Have you thought about what it means to grow old and how you will die? I know it’s not a pleasant thought for many but one you should explore. In the United States, we don’t have traditions or customs to help us prepare for death. There are hospice workers and palliative-caregivers that offer pain management but what if that’s not what you need. What options do you have?
Death Doulas, End-of-Life Doulas, Soul Midwives or Transition Coaches fill that need. There are many roles that a Death Doula can fulfill from running errands, to honor the experience of the dying person and their family and using alternative healing methods such as crystals, aromatherapy and Reiki to promote a peaceful transition.
I had the honor of interviewing 2 Death Doulas to learn more about this sacred calling.
CL: Please introduce yourself to my readers.
BH: I’m Brittany Holtson, Owner of Guided Transitions CA and Managing Funeral Director
AA: I’m Adrian Allotey, Owner of You Are Not Alone Elder Care and Certified End-of-Life Doula serving the state of New Jersey.
CL: How would you describe a Death Doula or a Death Midwife?
BH: A Death Midwife is an objective presence outside the family dynamic who holds space for the person actively dying, and guides families through meaningful, religious or nonreligious death rituals and ceremonies.
AA: “Doula” is a Greek word that means a non-medical person that gives physical, emotional and spiritual support to someone else. An End-of-life Doula is a non-medical professional that provides holistic support for the dying and their loved ones before, during, and after death. Trained in the various end of life stages a Doula is able to assist the family with understanding the natural processes while providing comfort and support.
CL: What led you to become a Death Doula?
BH: I work in the funeral industry and recognized the gap between modern needs and traditional funerals. I decided to fill that gap.
AA: I am a spiritual person by nature and death is a spiritual experience. For years, I denied my supernatural gifts. As an energy worker/healer and a level 2 Reiki practitioner who is knowledgeable about essential oils and crystals among other alternative modalities, I came into myself and found that the death arena was the place for me to share my gifts with the world.
It all began with me volunteering for a hospice who understood how these gifts and skills could make a difference in the final moments, days, weeks and months of a person’s life. I decided to become a Death Doula and became certified as such. It was the right decision for me.
CL: What is the number one thing your patients desire from you in your line of work?
BH: My patients want a compassionate, professional to guide them through their death experience.
AA: My greatest gift that I give to my patients is for them to be heard, accepted, and supported.
CL: In your experience, why are people afraid of death? How does your line of work help ease those fears?
BH: Death anxiety is a term used to describe this “fear” of death. It can be caused by a number of things from negative death experiences to just being afraid of the unknown. I aim to help the public develop a healthy relationship with death anxiety and remind people it is the most natural thing to do in the world, that it is a beautiful honor to care for our own loved ones, and that we don’t need to conform to traditions that don’t resignation with the true essence of our loved ones.
AA: Not everyone is afraid of death. Those who are may be afraid for different reasons. Most are afraid of what they don’t know. In addition, we have so much to leave behind in this world. The person with the terminal diagnosis may have experienced death secondhand with a family member or friend dying. Outside of the supernatural, we only get one chance to do it for ourselves. These final moments are unknown. No matter what has happened in our lives, we all know and understand what living is all about. We aren’t that fortunate to know what dying is all about, the fear of the unknown.
Some of us have a belief system of an afterlife. I have seen people with no religion or afterlife beliefs, develop them in their last moments. I have also seen people with a very long history of religion and afterlife beliefs question them and doubt their own readiness to die. There are so many societal messages that foster the good life vs the bad life and the effects of each on the afterlife. These messages can bring on fear as well.
In this world, we have many roles that we play; family member, friend, worker, pet owner, etc. There are so many wonderful reasons to live and the thought of leaving that all behind can be fearful. I find people want to make sure others are taken care of in their absence. Some people are not only afraid for themselves but their loved ones as well.
When I enter into a relationship with someone who has a terminal diagnosis, I listen intently. I allow them to feel what they are feeling. I allow them to ask the difficult questions of themselves and their belief system. I don’t rush them through their feelings. That is not my job nor is it beneficial for anyone. Fear does lessen over time with the proper care, support and education. I haven’t ever personally worked with a person whose fears haven’t been minimized. If I ever do, I am ok with that too.
CL: Is being a Death Doula as scary as it sounds?
BH: Define scary? When I think of scary, I think of running away in a horror film. But if you think scary is facing your own mortality, nurturing a relationship to the Divine, and helping others across the bridge that connects these realms. Then yeah maybe. It can be nerve-racking. But with prayer, practice, and compassion, it can be accomplished with grace.
AA:I have felt many emotions when serving the world as a Death Doula, but feeling scared has never been one of those emotions. I am constantly developing and preparing myself to serve the world in this capacity. Continued professional learning and experiences allow me to be prepared for the people, families and communities that I assist. I volunteer at two local hospices and am a part of many online and in-person learning communities.
CL: What is the key to getting families to be more open to talking about death/end of life?
BH: Ask questions. Ask what was the first time they experienced death. How did the people around them early on in life view things that were death related. What do THEY think, etc?
AA: I meet people on their terms, see them as whole beings, and build relationships with them and their loved ones. I enter into their lives with no expectations. Trust, honesty and relationships are important factors that allow people to open up and share. Communication comes in many forms other than talking. It can be relaxed shoulders, eye contact, a smile, a stretched-out or a held hand, etc.
CL: For those of us who aren’t familiar, could you describe the phases one goes through at the end of life? How do you assist in each phase?
BH: Everyone is different. This is almost an unfair question because to answer in one or two sentences, does not really do this justice. But I suppose if I had to, I would say perhaps a stage of uncertainty, reflection, and acceptance would be a common thread.
AA: The Shock Phase: This is when a person gets a terminal diagnosis. Both the patient and his/her family can experience an overwhelming feeling of shock. I always begin by asking what can I do for you. I allow them to give me direction on how I can best serve. I conduct an assessment to determine if there are any immediate issues, especially around safety. I begin to lay a foundation that includes trust, support, active listening and a sense of security.
The Stabilization Phase: This is a time when things begin to become under control. Immediate issues from the Shock Phase have been addressed. As appropriate, work is done in this phase. Death plans are created. Difficult conversations are had. Forgiveness is sought and given. Life reviews are conducted, evidence that they are more than the current situation but a culmination of their life decisions, actions, roles and contributions. I help to facilitate the highest quality of daily living for both patient and family during this stage. This phase sets the groundwork for a peaceful death as unresolved issues can be a hindrance.
The Transition Phase is the period of time right before a person dies. It can last from hours to days. It is during this phase where I pay close attention to the body shutting down. I continue to communicate what is happening to those around and offer interventions for comfort. Most importantly I reassure the family that the changes that they are observing are a natural part of the dying process as this knowledge alone can be very comforting. Together we give the patient permission to go or say our goodbyes, all while creating the most sacred, spiritual experience and optimum environment.
CL: Why should someone hire a Death Doula?
BH: If you like the idea of getting more involved in any part of your loved one’s final days, but need some guidance and support.
AA: In this day, we are a service-oriented society. Death Doulas provide the education, support and care through a difficult and perhaps unfamiliar time. I believe each death happens just the way it is supposed to and all are equally beautiful.
CL: What’s the difference between a “good” passing and a “bad” passing?
BH: People probably think a good passing means falling asleep and never waking up. No pain, and maybe surrounded by loved ones. While a bad passing is thought of as painful, lonely, and/or the person is scared to let go. But it’s going to mean different things to different people.
AA: I have never personally witnessed a bad passing. I believe the universe gives attention to each passing and what is supposed to happen happens. I spend time supporting individuals in articulating what they would like for the passing to be. Whether they articulate it in their mind, on paper or vocally, I believe words have power and the universe responds to their requests.
I do believe that a good passing is one in which people honor that a person is still living until their last breath by respecting their end of life requests and who they are in that moment.
CL: What is your favorite part about the work you do?
BH: Getting that feeling that I’ve made a positive impact and helped someone at a time they need it most.
AA: I am most grateful for being a part of miracles daily. I won’t say that I am a miracle worker. I don’t have that type of power, but I can say that my formula allows for miracles to happen around me every day. My formula is to take care of myself, open my heart space, tap into my intuition and allow the moment to speak to me. It never fails. I don’t practice mindfulness in this work, I am mindful. As a result, miracles happen.
CL: What is one of your favorite resources to learn more?
AA: I was originally trained by Suzanne O’Brien, former hospice and oncology nurse and current world-renowned Doula, founder and creator of the Doulagivers training program, and founding member of the National Hospice and Palliative Care Organization (NHPCO) End of Life Doula Council. I continue to learn under her leadership but have since expanded my professional development with the leading gurus in the death field. I also find that Death Doulas are a closely-knit community and we share information and experiences all the time. If there is ever a question, I have a growing community where to seek the answer.
CL: Tell us about one profound or unforgettable time in your journey.
BH: The very first time I entered a prep room in mortuary science school was the first time I had actually seen a dead body up close and personal. And it was an unexpected emotional and spiritual experience for me that I had no idea would take place. I thought I would walk in there no problem, but I was more sensitive to the sacredness of it all than I realized and that changed me. I went home and cried and thought about my own mortality and of the people I love. The first experience cracked my heart wide open and I’ve only had more profound experiences since then.
AA: I don’t think I will ever be able to fully articulate the beauty, magic and the miracles I encounter in this work. I hold these moments sacred and in my heart. I choose not to taint them by sharing them.
CL: Thank you for sharing your stories and wisdom today. I truly appreciate you both.