End of Life Doula/Transitional Coaching(Also known as death midwifery)
No matter what the circumstances of our death, we can come to an acceptance and choose a conscious death. This is the heart of the Doula’s work with the patient and the family.
The Doula/Transitional coach is there initially to help with deep active listening, guided visualization for relaxation and to help relieve fear and anxiety, to concentrate on legacy and life review with the dying person and the family, and inevitably to hold sacred space for the vigil and attendance at the bedside in the final stages.
Working alongside the rest of the hospice team, the Doula initially has the opportunity to help the dying person expand their vision in terms of their needs, longings and understanding of death. We hope to make it peaceful, graceful and free of suffering. The Doula’s goal is also to help rekindle the ritual and rhythm in dying, creating the opportunity for a sacred relationship to death for the person and their family, to help assuage spiritual distress, and address unfinished business.
We believe it is important to re-introduce a sense of sacredness to the dying process. The Doula focuses on creating a plan for patients at the end of life. The idea is to emphasize thoughtful planning on how the last days should look, sound and feel. The Doula’s role is multi-fold, but in essence, it is about a new approach to dying, one that encourages a dying person and their loved ones to face their fear, break through denial, and engage in an honest, open exploration of death and dying.
The Doula approach encompasses three different areas of activity. The first involves the dying person reflecting on their life and planning for how they envision the last days to unfold. The second area centers on holding the space for the plan of those last days, when the body is finally breaking down. The last aspect of the plan begins shortly after the person dies, as family and friends process their experiences of the dying time and begin their work on grief.
Of course, there is often not time to implement the entirety of the plan when a person is actively dying, but a Doula can provide whatever comfort is possible in those final days or hours, as well as build a group for around-the-clock vigil care, which provides emotional and spiritual support for both the dying person and their loved ones.
When time permits though, the Doula can offer opportunities to explore the meaning of a life and to convey that meaning through legacy work - expressed through memory books, videos, stories, art projects, etc. It helps people to introduce a sense of sacredness into the dying process, utilizing ritual, guided imagery, touch, music in order to bring greater comfort to everyone. This is a spiritual practice, though, not a religious one. The Doula does not impose a specific belief system, but rather takes their lead from the desires of what the dying person or family would like to incorporate.
Finally, it helps family to understand the importance of reprocessing the dying experience after their loved one dies, reshaping the images and thoughts that may be haunting their waking mind and dreams, carrying them through this period of grief and bereavement.
Naturally this approach to dying helps the patient and family to be more in control of how the dying process will unfold.