by Jo Eckler
Over the past few decades, it has become increasingly common to hear about pregnant women using the services of a birth doula or midwife to help them through the journey of childbirth. Now a group of compassionate professionals have arisen to provide similar support at the other end of life: death and mourning doulas.
Sometimes known as death midwives, these individuals offer a varying range of assistance to those that are dying, as well as to their loved ones. It is uncertain exactly when this movement began or exactly how many death doulas there are in the United States. Although the concept of hospice care has been gaining momentum since the 1970s, there are still gaps in care that are not always possible to cover with hospice alone.
Death and mourning doulas hope to fill in those gaps. Some offer help before a death is known to be imminent by helping families have conversations about final wishes, medical decision-making and funeral arrangements, thus easing worry and stress for the survivors.
Doulas can help the dying individual figure out what they would like to say or do with the remaining time in life and then assist the person in carrying that out. This could be anything from writing a memoir or calling an estranged relative to simply watching the sunset.
A doula’s services may focus on the time that a person is actively dying, holding vigil with them and supporting the family. If a death doula has a background in a particular healing art, such as massage, aromatherapy or reiki, they may offer that as another form of support. At times techniques such as conscious breathing, guided visualization or music may be employed to help with anxiety or fears.
Some death and mourning doulas continue to play a role after the loved one passes. This could be helping to make those difficult phone calls to notify family or the funeral home, to picking up people from the airport or preparing meals. Doulas act as assistants and tend to those details to relieve exhausted and grieving family members. They hold hands, help direct guests and hand out tissues. Most of all, they are a caring presence.
There are also doulas that offer home funeral services, which can range from simply aiding in bathing the body and preparing it for viewing to burial itself. Doulas and funeral directors can be involved in different aspects of the care of a loved one’s body, or one or the other can take over those responsibilities.
One misconception about death doulas, and sometimes about hospice, is that death doulas are involved in euthanasia or assisted suicide. This is not true. Death doulas aim to help reduce the distress and fear around dying but do not directly help people die. Death doulas are generally not trained medical providers and do not provide medical care. Medical treatment is best left to palliative care physicians or hospice.
When seeking the services of a doula, it is important to learn of their approach, services and training. There are several different death doula-training programs, and they vary in focus and comprehensiveness. A thorough list of questions to ask when interviewing a potential death doula is available from Laura Saba (MourningDoula.com/interview-questions). It’s also possible to ask to retain a doula for the future, much like one retains a lawyer.
The time when a loved one is departing this world is an emotional time, full of mystery. Just like birth doulas, death doulas offer practical and emotional support, and they provide information to support families in making decisions that are the best fit for them. They coach the family as a unit through the process, educating them on what might be expected and ways to take care of themselves as they move into grieving and remembrance.
The goal of every death doula is to help their client have a “good death”. That is, a death that is as peaceful as possible, with as many of their wishes fulfilled as feasible and companionship throughout the journey. For the family and loved ones, a “good death” is also one in which they know they are doing what their beloved wants and are able to say and do what they need to, as well as have the space to grieve. It is a gift for all involved.