what is a doula?

why, and when, hire a doula for an elder, someone experiencing illness, or someone who's facing uncertainty, rather than death?

Doulas are usually known as birth support folks. Here, I explain what doulas from the so-called "other side" of the spectrum do.

It's hard to put a name on my work. I consider myself a:

-doula to the aging, doula to the ill, doula to the dying, and, most importantly, a doula to the living

The most commonly known kind of doulas aside from birth doulas are "doulas to the dying," or "end-of-life doulas." This is one aspect of the work I do, and I write more about this specific support, and why I use the term, "doula," in the next section below.

I do often accompany folks through their dying process. It is a sacred and humbling experience every time.

Yet: life isn't black and white. Just like everything else--and often more so--issues around life and death are gray area. None of us know when we will die, or how. Part of a doula's duty, in my eyes, is to respect that big mystery.

Referencing "death" in my work's title continues to worry me that folks won't think it's a good fit unless death is imminent.

Nothing could be further from the truth.

I am a "doula to the living" first and foremost. What does that mean? When someone is experiencing challenge in life--especially related to aging or illness--I'm here to provide holistic, personalized, experienced, grounded support. My goal is simple--to support my clients in living the richest, most fulfilling, most amazing, most easeful lives possible, whatever that means to them. I'm a "doula to the living," because whatever the situation of my client, it's all about squeezing the good stuff out of life. Sometimes clients die, and sometimes they live. Whether someone will live or die is really beside the point, when it comes to the work I do--all of us can use support in trying times. If the idea of a aging, illness, living, or death doula for you or a beloved sparks a little relief or intrigue inside your body--chances are it's likely a good time for one.

When an individual or their loved one moves into a nursing facility, or faces a serious diagnosis, or faces challenge of any kind related to aging or transition, a doula can ease the process and with skill and intentionality, keep the focus on love and care.

It takes a lot for families to invite a stranger into the intimacy of a trying time. I really can't say how much of an honor it is to do this work.

I particularly like working with clients with limited support networks. Elders, for example, are at increased risk for loneliness, and it has serious effects. When families are busy or far away, a doula can provide connection and support for that individual, and peace of mind for their family, too. I've also worked with homeless folks for years, now. I love connecting with people who might otherwise have barriers to quality care and community. I support people of all walks of life in navigating complicated external and internal systems and circumstances.

I also support families and communities in mourning, after death or loss has occured.

As a doula for the aging, ill, living, and dying, I thank you for taking the time to read this and learn about my work. It's not always easy to explain. This is a challenge for me, as a professional, but I also find it to be one of my strengths. After all, my work is about meeting the needs--whatever needs--I'm presented with in a spirit of love, presence, mindfulness, and service. We don't know what's going to emerge as challenging in our lives. It can be helpful to have someone who's flexible, adaptable and caring there with you through the challenges.

what is a doula to the dying?

We go by many names. Doula to the dying; end of life doula; death doula; thanadoula; death midwife; soul midwife; holistic end-of-life support; end-of-life guide; end-of-life coach; natural death assistant; "wing walker."

Despite new and variant names, the practice is ancient and simple. Doulas offer integrative, non-medical care and support for the body, mind, and spirit of individuals going through transitions. We also offer care and support for these individuals' community and loved ones. You may recognize the name "doula" (and "midwife") from holistic birthing practices. Birth doulas have worked to change the perspective of pregnancy and labor from a purely "medical experience" to a powerful and natural life experience that is rife with opportunities for growth, connection, and embodying empowerment. Death is the same--it's been taken out of the hands of community, and is now often understood as a medical event. Yet in many cases, death can be a poignant, powerful experience for both the dying and the living who accompany. Rather than viewing the medical system as an all-knowing and all-powerful entity, doulas know that clients themselves are the experts of their own experiences, and advocate on clients' behalves when others in end of life systems do not understand this or respect their clients' rights. End of life doulas offer parallel services as birth doulas--we aim to empower clients to both give birth and to die in the way they choose, in the environment they choose (often at home), feeling supported and not alone. We can also offer adaptive and sensitive support when death is unexpected (I take particular interest in providing this particular form of support). We can help families with decisions and rituals and caregiving techniques (care for the dying/dead, and self and community care), offering our experience and knowledge to inform and mitigate anxiety, and then stepping back and holding empowering space for clients to make their own decisions.

Many folks find it useful to have a grounded, experienced presence around in the midst of difficult or confusing times. We can help with the most simple, pragmatic needs (like making a pot of fresh coffee or driving across town for a dying client's favorite sandwich), to the most intense or sacred (like holding compassionate space while a family member first touches their loved one's face after death). Doulas to the dying do the simple, whole-hearted work of support before, during, and/or after death.

As with most other doulas of different forms, I value relationship-centered work and find great joy in getting to know my clients. Adaptability, listening and self-awareness are vital practices that help us to show up in the way our clients need us most.

what are home funerals?

Most people don't know that there's an alternative to using funeral homes as the sole service provider after a death. For most of my time as a hospice worker, I'd never even heard the term "home funeral"--and I was steeped in the world of death and dying every day. Yet, in the United States, we do have a right to care for our own at death. We can do completely family and community-led funerals; and for many, this feels like the right fit.

Some folks feel drawn to participating in the intimate care of their loved one's body, and having more leadership in the process of laying their loved one to rest. Home funerals can be empowering for all involved; they can be slower, and more intentional. Providing care for a loved one's body in the comfort of home can offer a safe space to mourn, to gather, to connect, to remember, and the opportunity to perform a final act of service for the deceased beloved. Home funerals are also inexpensive compared to funeral home services. They are almost always much more natural and eco-conscious.

Bodies can be kept at home for up to three days, kept cool with ice packs. Families can gently bathe their loved one's body, perhaps with lavender-scented oil, and dress them in their favorite outfit. Family and friends can gather, sitting vigil, sharing tears and laughs and stories, or singing prayers or songs. Partners and children and parents can awaken in the night and light a candle alone with their loved one's body, taking the time they need. Self-directed, the community chooses what feels right for them in honoring their deceased. Often home funerals embody a more natural approach--the body doesn't need to be embalmed, coffins need not be fancy, and there does not need to be a cement vault for a burial. The body can be transported to the burial site or the crematorium in one's own car. If burial is the preferred choice, some individuals decide they want to be buried in a simple shroud, a thin pine coffin that was crafted with their own hands, or a cardboard coffin that the children decorated. There is a growing movement of green burials, which offer simple, beautiful solutions that are less invasive to the environment than most current burial norms in the United States; many folks are drawn to the notion that their body will return to the Earth and nourish other living beings.

Rituals and ceremonies can be planned and performed solely by family and friends, or they can invite assistance from a religious leader or home funeral guide.

With more ownership over how the process goes, communities often feel empowered and connected, to their loved one, and to each other. 

A great resource for further learning is the National Home Funeral Alliance.

my learning communities

If you're interested in learning about some of the most influential communities in my approach to deathcare and bodywork--the places that paved my path--click on each name for a link: Joseph's HouseMetta InstituteSmith CollegeGallaudet UniversityPotomac Massage Training InstituteL'ArcheCatholic WorkerHaley House, Barre Center for Buddhist Studies, Insight Meditation Community of Washington