Thoughts on Self-Care from Janie Rakow

by Janie Rakow

“How can you do this work?” is often the question I hear.  “Isn’t it so depressing?”  “I could never do what you do.”

Those of us who are end of life doulas understand full well how we can do this.  We understand that there is nothing more fulfilling than helping a dying person, and their family, during the dying process.  We understand the service that we are called to do, and the honor it is to serve those who need us at this critical time in their lives.

Along with that meaningful and heartfelt service comes a gentle reminder.  Self care.  It is easy to get caught up in that world of service and assistance that we neglect to take care of ourselves. 

We are so busy immersing ourselves in the lives of those who need us.  We are called day or night to the vigil, and off we go. Being available, both physically and mentally, for days or weeks on end can take its toll. If we are not careful and mindful, we will burn out, and we will be of no help at all.

The moment I am called to a vigil, I start to prepare.  I sit in quiet meditation, and ask the powers that be to allow this person’s death to unfold in a loving, peaceful manner.  Not all of us believe in a higher power, but this method speaks to me.  I center my mind and body and leave all my personal baggage of the day behind me. I focus on the patient and the family, and their needs.

When I go to a vigil, I dress comfortably because I never know how long I may be with the dying person and their family.  I often bring layers, just in case the hospital or house is cold.  I find I can concentrate better when I am comfortable.

There are times when I have been confronted with difficult situations.  Sometimes tension in the family is high, and as death gets near, family members can lash out at each other.  I have been in situations where family has tried to pull me in and asked for my opinion.  In these times, I always pause, take a few deep breaths, and try not to react.  Although I may believe one family member is right, I will never get drawn in.  That’s a sure way to lose direction, and lose focus as to the reason we are there.  I breathe, tell them that perhaps we all can take a break and then discuss the situation.  I let them try to work it out and remind them that we are here for their loved one. Often that brings everybody back on track.

I find reflection and breath always helps when we are put on the spot.  And believe me, that happens a lot!

After I leave the vigil for the day, I go home and decompress.  I try to either take a bath or shower, just to bring my body back into my own world, and let go of the vigil. We can never truly leave it behind, but we can be mindful that to be compassionate and effective as a doula, we need to put that family and that vigil in another compartment; to be taken out again when it’s time to go back. 

I also try to go for a walk in nature.  This grounds me and helps me reflect on the vigil in a clearer way.  I find nature helps to calm my body and mind, and restores my energy.  Our energy can be easily drained if we are not careful.  We often hear that as doulas, we “hold space” for the dying person and the family.  Just remember to release that when the vigil is done. 

Lastly, we need to remember that we are human.  Some vigils are more traumatic and difficult than others.  It is useful to reflect on those experiences and learn from them, but not stew in them.  I find if I am conscious that I have tried to do my very best, I can let go of nagging thoughts that I could have done something different or better.  Doulas are always a gift.  To give that gift again, nurture yourself and take care of mind, body and spirit in any way that allows you to keep on giving.