3 Ways Death Doulas Help Navigate the End-of-Life (That Aren’t Sitting by the Bedside)
Trained death doulas offer their skills on a colorful spectrum of end-of-life care. But often, when people hear the title, “death doula,” they assume that most of a doula’s work is conducted by the bedside of the dying person. Maybe they envision the doula holding the person’s hand, keeping a quiet vigil. Or perhaps they imagine the doula gently and efficiently navigating the turbulent emotions that arise for the family once the death occurs.
While sitting bedside vigil is profound and crucial work, this is merely one of many types of services that a death doula can offer. It is crucial to correct the claim that doulas are only useful at the moment of death, because it implies that a death doula does their greatest work at the eleventh hour.
And this is simply not true. The reality is that working with a death doula – long before death, or long after a death – can be a healing and highly beneficial experience.
Back to basics: what is a death doula?
A death doula is defined as a non-medical person who provides trained logistical, emotional, and/or spiritual support before, during, and/or after dying. A death doula can be hired to support the individual who is facing the end of their life, or they might be hired by the family and caregivers to offer additional support and guidance during what is often a painful, incredibly stressful time.
There is nothing in this description that restricts death doulas to sitting bedside care. Instead, the services of doulas run a gamut as varied as the doulas who serve. Some doulas choose to offer a full suite of support, while others opt to focus on one key area.
Death doulas can serve individuals and families long before death…or even a terminal illness!
When people assume that death doulas only help at the hours right before death, they are missing out on one of the most valuable components of doula service: time. If a doula is hired early on, the individual has the luxury of time to cultivate a relationship with the doula, along with the ability to devote weeks or months to exploring mortality or crafting meaningful legacy projects.
Death doulas are not time-bound in the same way as hospice workers. For example, a terminal patient can only receive hospice benefits when a doctor determines that they have six months or less to live.
Unfortunately, many patients receive the benefits of hospice care far less than that. Most sources conclude that an average length of hospice stay is around 3 months, but the median length of stay is a meager 3 weeks. By contrast, an individual can contact a death doula at any point in their life, even if they have not received a terminal diagnosis.
How does a death doula help?
Death Doula Lauren Hunter Smith of Kentucky discusses end of life wishes with her perfectly healthy Clients.
Pre-planning
One of the ways a death doula can support individuals facing the end of life is by helping them “get their affairs in order.” This could encompass many tasks, such as planning a funeral, preparing their advance care directives, or writing an obituary. A doula could assist with compiling a place for important documents, passwords for bank accounts, and other critical credentials. Completing these tasks before death is a gift to family who are often left to wade through the logistics of closing down a life while navigating their heart-wrenching grief. These logistics become a heavy burden when grief is the most raw.
Often, pre-planning entails conversations between the doula, the dying individual, and the family involved. The doula is a resource to provide end-of-life education or navigate the complicated landscape of hospice care.
End-of-life doula Julie of Wisconsin, USa works with james in recording his life story as part of Adoray Home Health and hospice’s doula services.
Legacy work
Legacy work refers to documenting the legacy – or the story – of an individual’s life. Legacy projects are a creative outlet that can take almost any form.
People may choose to write a short book with their life stories or compile a scrapbook of memories. Some families create cookbooks from the recipes of a beloved grandmother. A terminal father might pen a collection of special letters for his children, each with personalized wisdom tailored to the recipient. Crafting a highly customized eulogy or obituary can also be considered legacy work.
Post-death support
There are a whole host of things that must be considered in the aftermath of death. If the deceased took care of their end-of-life planning before they died, then post-death support would not likely involve any logistics. It would instead be focused on other areas, such as grief support.
But even if the deceased was diligent about their end-of-life planning, there are still other tasks that can come into play if large estates are involved, or if the deceased had a large collection of belongings. A death doula might offer a service called Swedish Death Cleaning, where they help the family sort through and pare down the deceased’s belongings.
Death doulas are knowledgeable companions before, during, and after death.
These ideas barely cover all the areas where a death doula might help, at or long before the end of life. Some doulas choose to niche their services even more, offering modalities such as reiki or massage therapy to enrich their services.
This is where we return to the scenario posed at the beginning of this piece. When you hear the title, “death doula,” what do you see? Yes, you may very well imagine a caring individual sitting by the bedside of someone in the final hours of life. But hopefully now, your vision has expanded to include doulas who sit with clients to collaborate on their end-of-life wishes; who login to Zoom calls to provide grief support; who facilitate conversations with perfectly healthy people in their community on all things death and dying.
A death doula walks the space between living and dying – and that space can be vast.
It’s a myth that death doulas only offer their support during the eleventh hour of life. It’s a fact that death doulas fluidly move wherever they are called, serving at the threshold of life and death along its many stops before the final moment of dying.
Niki DiGaetano is a death doula specializing in grief support and legacy projects. She is also a freelance writer who puts her writing skill to use by helping clients pen their life stories. Based in Salt Lake City, Utah, she provides support locally in-person and virtually worldwide. When she isn't doula-ing or writing, you can find her hiking through the mountains or falling off the bouldering wall at her local climbing gym. To work with Niki or to request support, visit her website at www.numbered-days.com.
