Dying is Everyone’s Outcome
Recently the Irish Hospice Foundation asked Irish people, in a survey, what their deepest wishes are with relation to the dying. A team questioned over 3,000 people and reported the following responses, reflecting the following needs and hopes;
- Death is talked about and not in hidden away.
- I am supported to stay in control of my own decisions.
- My dignity is respected and maintained to the end of my life and after my death.
- I can get information to understand what is happening to me.
- I can prepare for what lies ahead.
- I can die, surrounded by people I love, in a calm and comfortable place, in my home if at all possible.
- I, and the people who care for me, can get the practical services needed.
- That people understand grief and do not avoid thinking of talking about it.
- Family and friends are supported during a loved one’s illness or after death.
- People get space and time to grieve, talk and remember.
Getting to the point where we can start to collaboratively wonder about death, our fears and our imaginings, requires recognising that Death is common ground! No matter our gender, culture, orientation, or desires, everyone shares this inevitable ending.
Death Doula Role
A Death Doula is similar to a Birth Midwife (Birth Doula) but acts in the service of the opposite end of the life spectrum, upholding the validity of dying as a transitory threshold. Instead of assisting on the entrance of a human being into the World, a Death Doula supports the departure or dying process by acting as a companion to those affected, encouraging explorations into a person’s personal story and relationship to dying, and helping to shape perspectives and ideas on what end of life means to people, including creating a narrative around that relationship and its investigation.
A Death Doula role can involve some of the following themes;
- Companionship (to all those affected, family and friends included)
- Preparing end of life wishes
- Family support
- Anxiety relief techniques
- Wonderings on grief and bereavement support
- Considerations on Spirit and perception of the Afterlife
As a companion a Doula can assist you to share your thoughts around death and dying in a way that is supportive, both to yourself, and your friends and family. Often, for those of us approaching the Departure Lounge, or at least, starting to allow the theme of Death to become important (see Dead Good Cake and a Chat), talking to someone other than family or friends can allow for an authentic investigation of how to create a roadmap for your future departure. This framework can be done at any stage of life. You do not need to wait until you are dying to prepare an End of Life Plan. Some people do, but it can be easier to engage with the process while you are still energetic, well and healthy. In books like ´A Beginner´s Guide to the End¨ author BJ Miller references that next to birth, death is one of our most profound experiences of our life! Shouldn’t we prepare for it with as much attention as do to birth? Can we not in fact use what it can teach us in order to live more vibrantly?
A Death Doula can assist you to design a framework for your goals of care and how you might make the kind of preparations that will allow a more conscious departure. Death as a subject is not easy and is not always painless. Sometimes the theme is unavoidable because of your current timeline. A Doula can encourage you to wonder about how you might like your end of life to look like and support you to create more time in order to listen to yourself about the priorities that matter to you. For example,
- What kind of treatment would suit you if you are unwell?
- Have you thought through all the logistics?
- How you hope to be remembered?
- Where would you like to lie-rest?
- Have you ever considered creating a will?
- Is it time to de-clutter or tidy up any unwanted uncompleted stories?
- Is it time to label special things that you wish people to inherit?
These goals will change over time, but that depends on the schedule and the personal history. It is a very individualistic thing, but having a companion or someone to emotional support in its design can be comforting. It is a big topic, and not everyone can face into it alone. The vast majority of people find it difficult to source a neutral friend or family member who is able or willing enough to engage in this practical and crucial challenge! Some even find the topic morbid!
Ideally, Death and Dying should be one of the core themes that are presented during our schooling years!
What a Death Doula encourages you to do is free up as much Life as possible by dealing with the crucial aspect of Dying while you still can. People who have completed this process report feeling freer and less burdened. Hidden in our psyche are fears about this theme, reflected in some of the following terms used to describe death – lost the fight, kicked the bucket, etc.
If you are considering engaging a Death Doula in a contract remember it is O.K. to have concerns about the bond that will be formed between you and your potential companion. This is not therapy, although, in my case, I am a trained Psychotherapist, however in this role I shape the client relationship differently. The model in use is based on the Red Tent-Sacred Circle CIC guidelines, which focus on a non-directive approach, recognising the innate internal wisdom each person has with respect their own mortality and making space for conversation in a positive way that gives the client full autonomy. Coming to terms with the guiding someone through their own set of principles to complete an end-of-life plan takes loving support. If it does not feel like the right personality fit than we can look at finding you the right match from a beautiful group of caring people who have trained here in Ireland. For me, as a trainee Doula I have a huge supportive resource at hand, with a wise and well versed community of E.O.L Doulás to witness my work. I am happy to use their wisdom to enhance my learning and I am supervised in my work by a solid soul who gentle accompanies members of his community on their path at a pace that matches their needs. He is a wonderful guide and my companion to my own life plan.
Receiving bad news of any form can have an instant effect on your body and cause your flight-or-fight response to kick in quickly. Your adrenaline may start pumping and your mind may begin to race to several worst-case scenarios in seconds.
Furthermore, you may need to manage all the consequences that come with the bad news paying bills, doctors appointments, calling work to take time off or informing friends and family as well as coping with the way the news affects you both physically and mentally.
It can be so daunting to receive news that we are unwell that often things are left unsaid when attempting to communicate with loved ones about possible outcomes, especially if you have only recently received a diagnosis. These conversations can backfire when we are frightened. The best outcome is to wait and take your time to allow the shock to disperse. You might need support in managing this, and it could take a few days, weeks or months. Each person responds differently. A Doula can assist you to facilitate dialogue with those who care about you, so you are not silenced by their vulnerability or resistance to end of life conversations.
Other Supportive Elements of the Death Doula Role
A Doula can act as a support to ANYONE who is directly affected by a loved one who is dying. Acting as a support to a family or a group of friends can help everyone understand the impact the loss is having. It can also assist with the cohesion of a group of people who are struggling to know how to operate a system of care. Each person has their own emotional response to the situation and having a neutral coordinator can take the pressure off those who feel they are in the firing line of unconscious projections, like anger or resentment, of the other members of the group or family. We all have a history and at times, when we are needing to create a timetable of support, old storylines can get in the way. If you feel you could benefit from an external supportive person, a Doula can take on this role with careful negotiation. Here are some areas a Doula can offer support around:
• Understanding the medical model, the system as it is
• Legalities surrounding death, care of the dead and funerals
• The stages of “end of life” – before, during and after death
• Listening to the needs of the person who is dying, advocating for their wishes to be fulfilled
• The importance of creating peaceful environment
• The importance of looking at the family constellation within which this death is happening
Why am I committed to the role of Death Doula?
My journey towards this current stage, trainee Doula, began as part of a deeper investigation and questioning around my own mortality, the nature of existence and as an extension of personal grief work. During various non-ordinary-state experiences I came to understand the cycle of life in a new way and began to interpret Death differently. Through that process I understood that I needed to use tools to release unacknowledged losses in my system. Cut past the narrative, one of the things I naturally began to do was Lament. Through divine law I met people who appreciated the art-form and I started on a path of collaborating in a restoration project focused on the tradition of Keening. Through the development of this work, and in addition to plant and breath-work sessions (following other traditions), I experienced a multiplicity of mystical states that fall outside of the scope of ordinary, and these changed my attitudes to family lineage, genetic inheritance, behavioral patterns, and my also, my Spiritual perspective. During the creative process of developing a framework for the Lament workshops I met people who were working in their communities in different roles related to dying, Midwifes, Celebrants and Doulas, and I began to understand the potential for attending to our own stories of death and grief in a new way. These people work to bring death back where it belongs; in the hands and hearts of loved ones, in the home and the community. They bring back touch, love and connection as aspects of caring for the dying. Within this structure there is a vast range of belief systems, with a shared opinion that when assisting someone in a Doula role the focus is on making neutral suggestions and recommendations around care protocols, consulting services and advocating on the client’s needs. By no means does my spiritual perspective need to contribute to the work. I chose a supervisor who translates his environment in a completely different way to me which allows for a very rounded approach to this role.