by Lisa M. Wolfson
As a cancer survivor and someone who is drawn to helping others in need, I have always explored ways to help people improve their health with a holistic approach. In recent years I have also been drawn to explore the full-life process, including the process of dying, and have felt a desire to help people and their families when faced with the realization that they were entering the final stage of life. So I researched and did training as an end-of-life doula and I’m immensely grateful that I did. I expected to learn about the dying process but what I really learned in this training was how to live.
An end-of-life doula is someone who provides informational, physical and spiritual support to a person who is dying and to their family as well. The doula honors the sacred part of the dying process while addressing it as a normal part of the human life cycle, with the goal being to achieve a “good death,” meaning a death with acceptance, without struggle, with grace and peace. The role of the doula can include planning for the final phase of an illness, maintaining a continuous presence when the person is actively dying and working through, or reprocessing, the experience with caregivers and family.
A doula will explain the dying process to the person and the family members, and help develop a plan for the final days that honors the wishes of the person who is dying. These wishes may include the setting for the vigil and who they want present during their final hours. The vigil itself may be just a day or two, or run longer. The doula will work with the near-departed in advance of the vigil stage to develop a relationship and have time to honor their wishes. For instance, some people may want to be at home with only their immediate family members present, with candles and some specific music playing or perhaps something being read to them. Another person may request to be alone with their spouse and children when the end nears. The doula will orchestrate these wishes as much as humanly possible. The doula may do legacy writing with the person as well, helping to put certain sentiments into words to be shared with the family and friends after they’re gone, or use guided visualization during the vigil stage to relax and comfort the person. Or the doula can simply act as companion when needed, talking or reading to the person as desired. They may also use aromatherapy or therapeutic touch to comfort the person and help them let go when the time comes.
The doula may also be able to see things that those involved and actively grieving may not be able to recognize. When I trained for this role, our instructor told us about a woman who was dying, who was surrounded by a large loving family — her husband, children and grandchildren — who were with her constantly throughout the vigil of her last days. The doula noted that she was never alone with her husband and gently spoke to the others, suggesting that they give the couple some time to themselves. After the vigil ended with the woman’s passing, one of the children thanked the doula, saying that, in their own grief, none of them had realized that they never let their father have time alone with their mom and the dad had been too distraught and weak to claim that time for himself. Had it not been for the doula, their father may have suffered more after the death, having never gotten a chance for private goodbyes, and the children would have felt such remorse for not having allowed him that opportunity.
The doula is also able to give caregivers a much-needed break, allowing them to step away with the assurance that the person they are caring for is in good, knowledgeable, loving hands. The doula will also meet with the family after the death to help them process the experience, putting their grieving process on the proper path by working through any potential feelings of anger and abandonment. The doula will also help with any after-death wishes or requests, such as washing the body. Some people may request that the body of their loved one not be immediately removed after death or that certain music be played as a parting wish.
The issue of patients dying alone, even when they may have loved ones nearby, can be avoided by having a doula. The doula is present well in advance of and throughout the dying process and will notify family members when they need to be present. The active dying process can be overwhelming for loved ones, so having a doula navigate that process can make all the difference in how the experience is handled and remembered. The experience of those final hours affects the entire grieving process.
A lot of people are not afraid of death, they are afraid of dying. As Woody Allen once said, “I don’t mind dying, I just don’t want to be there when it happens.” A doula can greatly aid in the process of dying, reducing the fear and anxiety and helping families and caregivers. Training as a doula was truly a life-changing experience for me and to have the opportunity to help someone at the end of their life is a honor and a gift beyond compare.
Lisa Wolfson is a Reiki Master and lives in Rockville Centre, NY.
Photo by Karen Keller Capuciati.