The gift of a good death

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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