End of Life and Death Doula Work
Death Doulas and Soul Midwifery- Changing The Way We Die
Welcome. My name is Rev. Julia Lawrence LMT, MCA. I am an LMT in NE and IA, a Master Clinical Aromatherapist, an ordained Priestess of the Old Gods, an author, an educator, an artist and a Death Doula.
What is a Death Doula?
An end of life doula can be described in the same way, A NON-MEDICAL COMPANION AND SUPPORTER WHO WALKS BESIDE A PERSON ON THEIR END OF LIFE JOURNEY. They may be required before, during or after death for the passing as well as their spouse and or family, by providing emotional support, resources, organization skills, options and physical support (massage, reiki, relaxation tools, a hand to hold and the occasional beauty treatment are good examples of physical support in end of life). End of life doulas work with people who have been given a life-limiting diagnosis or those planning for and or approaching their end of life and or those close to them.
What does a Death Doula, Soul Midwife or End of Life Doula do?
That, is an excellent question and one that is varied depending on each Doula and the dying person's and family of the dying person's wishes.
When people face the end stage of a terminal illness they often feel alone, even when surrounded by family and friends. In quiet moments they wonder if their life has had any meaning. All of this as they struggle with worsening physical symptoms, periods of emotional turmoil, anxiety about how the actual dying process will unfold, and worries about how their loved ones will cope after they die.
Family of the dying suffers in their own ways. The months or years of care giving result in physical and emotional exhaustion. Their world narrows to the basic acts of providing medication and assisting with the tasks of daily life. In their moments of reflection they can become overwhelmed with sadness, longing, and fear. As the last days arrive family often feel ill prepared.
Addressing all of these needs of the dying and their families takes intense and continuous guidance and support. Hospices, hospitals, communities, and other settings where people die don't have the organizational structure or the resources to provide that kind of guidance and support. A Soul Midwife, Death or End of Life Doula not only fills this gap in services, they also introduce best practices that offer the dying deeper meaning and provides greater comfort to family.
Ideally, a Death Doula will begin their work with the dying person and family a few weeks to months before death. About the time that the dying person has already chosen hospice. Of course this is not always possible when Death comes quickly. Either way the Death Doula can assist the dying person and their family through this momentous time.
Part of a death doulas responsibility is to be adaptable to all cultures, world views, life paths, and religions. To be able to work within the framework of each dying person and their family without imposing our own beliefs on them. THIS is what I strive to do.
There are three phases to The Work
- 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
- 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
- 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..
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.
- 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.
Explaining some of the process a little more..
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. What a vigil, 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 is burnt
- Family is kept up to date
- Candles are lit
- Holding the dying person is encouraged as long as it is comfortable for them
- Scented oils will 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.
Explaining some of the process a little more..
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?
Cost for Services
Part of being a 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 an 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, the costs will vary based on exactly which services you are requesting, how many hours or days the contract will last for and if you are lower income as I do have a sliding scale. I feel that these services should be available to all- not just those who can easily afford it.
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. with the total cost being a set number. There may be additional charges for an exceptionally long vigil.
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. This is more the way to go in a sudden injury leading to death than a long illness.
I realize this is all very vague sounding but it is because there is SUCH a plethora of options I could be doing that one set cost scale is not feasible. $18 to $60 a hour- with a sliding scale- should give you a ballpark idea on the hourly rate and $500 and up (again with the sliding scale) for a non hourly contract
I promise it won't break you. I am called to serve, not make a bazillion dollars
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