Karen Bellone, The Seventh Sense and Exit Strategy for the Dying

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

I have been inspired by the mystery of death throughout my life. After living through less-than-perfect deaths of precious loved ones when I was young, I became acutely aware of just how many things do not necessarily go right in the 11th hour. I realized that I needed to find a better way to be present for those I loved and to ease their transitions. In 2016, after many years working as a filmmaker and photographer, I answered a growing passion to seek out ways to use my skills to create visual and auditory tools for those transitioning in death—to create ways and means to calm, comfort, and assuage fears and anxieties, to clear a path for a good death. I believe bearing witness in death for one another is a gift, and a responsibility of our humanity. I had never heard of an end-of-life doula before, but in researching the field I discovered INELDA, as well as other organizations offering training, and decided to embark upon this life-changing path.

How long have you been doing this type of work?

I feel as if I have always been engaged in end-of-life work in some form or another. After I attended the three-day INELDA workshop in 2017, I committed to working directly in the field. I was extremely fortunate to find a full-time job as an end-of-life doula working in an innovative hospice, where I also trained the volunteers. I became certified by INELDA in 2019. I have spent the last two years building Exit Strategy for Dying, an online resource hub for all matters relating to death from the mundane to the sacred. I am dedicated to building death awareness through inspired education, as well as through my private practice.

What type of environment do you work in?

I run my practice from home in New York’s Hudson Valley in a bucolic, light-filled environment, where I also hold classes. I have seen clients in my home, in their homes, in assisted living and board and care facilities, in hospitals, over Zoom and FaceTime, and even on the phone. I meet the person where they are, literally and figuratively. My practice is open to animals as well as humans.

What do you do before you meet with a new client?

I like to try to center myself with breathing and meditation before a meeting, even if on the phone, so that I can open my heart and my intuitive abilities to the person through deep active listening. I believe that each life is a profound story, and we all deserve to have our stories heard, preserved, and told. In whatever way is possible, I like to find out as much information as I can before meeting with a new client—from their doctor, nurse, caregiver, loved ones. Of course there is the medical information—what is the nature and the trajectory of their illness. More important, though, is listening to the individual and to what the focal points of their life are, their loves, where do they find inspiration, who is in their circle of care, what are their belief systems, even what type of music they like, any and all—no detail too small. Everything about a person’s existence comes into play at end of life. It also depends on what stage I meet them. The more I know, the better I can offer my services to the individual, and to craft a care plan with the team that carries the client into and through their transition from this life.

Can you share a short anecdote or insight that changed you?

My very first experience in hospice was to sit vigil with a man who was imminently dying. He had no loved ones to attend to him; he was virtually alone. All I knew before meeting him was that he resided in a care facility, that he spoke only Spanish, and that he was Catholic. I felt overwhelmed, asking myself, “What am I actually able to do to aid him in his final hours?” I sat with him and looked into his eyes to make a connection, and I could see that he was seeking that connection—to be seen at his time of passing. It is amazing how communication needs no words; the eyes can say it all. Then I took in the surroundings. Often in facilities they tend to leave on bright lights and the TV to keep a person “company,” but I could sense that the environment was too chaotic and it needed to be brought down to a more peaceful feeling. I turned the TV and the lights off, and it had an immediate effect on his countenance. It calmed him down. I had downloaded some Catholic prayers in Spanish before visiting with him, and I recited those to him. I played him classical music, held his hand, and touched his forehead. In other words, I simply concentrated on him, connecting with him through the heart and the intuitive senses. I learned three very important things that day. Firstly, in this work, the best we can do is to truly meet each person exactly where they are on their journey without any preconceptions or expectations. Secondly, I can’t go wrong if I connect from the heart in leading my actions. And thirdly, an understanding that self-care is a crucial part of doing the work, because it can be at once exhilarating and depleting, in ways that might not seem obvious at first.

Who has been one of your teachers or mentors?

More than anything, I have been taught all of the most profound truths by those who have allowed me to walk alongside them on their journeys in transitioning from life. My teachers and mentors have been diverse, and although I have not worked directly with most of them, they have influenced my practice deeply—Robert Thurman, BJ Miller, Frank Ostaseski, Stephen Jenkinson, Barbara Karnes, Henry Fersko-Weiss, Ram Dass, Amy Cunningham, Peter Fenwick, Olivia Bareham, David Kessler, Irene Smith… I believe it is of the utmost importance to stay connected within a network of thought and influence, with other doulas and with those in palliative medicine, social work and hospice, spiritual care, and with grief and loss practitioners. It takes community to bring about more understanding and accessibility to this work and its profound value for all of us.

What do you wish you had known when you started as a doula?

As soon as I finished the three-day INELDA training, I was highly inspired to find, or to create, a thriving doula practice with others to provide a much-needed community service for end of life. In the process of getting certified, and especially working in hospice care, I had my eyes opened wide. I realized there was a hill to climb in order to open up our culture to what we may miss by denying death. I quickly found that death education would also be part of my calling, and that is when I cofounded Exit Strategy for Dying. All of us in end-of-life work are in an activist movement too, perhaps without realizing it.

Do you have any words of encouragement for fellow doulas?

If you discover that this work is your passion, then try not to be too discouraged by the obstacles you may find traversing this little-understood path in modern culture. We are all trailblazers, and that comes with a certain kind of responsibility. Keep forging ahead, with the help of others in our community and people that believe in the beauty of our work. We are an important part of bringing light into the darkness. Each and every person we encounter is a gift, and we in turn are a gift for them. There is power in networking and keeping in communication with like-minded people—we all have different approaches and strengths we bring to this process, and we grow exponentially in our impact on our culture when we find strength and resilience in one another, as well as in the families with whom we walk the path. Reach out; don’t be alone in this work. The good news is that from the time I did the initial three-day INELDA workshop until now, I have seen an incredible rise in general interest and focus on end-of-life work and doulas specifically.

What is your dream for your practice or doulas in general?

My working dream is to be an integral part of a local community, as well as a worldwide community, that treasures the mystery and the wisdom that death offers us on our human journeys. No one should die alone or afraid, especially if they do not want to. We can take care of one another and “walk each other home.” There are so many gifts bestowed when we embrace death within our lives, one of which is perhaps to live more fully while here. For me this is great inspiration! As Mahatma Gandhi said, “Life and death are but phases of the same thing, the reverse and obverse of the same coin. Death is as necessary for man’s growth as life itself.”