End of Life, or Death, Doulas are all of a sudden getting press and recognition. The concept was created in 2003 by several hospice workers who saw that all the needs of the dying and family were not being met through standard hospice programs. Doula was chosen as the recognized term for someone who assists a mother as she brings new life into the world, making things easier on all involved. So, it made sense to use the same title for someone who would create space and peace around a dying person as they leave this world, regardless of their religious beliefs. Someone with a more holistic view was needed, to guide the patient and loved ones, to offer guidance and rituals to bring comfort and peace.
An End of Life (EoL) Doula encompasses many different aspects of dying; they are non-medical people who believe in addressing mind, body & spirit together as a person approaches their death, making this natural process more comfortable and hopefully less scary for everyone. Death, like birth, is a transition. My wish is to help people plan, as much as possible, how they wish to be treated at the end of their lives, their funerals and burials. This can provide tremendous comfort for the person as well as their family & loved ones.
Why do I want to help people plan for and think about death? As a paramedic I saw the pain for both the patient and family in emergent situations when there hadn’t been discussions or planning for the last moments of life, making it much harder for everyone, especially the patient who was dying. As a cardiology Physician Assistant I had to broach these topics when a patient was already on a ventilator or receiving aggressive treatment. So many times when a patient was no longer able to communicate the family would say to me ‘This isn’t what I would want, but I can’t make the decision for them.’ Patient’s suffering was prolonged, since they had never given their loved ones any indication of their wishes, making the situation more traumatic for all involved. And in years past when present with loved ones I always had a sense that there must be a better way to prepare, a more sacred way to honor the transition out of this life.
Due to a complicated heart condition I have faced my own death, and understand better than many the emotions as you contemplate your own demise. It's not easy, but having some plans and increased understanding about the things that may happen generally makes everyone more comfortable. The problem is that we are a 'death phobic' society, seeming to believe that talking about death somehow makes it happen. Guess what? It's going to happen, whether you talk about and plan or not.
Since becoming an EoL Doula my mother entered hospice and died. We had in-depth conversations about exactly what she did, and didn't, want in her last weeks. Many of her friends, workers in her assisted living facility as well as hospice people commented that they had never seen such open communication and detailed plans. It brought my mother peace to know that her wishes were being and would be honored, and made a difficult time so much easier for me, because I knew exactly what she did and didn't want. Let's talk about things honestly and openly so that everyone can be more comfortable during the transition, both the person dying as well as those who will remain.
Here are some things I can assist with in planning for the end of your life:
Advanced Directives: You are never too young to think about this issue and relay your wishes to loved ones. Do you want to be on a ventilator? Do want to receive feedings through a tube? Do you want dialysis? Do you want pain medications, even if they will hasten your death? Do you want aggressive measures to continue living? If you are younger these answers will most likely be different than someone with a terminal diagnosis, or someone in their 80s. What is the best legal way to make sure your wishes are fulfilled? What is the best way to make sure that regardless of the situation someone will do their best to honor your wishes? My decades of experience in health care will allow me to guide you to the decisions that are best for you, including that these decisions may change.
Legacy projects: What would you like to leave behind that isn’t covered by your legal will? Are there family stories you want the next generations to know? Do you want to create something to give to specific people, like photo cards or scrapbooks? Do you need to document your grandmother’s recipes, or make sure old photos are identified? Do you want something done with your clothes created as a memory for loved ones? Do you want to leave messages for your spouse, children or grandchildren to mark special occasions, like graduations or weddings? Are there specific life lessons you want to be sure are remembered? I can help you figure out what you believe the most important things are to leave as your legacy, and how it might be accomplished.
Discussing death: Talking about death and dying is spiritual, it doesn’t need to be religious. I’m not going to tell you whether your beliefs about what happens when you die are right or wrong, but I will listen while you think about things out loud, be a sounding board. Sometimes it’s easier to talk to someone you don’t know, whose feelings you don’t have to protect. What would you like to accomplish in the time before your death? Is there something or someone(s) you need to have resolution with before your death? What will make you more comfortable in facing your death? What, physiologically, might the last days and hours before your death be like?
Vigil planning: If there will be hours or days leading up to your death how do you want to be treated, and how do you want the people around you to behave? Who do you want with you? Who do you not want with you? Do you want to be read to or have music playing? Do you want someone with you at all times, or just know people are around? Do you want to be touched or massaged, have loved ones lie next to you, or just have your hand held? Is there something you want done or read in the minutes after you have died?
Burial planning: Do you wish to be buried and where? Do you want to be embalmed? What would you like buried with you, ie pet’s ashes or jewelry? How would you like to be dressed, or what fabric would you like around your body? Do you want to be cremated? Where do you want your ashes? Do you want a green burial? Do you want a casket, and, if so, what kind? Does your religion require certain specifics? In the grief following a person’s passing it’s common for the family to choose much more elaborate caskets and spend much more than the person would have wanted. The funeral industry has thrived playing on people's grief or guilt; having this planning taken care of can provide tremendous relief, as well as significantly lower costs.
Funeral & Memorial planning: What will make your funeral or memorial more personal? If you aren’t a member of a particular religion or church you don’t have structure, but that gives you freedom to plan a more personal service. Where would you like a service held? Do you want a funeral, a memorial, or just a graveside service of some sort? Do you want something quiet & meditative, or more celebratory? Are there any rituals which are important to you? Who would you like to officiate? If your body or ashes are being interred what readings or songs would you like to mark the occasion? Who would you like to participate in your service or interment? Are there specific hymns, songs, or readings which you would like at your service? Do you want to write your own eulogy or short biography? Do you want flowers, or donations to a specific organization?
What do you want people to know about you when they leave your service?
Why did I pick Rainbow Tree Doula for my name? Rainbows, for me, have always signified both an ending to something as well as a beginning, and this is what death represents to me personally. It’s an end to this life, my personal beliefs are that it is the beginning of a new existence, just in another form. In many ancient cultures rainbows are associated with the afterlife, as a pathway or bridge. Trees are also frequently a symbol of death, not only as the well-known Tree of Life found in many cultures, but also in the passing of the seasons, comparable to a person’s life. Both start as a seed, then the spring and growth of childhood, the summer and work of an adult to bring things to fruition, the autumn of harvesting the fruits of your labors, and then the winter which seems dormant, but allowing for rest and renewal. The cycle repeats, with the leaves of the previous season’s tree providing the nourishment for the next season, much as what we do in our lives can provide knowledge and guidance to those who come after us in this world.
How much do I charge for my services? My belief is that dying is sacred, the death of one person alters things in so many lives. I don't want anyone to feel they can't afford help at this important time in their or their loved ones lives. So, my services are without cost, because I believe that this is sacred work. That said, free will donations are gratefully accepted. I've spent several thousand dollars between courses, memberships in different organizations, books, materials and even clothes specifically for working as a doula. If you are able to help me defray some of those costs it would be greatly appreciated, but at your level of financial comfort. The only time I'll ask directly for reimbursement are for booklets given or materials purchased specifically for you, but if you can't swing it that's okay as well.