The gift of a good death

Solen Lees

You have probably heard about the natural birth movement. But what about the natural death movement? Solen Lees explains the growing demand for ‘death doulas’

We will all, without exception, face death one day, but despite this, death remains the last taboo – in western societies, at least. But a change in attitudes seems to be on its way: discussions around death and dying are slowly becoming more acceptable.

This can only be a good thing: the more people talk about death, the more likely they are to share their wishes about what they want to happen at the end of their lives or when they are extremely sick. Most people want to die at home, surrounded by their loved ones; but as life (and death) become more medicalised, the reality is that the majority end up dying in hospitals, or at best, hospices.

In the UK, Living Well Dying Well (LWDW) has helped raised awareness on these issues. It is currently the only organisation offering training for death, or end-of-life, doulas. You may have heard of birth doulas – trained professionals who are there to support a new mother and her family from the preparation for birth through to the birth itself and beyond. But death doulas? Is that a thing?

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Death doulas are trained professionals who support those who are dying and their families in non-medical ways as they make the transition from this life to the next. Their role can vary depending on what the dying person or their family wants from them, ranging from companionship to practical support, such as signposting resources.

Hermione Elliott, founder of LWDW, explains how it all began. “My background is in nursing, midwifery, complementary therapies, palliative care, training and personal development. Then I lived through three deaths in my family, each very different.

“The first was my father, who was 84 when he collapsed in the bathroom one day. My mum, understandably, called an ambulance. When the ambulance service came, they tried resuscitating him with CPR. I was horrified that this could be considered a routine way to approach the situation. Fortunately, he didn’t let them bring him back. I was very proud of him: he would have been an appalling patient and I would have been furious if they had left him handicapped in some way. He was happy with his life, and had no problems about dying.

The need for the doula role has become clearer as death has become increasingly complicated

“The next death was my mum’s. She had a hip operation after a fall at 90, and recovered, but was very frail when she returned to her nursing home and was struggling to rehabilitate. One weekend when I stayed with her, I knew she was trying to weigh up whether she had the energy to get better or whether she wanted to go.

“On the Monday morning she said to me: ‘Hermione, I’d like to pass on now, is that alright?’ And I said, ‘yes, of course.’ The doctor asked her in all sorts of ways if anything would change her mind, but she insisted that she wanted to go. He, the keyworker and I all agreed that this was fine. So she was just given a little patch for pain relief and a catheter so she didn’t have to go to the toilet, and she basically turned her face to the wall and died 48 hours later. She literally left.

“My aunt’s death a few years later was completely different: she had the whole, appalling, medical nightmare. She should have died around Easter time, but she was in and out of hospital, with attempted operations, failed operations, a hospital-acquired infection: she nearly died and was resuscitated. This lasted for about four months, until they eventually got the message and transferred her to a cottage hospital and allowed her to die.

“The idea of end-of-life doulas came to me a couple of years after that. I knew that we needed to be able to support people to die naturally and in their own time, without any of this intervention, and I realised that if people want to die at home, another kind of assistance was necessary. Medical professionals – nurses, doctors, care workers – don’t have time to spend long periods with the family, which can find itself alone. What is needed is someone to walk alongside the family or the individual to give them the confidence to stay with the process, because you never know how long it’s going to last.

The doula can be a facilitator or manager, just put the washing on, or take their place by the bedside so that the carer can have a rest

“This someone is a doula. A doula can step in and relieve the burden of caring for the dying person. When someone is dying at home, it’s usually the spouse or another close relative who tends to end up as the ‘manager’ of everything that is happening surrounding the death, for example answering the phone to friends and family, doing household and administrative tasks. All this is exhausting and takes away from time actually spent with the person who is dying.

“The doula can be a facilitator or manager, just put the washing on, or take their place by the bedside so that the carer can have a rest. He or she can even stay with the family beyond the funeral to help with the transition from a full and busy household to a painfully empty one.

“The need for the doula role has become clearer as death has become increasingly complicated. People are increasingly unhappy about what they’re seeing in hospitals, so there is a need for a huge shift.

“An awareness has been growing for the last five or six years that we need to take ownership of death again, to forge how we would like it to be.”

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  • Jane Adams

    I was my dear mum’s part-time carer for years and fulltime for the last 5 years. The whole hospital/hospice experience was a nightmare for her and me. She had heart failure and cancer at the end and I was rather ill myself caring for her, almost entirely alone. She accepted that she was going to pass and didn’t want to know how long she had. She signed a DNR after discussing it with me, and the hospital revoked it, much to my sadness and disgust! She was 81 and riddled with cancer! All she wanted to do was go when it was her time. Five months into the total nightmare she passed after a frantic rush from the nursing home. I’m a deeply spiritual person and did not want her transition to be as fraught as it was. A doula would have been very welcome especially as most of my family didn’t see the need to help me as well as my mum. Things have to change and the individual’s way to pass must be respected by all! Life is eternal and no life or love ever dies, but what we do while in the physical is important too! <3

  • Devon SeaMoor

    What a beautiful article, honouring the human dying process. I’m fortunate that I’ve never had health issues and a need for a hospital bed, or death.
    With this comment I hope to share some of the beauty that accompanies the dying process, when love and kindness is kept in the room with us.

    My parents have passed on and my father died after 10 years of dementia with my mother caring for him, shielding me and my 8 siblings from
    that task, never asking for help. My father was a minister and in his last service in church, this was one of the lines in his sermon “….when the
    crown is knocked off of one’s head……” suggesting the loss of his marbles. English isn’t my mother’s tongue, it’s perhaps said in a blunt way.

    The first close encounter with my father, was when he was in hospital with the veteran disease, almost lethal. The day we visited him in that state,
    all 9 siblings and my mother, I went to his bed and the look in his face was completely free of “keeping up appearances”. My father was a boy
    of 8 years old, suddenly! He looked at us all with much love in his eyes and I cried… cried… without stopping. I was the only one who cried.
    I still remember our descending in the elevator, with my tears going down as well. One of my siblings was amazed by my crying, we never were
    allowed to share emotions openly in the home…. “keeping up appearances” was the name of the game on many levels.

    I chose to be with my father during the last week of his life and intended to be one night alone with him. My father and I were rather awkward in
    each other’s company, we never had a proper talk. Neither had my 8 siblings. And so, in a way, helped by my father’s unconscious state, there
    were no awkward silences and downcast eyes, at a loss for words. It’s a special humor, also due to being lost for words, literally. Only when I
    moistened his mouth with water and lemon, my father roused a little, sinking back in his own world again soon, afterward.

    In the small hours of the night I’ve knitted the front-side of a sweater that I still wear and so I’m always remembering him when I wear it.
    I’ve read the text of 1 Corinth.13 to my father, that begins with “If I speak in the tongues of men or of angels, but do not have love, I am only a
    resounding gong or a clanging cymbal”. and wrote these verses on a piece of paper and hung it above his pillow. That felt like a proper peace
    treaty, for going to church and hearing all that crap about God looking down at us with frowns, ready to spot our sins and send thunderbolts to
    punish us, was nonsense to me. My intuition and rebellious nature serve me well in life.

    Near my father’s bed, in his last days, I left that part of our past outside our shared space together, in the silence of that night and what counted
    was my father’s peace and comfort. We were in silence together and this time it wasn’t an empty silence. I still remember the grey light of dawn
    entering through the window and the squirls running up the tree nearby. All was silent and when my mother came to be with my father, I left,
    knowing that he would die soon.

    The other special humor during this time, was that the day after his funeral, I was sitting in my garden, in peaceful twilight, and felt a greeting in
    spirit coming from my father. I raised my hand and in some funny way, I shook hands with my father, which felt like he was finally free from the leash
    of having to live up to his role as minister and from having been a rather absent father. That was the 2nd close encounter with my father, that I’ve
    had in my life.

    My mother lived another 10 years and died peacefully, after deciding to stop with eating and drinking, after numerous falls and hurting her back.
    She was fragile like a bird, but strong in her decision to move on to greener pastures, at least, that’s what she hoped for. Also with my mother I’ve
    been alone, seeing her asleep one afternoon, sensing an angry frustrated feeling coming from her. She actually looked like a dark skinned woman.
    I decided that evening, in my home, to call a psychic woman who was experienced as a doula for people who move on to the other side of the veil.

    I told her what I felt about my mother and she asked me to tell her my mother’s full name, including her maiden name. In that way she could discern
    if there was an okay to look into my mother’s dying process. After a while, she conveyed to me, that she witnessed my mother in emotional turmoil,
    about having taken sugar from the sugar bowl at home, about 80 years ago, and for being caught red-handed, also severely punished for it.

    That incident caused my mother to doubt strongly, about losing her right to enter heaven. My mother was in fear for God, my goodness!
    How strange it felt, to witness this fear and doubt in my own mother, who as a minister’s wife. My whole stack of pictures that I’d created around
    the image of my mother, was in ruins. Here I was, her oldest daughter, watching my mother dying, struggling with her fear for punishment!!

    A strange effect this had on me, for the world turned upside down, sort of. I became the mother of my mother, or should I say.. doula? In this
    phone conversation, the woman who clarified my mother’s condition was able to support my mother a bit, by bringing her to Jeshua and Mary
    Magdalene, in spirit, and place my mother’s hand in their hands, for comfort. I felt so touched by this gesture and so relieved!

    A couple of days later I stood near my mother’s bed again, alone, and was amazed by the change in her features. She looked so peaceful!
    I knew at that moment that she was ready to pass over and all was well. Two of her daughters were with her on her last day and my youngest
    sister told her at some point “Mom, you’ve got to go a few steps more and than you’ve arrived” And so it happened, one.. two.. three… and
    my mother blew out her last breath. Personally I felt a huge liberation after my mother’s death, in contrast with my 4 sisters. The fact that
    I’ve helped her to pass over in peace, with the help of a wise doula, was the best goodbye to my mom, who rests in peace with my dad.

  • Devon SeaMoor

    Thank you for your beautiful comment, Jane Adams. You seem to have been quite alone in caring for your mom.
    I think you’ve been an excellent doula-daughter for your mother, blessings on your heart :) <3 :)

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