.
The Beginning of a New Era for End of Life Doulas
End of Life doulas are helping our culture embrace dying and death. Fears are alleviated when we feel valued, heard and supported, and when we have autonomy and personal control over situations that are often highly emotional. Having open, honest and frequent conversations marks the beginning of reducing death fear and bringing death care back to the arms of families.
Doulas share information about options, rights and choices that may be suitable to help individuals plan and prepare for a positive experience during dying and death. The funeral which we have come to know as “traditional” in North America is just one way to honor our loved ones’ lives. There are many ritualistic, celebratory and truly meaningful ways to honour life by drawing on individuality, personal and family values and culture. Many are low cost and friendly to our ecology (and socially acceptable). The process of life review and legacy work creates opportunities of connection and joy during the dying and death transitions and more importantly can enlighten us about our purpose and life path.
Individuals, families and communities need more support at home with the care of dying loved ones. The way we die has a lasting effect on families who often grapple with loss and experience grief that can be traumatizing. The ripple effect makes waves in other areas of our lives, negatively impacting our ability for adequate self care. Planning and preparation for dying and death eases our minds, reduces stress and allows us to live life more fully. When the end of life transition arrives, we are confident about the path ahead and our family is ready to support us. Those who need to be, are readily available and present during dying and death. This is how we find joy and transformation in sadness and sorrow.
As a society, we require a shift in perspective that includes dying and death processes as part of life. These are natural processes that provide opportunities for humans to be fulfilled intrinsically while they care for another human. Accompanying a person during his/her sacred life transition to gently support the process calls for nurturance, compassion and respect. Like pregnancy is to birth, dying is to death, the time period for dying is simply less defined. Every person deserves the honor of dying in peace, with dignity and grace. Death doulas recognize the need and are answering a call to teach, guide and support others toward reducing or eliminating death related fear and encourage us to find joy, meaning and personal transformation while transitioning through to end of life.