What is a Death Doula?
We often punctuate the significant events in our lives by ritual, preparation, and acknowledgement. However, in western society this is often not the case with death. We avoid the topic for as long as possible. We pretend it will not happen, although this is one part of life of which we can all be absolutely confident.
In previous generations, birth and death took place surrounded by the women of the household. The witnessing and personal involvement in these touchstones of life kept us rooted in the reality of our essential transient nature. The major differentiating attribute of humans compared to other forms of life is that we have an awareness of our own mortality.
There was a massive change in American society in the care of the dead during the Civil War because of the huge number of bodies that required preservation and transport. This resulted in the mortuary business, the practice of embalming, and the use of funeral parlours. At the end of the war, the popularity of this trend continued. Whereas death care had been a duty fulfilled at home, it became a task that was outsourced to professionals.
The relocation of death, together with after death care, resulted in a disarticulation of our understanding and ability to face death and dying. It was no longer an event witnessed by the family at home, but in large institutions such as hospitals. Ritual bathing, dressing and displaying the body in the front parlour became less acceptable.
We are going through a period where the gradual reawakening of this ancient knowledge is taking place and death is beginning to once again appear as a rite of passage we can discuss and plan and consider ahead of time. We are also finding parts of society discover that they can become more involved in the decisions of end-of-life care, such as where it takes place and how and who carried it out.
Sacred passage midwives, also known as Death Doulas/End of life Doula, are slowly emerging as a role in the community.
A client can choose to have a compassionate, caring presence dedicated to bringing the sacred back into this time and help midwife the soul out of the physical plane. A conscious holistic approach to end-of-life care can help the client take the opportunity to re-evaluate priorities and achievements and approach death with more acceptance and less fear.
Doulas may work in many situations and at different stages of end of life. In all instances, however, they bring with them the skills of attentive listening, questioning, and compassion that enable them to help the client map out an end-of-life plan. They are there to help enable this and to accompany the client on their journey.
During this time, the doula will coach the client and help them consider different aspects of their life. These seven elements of end-of-life care include physical, mental, spiritual, emotional, legacy, after death care and memorial wishes of the client. These opinions are fluid and may change with time. The important factor is the subject is in discussion.
The doula will work to illuminate what, in the client's mind, would represent an ideal passing.
Their questioning may cover such topics as:
Where would you like to be when you die, at home, hospital, hospice?
Who would you like with you in the room?
Would you like to be alone time?
What items are important to you for physical comfort?
Would you like a religious component to the vigil?
These are just some examples. In taking time to address these questions, and many more, the client becomes deeply comfortable with their own wishes. They explore the sacred mystery of end of life and can approach it with less fear and confusion.
The doula acts as a source of support and knowledge for the family and client and can play a role as an intermediary and advocate for the client and events taking place. She can help in supporting the care team and advocating for the client, but not involving any medical treatment or decisions.
She may help the family at varying stages of illness or fragility. Sometimes, this can be when a loved one has received a terminal diagnosis and she can guide and assist the client and family in navigating this period of change and stress. The doula can help by accompanying the client to appointments and treatment, organizing the treatment timetable, and putting together a self-care program. She can introduce the 7 elements of care.
Families may get in contact when a loved one is nearing the end of their journey or after a prolonged stay in hospice care. This is a very intense and exhausting time for everyone. The doula is there to “hold the space” for the loved one and to bring a grounding, healing, compassionate presence. The family finds relief to have someone totally focused on the dying person who can be attentive to all their needs. This gives the family space and permission to be truly present.
A fundamental tenet of a doula’s practice is that no-one dies alone. The period of the last couple of days or hours leading up to death the vigil. This can vary in time. If it continues for a longer period, then a doula team can work together to ensure compassionate, caring, holistic cover.
As the concept of the fundamental connection between life, death, and dying reawakens in society, it becomes more mainstream to approach this sacred transition time with love, care, planning and conscious attention.
The doula brings different healing modalities when she cares for a client. These may include such practices as gentle massage, healing touch, essential oils, guided meditation, music, candles, incense, clearing spaces with sage, and singing bowls. Some doulas focus on these and others have a particular specialty.
A doula may also offer support after death. They may aid in the ritual washing, anointing, and shrouding of the body. They may also help with burial and memorial planning. If this is the case, then the doula and the client will have discussed these wishes while going through the 7 elements of care. There are now many choices regarding after death care. Some clients choose traditional burial, entombment, and/or embalming. Others choose cremation, green burial, or a combination. The doula can act as an intermediary and guide between the family and the representatives of these services.
Essentially, the more discussion and preparation time a doula has with her client, the more confident and at peace they feel. They can share their thoughts, concerns, worries and wishes.
For the doula, the midwife of the soul, it is truly a sacred honor to help rekindle the message that death is a beautiful and mysterious part of life and to help a soul approach this time with loving care.
“For life and death are one, even as the river and the sea are one”
Gibran Khalil