An end of life doula provides nonmedical caregiving services to people who are dying and to their families (chosen and biological).
Whether you have just received a terminal diagnosis, are going into or coming out of hospice care, or are receiving care at home, a doula can be a companion in supporting you and your family’s spiritual and emotional needs as you transition away from this physical world. A doula can also offer resources and education through all stages of the dying process, and provides a continuity of care to bring meaning, thoughtfulness and grace in one’s journey into death.
As an end of life doula, I provide support in three main phases. The duration and depth of each phase will depend on the circumstances and desires of the client and their family. Here are some of the key components:
Summing Up & Planning
Listening to the client to address any worries and anxieties
Learning about a client’s cultural and spiritual values
Creating space for conversations that help clarify and articulate a client’s life meaning, and jointly designing a legacy project
Together with the client, formalizing the plans* for the atmosphere they want in their last days and hours, and communicating to the people they want involved during this time what is being requested of them
*plans provide a framework, but may not be adhered to strictly depending on circumstances
Conducting Vigil (begins once a client enters active dying)
Providing bedside presence and respite to caregivers
Facilitating following through on the agreed upon vigil plan
Holding space for sacredness, and normalizing the dying process
Continuing any legacy project work
Reprocessing & Early Grief (3-6 weeks after death)
Connecting with family to retell the dying story, holding space for family to express their experience
Providing education and resources on the grieving process; referring to grief counselors as necessary
Offering a closing ritual
I am not licensed to provide medical advice or perform any medical services (though I may provide basic care as a general caregiver). If requested, I may be able to offer assistance to a client or family in deciding what questions to ask of the medical provider(s) or offer information based on past experiences, but I will not make medical recommendations or decisions.
As it can be nearly impossible to know exactly when a loved one will leave this physical life, it is difficult for me to commit my presence for one’s last breath. My support is for the the wholeness of the dying process, not a singular moment. Each circumstance will be different and my involvement during each stage of the dying process will be considered according to the wishes of the client, and family, as much as is feasible.
My primary focus and responsibility is to help ensure that the wishes of the dying person are acknowledged and honored as much as possible. I will not involve myself in any conflicts regarding medical decisions among family members. I may help in creating space for a conversation to take place between the dying person and a family member, but I will not mediate it.
While I have experience with death and dying, and the grief that follows, I am not a grief counselor. Grieving is complex with many emotions, memories and thoughts to be processed. Specialized grief counselors are best equipped to support individuals and families through this process, which may be longer term. I am available and open to listening to the family’s experiences in the immediate weeks after death, and then offering referrals, as appropriate.
Engagement with me may last from a few days to a few months, based on either choice or circumstance. While there are stages to the dying process, there is no set schedule, and one’s understanding of their prognosis may play the most significant influence on an engagement decision. I seek to support clients and families for the time that feels most appropriate to them. There is no specific timeline or limitation as long as the requests are within the scope my services.
I plan for involvement after death as a family transitions to the grieving process, but it is ultimately dependent on the wishes of the family. Check-in conversations are opportunities for the family to process their experiences in the weeks after the initial loss occurs. I may offer my reflections, as well as resources to assist the family over the coming months.
I may be able to provide resources and serve as a sounding board for the family in helping them to understand the wishes of a loved one, but it is currently not within the scope of my services to manage specific after death arrangements.
A legacy project is an outward and concrete artifact or process that helps connect the family with the dying person after their passing. Depending on the circumstances, a legacy project may be designed by the dying person and/or their family before death, or just by the family after death. Generally, legacy projects strive to express meaning, improve emotional connection, and honor the dying person’s life and contributions. Examples of projects may include: a memory box, letters to/from the dying person, a quilt, a community performance (poetry slam, concert, etc.), or a recipe book.