This Month’s Tip:

For those who may have a challenging time when a client has visitors, I would suggest assessing the client’s needs. The doula role in these scenarios could be one of a gatekeeper, prepping the visitor for what the client would like to be met with that day. The doula could take a different role should a visitor arrive during scheduled time, such as tidying the space or offering to make tea if that seems appropriate. The client might want privacy with visitors, and it’s OK to ask and excuse yourself.

Themes or topics could come up in conversation with a visitor that might be worth exploring deeper when the doula returns to one-on-one time with clients. Did it go how they hoped? Maybe they need suggestions on how to get what they want from their interactions with visitors. Do they engage in small talk to appease those who are uncomfortable with their nearing death, when what they really desire is deep, authentic connection? Find out how they felt in their interaction with their visitor.If the surroundings get a little raucous, a doula could suggest diplomatically that the client might benefit if the energy were to be brought back down. My mother’s hospice nurse did this by having my four energetic siblings and me visit our mom individually once she was actively dying, knowing my mother would likely have an easier time leaving her body if we shifted gears. I’m willing to bet there is a lot of valuable information in observing our clients with their visitors. —Lauren Butler

Posted 10/12/22

I want to share the card “game” called We’re Not Really Strangers. It’s a deck of cards with questions that prompt players to reflect on their experiences and relationships with others. I think the questions are in line with the spirit of EOL doula work, and it may be fruitful to play it with clients. I also recommend playing it with hospice patients, if you volunteer. —Victoria Echevarria

Posted 9/08/22

Since masks are required in many situations, when you’re working with clients, consider wearing a lip-reading mask. It will allow them to see your lips, and it’s better for sharing facial expressions. I use lip-reading masks in the hospital for my spiritual-care visits. —Barbara White

Posted 7/29/22

There is no playbook for any type of sudden death scenario; everyone and every situation is different and requires a lot of improvising. Religion and language often become the hardest elements to navigate and can be the biggest unintentional trigger. For example, let the grievers lay out the language to be used. If they avoid the use of “suicide,” then you do too. If that’s the word they use, then you can use it, but be aware of the context in which the grievers are using language so you don’t contradict them or appropriate their usage. —Katie Owrig

Posted 6/09/22

When I am putting together a celebration of life, I ask family members if there is anything they want to contribute—a speech, poetry, prayer, music. We brainstorm some shared activities for the gathering, like telling a memory and then lighting a candle. Another idea is to have guests write down memories of the person and attach them to branches that are then “planted” in a vase for all to read. Create a moment of togetherness by releasing native butterflies or ladybugs after a funeral. If the deceased had a collection, such as crystals or miniatures, with the family’s approval it could be shared with loved ones. Set up a table with some of their signature items, like cameras, jewelry, favorite candies—anything that might reflect the person’s interests. Think about sharing a part of that person. One could have photos available for people to take home, or a recipe, birdseed, flower seeds, or tree seedlings. At one funeral I went to, each person who spoke added a rock to a cairn in descending order of size. The family took it home and put it in their garden. —Kerith Earlix

Posted 5/12/22

I had a client I was caring for over an extended period who was afraid to die and resistant to conversations about her end of life. While I was sitting vigil in the hospital, she would scream out for help and her eyes would be full of terror. While I was using meditative music, aromatherapy massage, essential oils to support fear and anxiety, guiding family to encourage and comfort her—nothing was bringing her peace. Finally, I climbed into bed with her and just held her for hours, while we had on a chant recommended by a fellow doula playing quietly in the background. I spoke in whispers, encouraging words of letting go. I figured when it comes to being scared or anxious, we have one basic human need…to be held. So that is where my intuition took me. My sweet lady journeyed home two hours after I left her, with her husband and two daughters by her side. No more fear. No more pain. —Tracy Walsh Merriman

Posted 4/12/22

I’ve found that if I have a robust conversation with a potential client via phone or Zoom prior to our first in-person meeting, I have a better sense of the environment I will be entering. During this conversation, I ask specific questions that allow me to understand the client’s comfort level with current COVID-19 protocols, who else resides in the home, who else may be present during our meetings, and many other details. —Angela Laakso, Astral Dragonfly, LLC

Posted 3/10/22

During COVID, planning and attending funerals, memorials, and other honoring and celebration of life ceremonies is challenging. Virtual memorial events (on platforms such as Zoom) are extremely impactful for family and community members, while also being relatively easy to organize. These events can honor a single individual or multiple people who have died over a given period, such as a group in an assisted living facility. 

Having a welcoming host to run the event is very important, as is a clear agenda. A typical opening can start with a prayer, centering exercise, candle lighting, or quote read by the host or a family/community member. If the family has a spiritual or community leader they look to for leadership, that person can be woven into any agenda the family would like to create. The host can invite attendees to unmute themselves and share a story that uplifts the memory of the deceased and those grieving their loss. If it is a large gathering, consider identifying a few select individuals who might have the capacity to share a story—perhaps family members—and asking if they would like to speak.Young people are often excellent contributors to this process and tend to provide the important focus of legacy for these events.

Some memorials use Facebook Live, which allows only the event host to speak but provides the chat function for attendees to share comments, memories, and photos. We often play a slideshow of images of the deceased from birth to death with a musical selection chosen by the loved ones. Both are opportunities for family and community members to participate in planning, which can support their grieving processes. These virtual sessions provide space to amplify any final sentiments or legacy projects created by the deceased and their community and are also an effective time to share grief resources. We may find that virtual memorials continue beyond COVID as another way that end-of-life professionals can make a difference in the death and dying process. —Leigh Ann Roberts, Thresholding, LLC 

Posted 2/10/22

I’d given up trying to make clients of the family whose elder man was dying. Over an 18-month period we had a handful of frank and promising phone calls, but nothing came of them.

So I was surprised and somewhat ambivalent when they contacted me yet again. He was dying. Would I sit with them that night? Perform a vigil? Resentful at this last-minute request, I questioned whether I cared enough to be useful, to drive an hour to an unfamiliar town, to people I’d been trying to serve for so long, when it now felt too late to do what I was trained to do.

Then I remembered the words of the visiting nurse who had cared for my father when he died. “You are taking great care of your dad,” she had said, and with that, she gave my sister and I the confidence to shepherd him through his last days. In honor of my father, I made the trip, equipped only with essential oils, poetry, and inner acceptance. I sat with them while we blessed him on his way, thanked him, and read him poems.

Death doula Sarah Kerr speaks of “lending (her) strength” to her clients. With no time to plan, and no emotional entanglement that gave me an agenda, I was simply there for them in the most basic way. Sitting. Sharing words of blessing and encouragement. Lending them my strength. —Frith Barbat

Posted 1/13/22

Contracts can feel awkward, especially when discussing fees for your services. My advice is to be flexible on the use of the word contract, a term that can feel rather legalese and therefore off-putting. Feel free to call it a “partnership agreement” or “memorandum of understanding” or to use other language that feels more comfortable for you as an end-of-life practitioner. I also suggest including general information about the role of an end-of-life practitioner along with the partnership agreement. This can outline what services you will and won’t cover. As this is an emotional time in people’s lives, having a document that both you and your client can easily refer back to will help define the terms you established together—allowing you both to benefit from the structure of the relationship. —Shannon McGinn-Corona

Posted 12/13/21