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Understanding the Role of a Death Doula

Have you ever wondered what a Death Doula is and what they do? Allow us to shed light on this compassionate and vital role that offers support and solace during life's most profound transitions.
 

At its core, a Death Doula is a non-medical companion and advocate who walks alongside individuals on their end-of-life journey. This journey might encompass the time leading up to death, the moments of passing, and even the aftermath for both the departing individual and their loved ones. A Death Doula extends emotional support, offers resources, lends organizational skills, and provides physical assistance—ranging from therapeutic practices like comfort touch and reiki to simple acts of presence, or even spa treatments, all tailored to bring comfort during the final stages of life.
 

These doulas collaborate with the dying person and the families and friends who stand beside them. While the specific role of a Death Doula can vary depending on the unique wishes of each individual and their loved ones, their overarching purpose remains consistent: to ensure that those on the cusp of transitioning feel supported, valued, and at peace.

As terminal illnesses progress, individuals often grapple with feelings of isolation and uncertainty, even amidst the presence of family and friends. These quiet moments of introspection may lead them to ponder the meaning of their lives. Balancing deteriorating physical symptoms with emotional turmoil, they may also experience anxiety about the process of dying itself, along with concerns about how their loved ones will cope in the aftermath.

The impact on family members caring for a loved one at the end of life is equally profound. Months or even years of caregiving can result in both physical and emotional exhaustion, narrowing their focus to the essential tasks of administering medication and aiding with daily activities. In moments of reflection, family members may find themselves overwhelmed by emotions of sadness, longing, and fear. As the final days draw near, a sense of unpreparedness often sets in.

In the midst of these complex challenges, a Death Doula steps in to provide continuous guidance and support. Unlike traditional healthcare settings or hospices, which may lack the necessary resources or structure, a Death Doula serves as a bridge, addressing the diverse needs of the dying and their families. By introducing best practices and holistic approaches, they offer a profound sense of meaning and comfort during this transitional period.

Ideally, a Death Doula commences their work a few weeks to months before the anticipated time of death, typically when hospice care is already in consideration. This proactive approach ensures ample time to forge connections and provide invaluable support. However, the role of a Death Doula is remarkably adaptable, as they are well-equipped to respond swiftly when circumstances dictate a more immediate presence.

A hallmark of a skilled Death Doula is their ability to respect and embrace the diverse cultural backgrounds, worldviews, spiritual beliefs, and life paths of both the dying individual and their family. By fostering an environment that is inclusive and non-imposing, they honor the personal choices and preferences of those they serve.

In essence, a Death Doula embarks on a journey that unfolds in three distinct phases, guided by compassion, understanding, and unwavering support. This journey is a testament to the profound impact that a Death Doula can have on the lives of those facing the inevitable, ensuring that the transition is met with dignity, comfort, and a sense of purpose

PHASE 1: SUMMING UP AND PLANNING

  • Exploring the meaning of the dying person's life

  • Initiating legacy projects

  • Assisting with unfinished business

  • Creating visualizations

  • Deciding on how the space will look and feel

  • Designing rituals

  • Developing a vigil plan

 

PHASE 2: CONDUCTING A VIGIL

  • Assuring the last days happen as planned

  • Using touch and holding to bring comfort

  • Providing family with respite

  • Making sure the patient doesn't die alone

  • Informing about signs & symptoms

  • Leading guided visualizations and rituals

  • Providing emotional support

 

PHASE 3: REPROCESSING & EARLY GRIEF

  • Retelling the dying story in detail

  • Uncovering traumatic moments to reframe them

  • Giving back to family beautiful moments

  • Explaining the journey through grief

  • Providing emotional & spiritual support

  • Bring completion to the doula involvement

Explaining some of the process a little more..

Legacy Projects

A legacy project can be started by the dying person to leave something behind so that it is easier for future generations to remember or get to know them. It can also be started by family members before, during or after the dying person has crossed over. There are no rules here. Some clients choose NOT to do a legacy project for a myriad of reasons. There are no wrong answers.

Examples of some legacy projects are:

  • Memory Book

  • Video Compilation

  • MP3 or recorded songs with special meaning or sung by family, the dying person or friends.

  • Murals

  • Scrapbook of Accomplishments

  • Acts of Kindness given to family members to do in the dying person name

  • Scholarships Funded

  • Helping a certain population

As you can see there are endless options on what a legacy project can be.

Vigils

A vigil is starts when the dying person has entered into active death. This is a term used to describe the body undergoing a change. It is not longer creating new skin and dividing its cells but instead starts to shut down. Many times this is when the dying person become unresponsive. During the planning stage we would have determined exactly what the dying person and the family wanted the vigil to be and we doulas do our best to facilitate that while remain flexible to new ideas and situations that arise. At all times, the dying person's wishes will be upheld over anyone else. 

What a vigil is, what it looks like and what happens is completely unique to each client and family. It is a beautiful way to recognize this momentous occurrence and to make it feel important, comforting and sacred.

some examples of the types of things that happen during a vigil are:

  • Play the music (if any) that was planned

  • Rearrange the room in accordance to the plan

  • Songs or prayers can be sung

  • Adjusting the lighting

  • Incense can be burnt or diffusers are can be used

  • Family is kept up to date

  • Candles can be lit or electric ones turned on

  • Holding the dying person is encouraged as long as it is comfortable for them

  • Scented oils can be used in the manner that was prescribed.
     

Many times the dying person has selected a guided meditation to be used to walk them through to the other side. Even if they are not responsive, this guided journey is still done. This is also the time to make sure those people coming into the space leave their grocery lists and gossip outside the space. A small sign asking people to pause and realize they are about to enter into a room where something deep is happening or a chair sat just outside the room for contemplation before entering the room is appropriate. A vigil can take many forms. That is why it is important to have planning sessions with your doula so things go as well as they can.

Reprocessing

Reprocessing is where early grief is experienced and reframed as the family and friends begin the rest of their life without the dying person. As with the first 2 phases, no two situations are ever the same. This is especially true of grief. Different family members experience grief and loss in completely different ways and process that in different ways. A death doula helps with this early processing by helping the family remember the dying person, by giving back something to the family like written observations during the vigil or a retelling of touching moments that they noticed that no one else may have.

They help the family cope with the loss in many ways and if they see that someone is struggling and perhaps their grief is more complicated, they can recommend a bereavement counselor to further assist with the grief/loss process.

This is by no means an exhaustive look at what a death doula does, but it gives a pretty good idea. These services are needed more than ever. As a society we have turned death into a cold and clinical situation where the dying person does not have a 'good death'. We did not mean for this to happen, its been a slow progression with a variety of reasons for how and why it happened. but it doesn't have to be that way anymore.

 

How much do these services cost?

Part of being a death doula is about being flexible and holding space for changing needs during yours or your loved ones end of life journey. For this reason I offer a free phone consultation to firstly establish what your needs are now, what I can provide for you as your doula along the way and a clear understanding of how much it will cost.

If you decide to continue on with death doula services, you will know exactly which services you are requesting and what they cost, how many hours or days the contract will last for and if there are an 'extras' you will pay for should the need arise.

In a contract there can be a set number of visits for summing up and planning, total number of hours for vigil work and a set number of visits for grief work or any combination of these- you do not need to have them all. With the total cost being a set number. There may be additional charges for an exceptionally long vigil.

OR

The contract might be for an hourly rate with a set number of hours for each phase and with each phase potentially having a different rate depending on the services rendered. Again there may be additional fees for a very long vigil. 

In general an hourly rate with travel time and costs for
1-5 hours is $60 per hour.

5- 10 hours is $50 per hour .
10 - 20 hours is $40 per hour.

Services requiring longer than 20 hours should be a contract specifying days and hours etc and an agreed upon total cost

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