Sunday, January 30, 2005

Death Doulas

In a comment on one of my posts, DeeSign asked a very good question. Are there death mentors? And the answer is "yes." Well, mostly yes. I'll get to that qualification in a minute.

Several hospices provide support to the dying through doulas. In American society, doulas are commonly thought of as support persons during a birth. But like birth, there is a life force transitioning within a family at end of life - however rather than someone entering the world, someone is leaving the world.

The Hospice of Michigan uses social workers to perform the role of death doula.

Hospices are traditionally very dependent on trained volunteers, many of whom serve as an end-of-life doula. For instance, in NYC, hospitals train “CARE-ing Doula” volunteers to provide comfort and companionship to hospitalized patients and their families, particularly at the end of life. At another site in Manhattan, doctors use the Yiddish word for funeral, "levaya," which means "to accompany" to refer to companions who spend time with the dying to ensure that they do not die alone.

There are even doulas to support families as their pets are at the end-of-life: Thanadoulas for dying pets. Thana is Greek for death; Doula is Greek for servant.

If you live in NYC and would like to become a doula for the elderly, please see this site for Washington Heights' Isabella Geriatric Center. The Shira Ruskay Center in New York City also offers a doula training program.

Hospices exist throughout the country. If you have an interest in end-of-life issues and would be interested in serving a dying person as a doula, please contact your local hospice and inquire about volunteer opportunities. I recommend ensuring that the hospice has a good training program in place before offering to volunteer.

Hopefully more and more hospitals with palliative care programs will consider the value of training end-of-life doulas. At the present time, such a program does not exist at my hospital. But as I get more and more involved in the palliative care program there, I will definitely become a stronger advocate for this resource for people who are dying. I am seeing more and more cases where patients simply want someone to sit by their bed and hold their hand. Unfortunately, in a busy hospital setting, nurses are only able to spend so much time providing this type of support.

I want to add one more note with regards to the term "mentor," however. None of us has died before. Some people may have had near death experiences and been brought back. But if you are still alive, you have not truly died in the full sense of that word and that experience. We have learned an abundance from people who have had near death experiences, so I don't mean to devalue that insight when I say that. My point instead is that no one living can honestly be a "mentor" in the traditional sense of that word. I think that is why "doula" is so often used instead. We can try to empathize with the dying and accompany them on their journey through the process of dying as best as we can. But in so many senses, it is the dying whom are teaching us. My mentors are largely my patients.


Anonymous said...

I just acted as a death doula to my mother without knowing such a thing existed. She wanted to die at home and we asked hospice to assist. Unfortunately, she died more quickly than hospice had anticipated and they were understaffed for the number of patients they had transitioning this past weekend. It was an amazing experience to watch her pass over to the other side. I didn't guide her, I walked beside her. She led me. She said, "It's so peaceful here. There's palm trees. It's just so peaceful here." She returned for a few more hours and then her husband walked beside her for her final lucid moments along a beach at sunset. It was a beautiful death with lots of empathy and love. You are right, the patients teach us. She taught me.

Anonymous said...

I live in Michigan in the UP. I appreciate your blog and applaud your work. Are you aware of any "certification" as an end of life doula?

Melaina Comics said...

@Debra - I'm sorry; I haven't heard of any certification for end-of-life doulas. If I hear of anything, I'll post it on my blog.

Linda said...

@Debra. I just graduated as a thanadoula. The certificate is given from the Institute of Traditional Medicine. In Toronto, Ontario

Anonymous said...

Thank you for this amazing information. I am a Nursing student in NYC, and I'm interested in pursuing hospice care. Would you be able to post more information for the CARE-ing and other manhattan programs? I would love to investigate volunteer opportunities and be a part of this wonderful movement.