MAY 2021

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MAY 2021

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Supporting Children Through Grief

By Loren Talbot and Janine Jordison

Children experience grief just like adults do–the difference is how they do it. Prior to the pandemic, an estimated 5.2 million children in the United States experienced the death of a parent or sibling before their eighteenth birthday, according to Judi’sHouse / JAG Institute, a community-based non-profit bereavement center for children and families in Denver, Colorado. Recent public health research published in the Journal of American Medical Association (JAMA) indicates an additional 37,000 children lost a parent to COVID-19 in the first year of the crisis. “Development, environment, and individual differences all play a significant factor in how a child grieves. Grief directly relates to the developmental stage of the child and the communication level of the parent and child.” says Kevin Carter, the clinical director of Uplift Center for Grieving Children in Philadelphia, Pennsylvania. “You may have four children. They will have four different relationships with the deceased, and they are going to have four different ways of handling it.”

Doula Profile

Virginia Chang, Ph.D.

Virginia is an INELDA certified end-of-life doula based in New York City, NY. She has been trained by INELDA, the University of Vermont (UVM) Larner College of Medicine, and the Visiting Nurse Service of New York (VNSNY). She is currently working as an end-of-life doula privately and as a hospice and vigil volunteer for VNSNY. Virginia is a dedicated mentor within the field and is on faculty with UVM’s End-of-Life Doula Professional Certificate Program as Doula Facilitator.

She sits on VNSNY’s Ethics Committee and Review Board and advises on matters of ethical significance to its hospice and palliative care program as well as INELDA’s Council on Equity, Diversity, and Inclusion (CEDI). She is passionate about increasing awareness of end of life, self-care, and bioethics, and sharing her knowledge with others.

Q&A with Virginia Chang

When and why did you decide to become an end-of-life doula?

In late 2016 and early 2017, three people very close to me died in the short space of seven months. I was very ill-prepared to face death in others; I was emotionally numb and overwhelmed by what happened. Unfortunately, I had never had a conversation with my loved ones about death and what they would have wanted nor do I know if a conversation was even possible. I often felt like a bystander in the dying process of my loved ones, not knowing what my options were and mostly doing what was recommended. I tried, like many people, to do “the best” for my loved ones and that is what I live with now. Afterwards, in my grief processing, I began to see that the deep sense of powerlessness and hopelessness I had felt in those situations was not the only option.

Contact Virginia
[email protected] \\ Web: Till The Last \\ Ph: (917) 933-3400

News Briefs

The Proportion of Black Physicians in the U.S. has Grown Little in 120 Years

A new study conducted at the University of California, Los Angeles (UCLA) analyzing U.S. Census data from 1900 to 2018 shows that the proportion of Black physicians has grown very little over nearly 120 years and remains far lower than the proportion of Black people in the nation’s population. As of 2018 only 5.4% of physicians were Black, even though 12.4% of Americans are Black. READ MORE

Anesthesia as an Option in End-of-Life Care

In the United Kingdom and other parts of Europe where medical aid in dying is illegal, anesthesia is being considered as an alternative for people whose distress or pain can’t be well managed at end-of-life. This approach may also be used for people close to death who clearly express a wish to be “asleep” as they die. READ MORE

Efforts to Reduce the Misuse of Opioids May be Hindering End-of-Life Pain Management

The Oregon State University College of Pharmacy in April reported there has been a decreasing trend in opioid prescriptions for dying patients based upon data from more than 2,500 hospice patients over a nine-year period. This could indicate that some patients may have been undertreated for their pain. READ MORE

Hospices Need to Better Serve Patients with Disabilities
Patients with disabilities have been largely underserved by hospice in spite of the fact that almost 40% of people aged 65 or older have at least one disability, according to a 2014 Census Bureau report. And, an April article in Hospice News states that the number of seniors older than 65 who have an intellectual or developmental disability is projected to double by 2030. READ MORE

Advances in Smell Tests Could Provide Early Diagnosis of Parkinson’s Disease

Researchers at Queen Mary University of London developed an inexpensive, rapid, and easy to use smell test kit that has the potential to diagnose Parkinson’s disease. More than 90% of Parkinson’s patients suffer from loss of smell. Previous studies indicate that the right smell test could identify those at a high risk of developing the disease at least 10 years prior to more common symptoms. READ MORE

MEDIA OF THE MONTH

The Inevitable: Dispatches on the Right to Die by Katie Engelhart

St. Martin’s Press 2021

Reviewed by Jeannine Burgdorf

Physician assisted death (PAD), a term often used interchangeably with medical aid in dying (MAiD), has been a recurring headline in newspapers across the country since 1997, when Oregon passed the Death with Dignity Act. Most recently, New Mexico became the ninth state to pass medical aid in dying legislation.

Those nine states, plus the District of Columbia, have passed laws allowing terminally ill patients, usually with less than six months to live, to secure and self-administer drugs to “hasten death.” The legal and moral perspective underlying these laws is that care, even when palliative, need not be prolonged, if death is inevitable and expected to happen organically in six months or less.

Serving those who Served: Reflections on the Meaning of Memorial Day
By Qwynn A. Galloway-Salazar, M.A.
I am sure many of you are familiar with the quote, “not all who wander are lost.” This quote took on a new meaning for me when a mentor and shero woman combat veteran diagnosed with stage 4 breast cancer used it to describe my journey to becoming a veteran hospice volunteer and end-of-life doula.
My journey was not a surprise to her, as she reminded me that the last 20 years of my existence were preparing me physically, mentally, and spiritually for the work that I was called to do. You see, I am an Army veteran, spouse to a combat veteran, mother to military children, a behavioral health professional dedicated to serving the needs of service members, veterans, and their families, and a researcher with an interest in storytelling and the lived experiences of veterans.

INELDA UPDATE: TRAINING & STAFF NEWs
Training Update
Our next end-of-life doula trainings will be held in September. Registration for both September and October will open on the website July 1st.
Staff Update
Welcome Rev. Jamie F. Eaddy, D Min. as Director of Program Development, Victoria Hunter as Program Coordinator, and Brent Marcy as Finance Coordinator.

PRACTICE CORNER

TOOLBOX TIPS

When dealing with a client who may have experienced the death of someone with whom they had a difficult relationship, encourage them to write a letter to the deceased person.

First, have them focus on a positive attribute they received from that individual. It may be challenging, but somewhere deep in their memory there may be a positive moment they remember. Next, have the client write about taking all the disappointments, criticisms, and negative interactions they experienced and bundle them in a package. Lastly, have them write freely about what to do with that package. Inspire them to write from their heart instead of their mind. There is no right or wrong way to deal with those bundled up hurts. Whatever they do with that package will lessen the hurt they experienced with the deceased. Writing from their heart creates a powerful soul communication with the deceased.

– Mary Lemons

SHARING SOURCES
But What Should I Wear to My Own Funeral?
Shrouds have been part of human death rituals for thousands of years. Some- times called “winding sheets” because they may simply be sheets that are wrapped around the deceased before burial, shrouds appear in the funereal customs of cultures and religious prac-tices all over the world. Use of shrouds decreased in western cultures in the
20th Century, but with “green” burial gaining currency, there has been a resurgence of interest in their use.

ASK INELDA

I have a large family and imagine someone asking me soon to act as their doula. Can I use the time aiding my relative towards my certification? —G.

INELDA: We ask that you not include immediate family, close friends, anyone you would consider in your inner circle, for case studies towards your certification. A hall-mark of the doula approach is the ability to engage with clients as a compassionate but objective presence. When you work with people that you share dynamics and attach-ments with, it is harder to maintain that objective presence. For example, if you need to advocate for the dying person with loved ones who don’t agree, being a family member or close friend can cause hard feelings. Also, the conversations that we have with people that we are not intimately connected to can be deeper because we don’t have to worry about the impact on the relationship or our relationships with other family or friends. We want you to have experiences where you are specifically in the objective doula role for your certification cases. If you are unsure whether or not a case will allow you to remain objective, contact us for further guidance.

Please submit questions to [email protected]

Self-Care Prescription

As human beings, creating and enforcing boundaries is foundational to taking care of ourselves. Without boundaries, we can easily lose track of where we begin and end. When we set personal boundaries, we are engaging in an act of self-love that, in its truest form honors the space between ourselves and others. It honors the spiritual exchange between beings.

In the many roles in my life – as a daughter, sister, friend, lover, teacher, nurse, doula, instructor, child of the universe, and student – I have learned that the most important self-care tool I can ever work on are my boundaries. Similarly, the benefits I’ve gained from creating and enforcing personal boundaries have been powerful contributors to my professional and personal evolution. It is essential to my physical, spiritual, and emotional health that I know my own limitations. READ MORE

– Nicole Heidbreder

Self-Care Prescription - Line in the Sand

UPCOMING EVENTS

26
MAY

Webinar: Poetry and Poem Making
John Fox, founder of The Institute for Poetic Medicine, will lead us in some experiential poetic exercises, as we explore the power of poem making at the end of life.

2
JUNE

Peer Mentoring
First Wednesday of every month. We will discuss creative ways to find and work with clients.

30
JUNE

Webinar: Music as Medicine
Catharine DeLong, a Certified Music Thanatologist will share her music and words about how she engages with a dying person through prescriptive music to alleviate pain and suffering.

The Final Word

Sometimes
Sheenagh Pugh
Sometimes things don’t go, after all, from bad to worse. Some years, muscadel faces down frost; green thrives; the crops don’t fail, sometimes a man aims high, and all goes well. A people sometimes will step back from war; elect an honest man; decide they care enough, that they can’t leave some stranger poor. Some men become what they were born for. Sometimes our best efforts do not go amiss; sometimes we do as we meant to. The sun will sometimes melt a field of sorrow that seemed hard frozen: may it happen for you.

International End of Life Doula Association

© INELDA 2021 International End of Life Doula Association is a
501(c)(3) tax-exempt nonprofit organization
Tax ID#: 47-3023741
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