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

 I decided to become an end-of-life doula after answering a call to support a dear friend’s mother and her family after she received a terminal diagnosis with less than one week to live. I visited with the patient and her family three times over four days. During those visits I spoke with the family about the process that was unfolding, spoke to them about the body’s natural process of shutting down and what they could expect. I let them know that it was OK to get up close and cuddle with their mother, to share favorite memories with her, even if she was unresponsive. I taught them how to perform comfort touch on her hands and feet, providing not only physical relief to their mother, but also offering a beautiful opportunity for physical connection and comfort for all involved.

As my wife and I were close friends of this family, my wife joined me on one of my visits and saw, for the first time in over five years of my working as a hospice volunteer, what it was that I had become so passionate about. After my friend’s mother died, my friend shared with me that my support had turned her mother’s, her siblings’, and her experience of those final days from a period of anxiety, grief, and fear into one of beautiful transformation. I shared with my wife that the amount of time and depth of services I provided to our friend and her family was simply not possible through hospice, due to the limited resources and bureaucratic limitations placed on hospice staff and volunteers. Those comments, coupled with my wife’s witnessing of how natural it was for me to serve in that way, led her to say to me, “You have to become an end-of-life doula!” I realized that she was right and signed up for INELDA training three weeks later. 

How long have you been doing this type of work?

 I have over 13 years of experience in end-of-life care (seven years working for a family-owned funeral home and six years as a hospice volunteer and now end-of-life doula). I have served hundreds of patients in their final days and accompanied many of them at the time of their passing.

What type of environment do you work in?

 I serve in a hospice inpatient care center, in nursing homes and assisted living facilities, as well as in patient homes.

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

 I pause—either in my car before entering a home or at the threshold of the hospital room or independent living apartment—and consciously set aside any personal thoughts, worries, or issues that have occupied my mind up until that moment, and I commit myself fully to serving this client and their family. I say a silent prayer to be a channel of peace in whatever form that may take, and then I surrender to what unfolds.

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

 I arrived at the hospice care center for my normal shift and asked one of the nurses if anyone was actively dying and alone. She said that Jen [not her real name], a woman in her late 70s, was transitioning but was really struggling. When I entered Jen’s room, I found her lying in bed, eyes slightly open and her breathing extremely labored. Her body was tense, and she had a very scared look in her eyes. I took Jen’s hand into mine, introduced myself, took a seat next to her bed, and said a silent prayer that I might be a channel of peace for Jen. I then surrendered to whatever feelings or sense of guidance came forward. After a few minutes of witnessing Jen’s anxiety, I felt moved to stand up and gently stroke her forehead. As I did this, Jen turned her head toward me. As I was doing this, a nurse entered Jen’s room ready to give her another round of medication to help ease Jen’s struggle. While the nurse was preparing Jen’s port in her right arm to receive the medication, holding Jen’s hand and using my other hand to stroke her forehead, I looked into Jen’s eyes and silently communicated to her, “You are so loved, you are so loved.” Before the nurse could administer the medication, Jen looked into my eyes, relaxed, and exhaled her last breath.

 That experience reminded me that when we open our hearts and commit to being fully present for our patients, we’ll know what to do to best serve them. I was also reminded of the power of unconditional love and that, at the end of life, that is often the single most important and transformative gift people can receive.

Who has been one of your teachers or mentors?

 I have been truly inspired by the many amazing hospice nurses, certified nursing assistants, social workers, chaplains, and doctors I’ve had the privilege to work with. Their compassion, love, and dedication to serving people at the end of life have deepened my appreciation for the sacredness of this work. But if I were to select one person who has influenced me most in my end-of-life service work, it would be Frank Ostaseski, cofounder of the Zen Hospice Project and Metta Institute, and author of The Five Invitations: Discovering What Death Can Teach Us About Living Fully. I work every day to put his teachings into practice.

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

 I truly view my doula work as an extension of the work I started as a hospice volunteer. When I started doing this work, I had a sense that I should have a tool kit filled with ideas of what I should do in certain situations, specific things to say, and steps I should take to serve my patients/clients. I quickly learned that there is no such tool kit. The reality is that the most important tool is your willingness to be fully present, to allow things to unfold as they will and to feel very comfortable acknowledging that you don’t know how best to serve a patient or their family. It’s in the moment that you surrender to that reality that you realize your unconditional love and complete openness to serving in whatever way is needed will inform your actions and empower you to serve in immeasurable and beautiful ways.

Do you have any words of encouragement for fellow doulas?

 Very few people are comfortable serving the dying, let alone finding joy in the service. But for those of us who find it a “calling,” we are truly blessed. As doulas, we don’t have to be everything for every client. If you haven’t already done so, I encourage you to identify from the broad spectrum of potential end-of-life doula services the specific services that bring you the most joy. In doing so, you will likely find the specialties in which you can best serve your clients. For other services your clients may need, tap your local doula collaborative.

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

 I dream of a day in which the idea of calling an end-of-life doula when someone receives a terminal diagnosis is as natural and common as calling one’s general practitioner when they feel sick. When that day comes, our society will have shed the stigma of death and will have come to see the wisdom in embracing death and the beautiful transformative experience it offers the dying person and their loved ones.