Over the past decades, death has increasingly become a medical and legal event. For most of human history, this has not been the case. Death, until very recently, was held to be a spiritual, community, and family affair with the dying person being cared for in the home, and visited and tended to by friends and family. Home viewings and funerals were the norms. Over time, the death process has increasingly become removed from everyday life. As this separation has grown, so have fear and anxiety regarding death and dying. Rather than being viewed as an integrated element of the life cycle, our culture tends to view death as something unnatural, to be feared and avoided. Since are all going to die at some point, this attitude is counterproductive, to say the least.
The idea of a Death Doula is modeled on the Birth Doula. Just as a Birth Doula is charged with holding a calm, peaceful, and sacred space for the mother and the new life entering the world, so the Death Doula supports the transition of a someone leaving the world, in the months leading up to death, during the dying process itself, and in the immediate aftermath of the death. In the midst of the very important medical work of pain and symptom management, whether offered through hospice or a palliative care agency, the Death Doula serves as a reminder that dying is a key aspect of living and can reflect how someone has lived life and impacted those around them. It is a spiritual and sacred event that can and should be met with a sense of awe and gratitude.
A Death Doula typically meets with a terminally ill person in the weeks or months prior to death, although this is not always the case. The Doula encourages the dying person to reflect on his or her life and to identify ways in which they would like to be remembered. These discussions may result in a “legacy project,” such as a blog, scrapbook, craft, or video. It may result in a list of conversations or tasks that need to take place in order to allow a more peaceful passing.
The second task of a Death Doula is helping the dying person and their caregiver(s) create a “Vigil Plan.” This plan may identify the people that the dying person wishes to be in attendance at the time of the last breath, and can include preferences as to music, readings, fragrances, candles, and so forth. Often the Vigil Plan also details preferences for the moments after death, for example, the reciting of prayer or the washing of the feet or body. Having this plan in place can offer tremendous support to both the dying person and the caregiver during the last moments of life, which can be unsettling or even a bit frightening. Although it cannot always be the case, the Death Doula is present during the vigil time and supports the dying person’s final wishes as outlined in the Vigil Plan.
Finally, a Death Doula meets with the primary caregiver(s) two or three months after the death has occurred to discuss those final moments of the patient’s life. This meeting is not meant to be a grief or bereavement session, but instead a chance to reflect on the vigil itself, and how the dying process was able to honor the life that was lived.
The Death Doula plays a key role, therefore, in allowing people to talk about death, to imagine a “good death” for themselves, and to relieve some of the uncomfortable feelings that most of us have when contemplating our own deaths (spoiler alert – unavoidable!) or the deaths of those we love. The Death Doula encourages us to remember that death is more than a medical event and to view death as a scared opportunity to explore the meaning of life.
For more information, or to contact a Death Doula, please visit www.INELDA.org.