When to Call the Death Doula
Recently, I began working with a new client. Their mom will die in days if not hours. The client said to me, "I guess we called you a little too late didn't we?"
I told them that having worked in a culture that avoids the D word for so long, I'm used to coming in late. Part of why I’m suited for this work is because I am naturally adaptable. One has to be very well moored to meet folks in the middle of a storm and help them get to shore.
And, truly, it’s never too late for support if you take a long view of time.
A month earlier I was doing a follow up debriefing session with a client who hired me to be their family member's death doula, but their loved one transitioned peacefully within days. After that we focused on grief and repair work instead. She said to me, "I only wish I'd have called you sooner. I didn’t know we were so close. I didn’t know when it was ok to ask for more help or even that this type of help existed. I didn’t know that dealing with death could be so life affirming. There is so much I didn’t know."
So, when is the right time to call in your death doula? In the words of Tarron Estes of the Conscious Dying Institute, start with the end in mind.
Radical idea: You are here.
You are now.
You matter.
Your needs matter.
You are designed to grow and thrive.
Your needs are satisfiable.
You get to receive multiple layers of right-fit support throughout your life.
Within these cases I’ve highlighted, I see two barriers to folks accessing holistic end of life care planning. One is that our culture treats death as a medical problem to be solved, rather than a natural part of the life cycle, a rite of passage.
A threshold each one of us will cross.
Most people think that contemplating death is inherently scary, lonely, morbid, and overwhelming. It can be life-affirming, heart-opening, relationally mending and can happen at a very slow, gentle pace and depth.
The second barrier is that within our culture of rugged individualism, capitalism on steroids, and patriarchal values, we are primed to experience scarcity around care and support. When the work of care has been desperately devalued, often invisible, deemed unpaid “women’s work” (because it comes naturally to us so it doesn’t have an energetic cost, right?), the unspoken expectation is that we self-extract, extract from someone who has assumed responsibility for our needs (hello, moms, wives, and aunties) or go without. The work of care comes last if it comes at all. I don’t know about you, but I have been conditioned to take care of everyone else’s needs first.
If I were to list out my subconscious priorities they would look something like this:
Tend to the demands of productivity
Tend to the family/friends/community
Tend to the plants and animals
Tend to the home
If there is anything left, help yourself
We don’t have to be martyrs and lone wolves. We are literally wired to thrive in communities of care. That’s right. Humanity as we know it only exists because a group of early homo sapiens learned to cooperate really really well.
It is possible to have reverence for the labor of care, to be in reciprocal relationship with the caregivers and workers in our lives, and to cultivate a much more robust support system than you thought you were allowed.
Loss of independence is a grief we will all experience. Save for an unexpected, accidental death, we will all require care at some point between now and death. It’s normal to grieve this. You don’t have to go without your needs being met because you are no longer able to meet them yourself or perhaps you feel you’re the only one who can do what’s needed. It’s possible to allow the grief of this to be acknowledged with tenderness and to open to receive the care that you need. Needing care can feel so vulnerable. It can be really supportive to build capacity for trusting others to do things you have historically controlled before your dying time.
One of the first things I will suggest to my clients is that we get to call in all the layers of support that are available to us. We get to surround ourselves with meaningful care and nurturance. Where there is a deficit of financial or communal resources, we get creative. Often I notice my clients have one or the other, communal resource or financial. We find what is already working, what is already accessible and we amplify it.
If I could make you believe one thing today, it’s that you are worthy of many layers of support and that care is a renewable resource born of reciprocal relationships and right-fit transactional caregiving. It’s never too late to start investing in relational abundance.
Here are some indicators that you may be ready to call the death doula:
You notice your independence slowly diminishing and you want help learning to cope with these changes while upholding your dignity. You can’t do it alone anymore.
You’re a caregiver and you want more support approaching end of life planning with your dying loved one.
You want holistic care that considers your needs in all realms, throughout your lifespan: physical, mental, emotional, relational, spiritual, practical
You want to know what your choices are as your body and your life changes
You want multi-layered, robust support for yourself, your loved ones, and caregivers throughout the transition from vitality to death.
You want support in approaching the developmental task of elderhood: meaning-making and legacy.
You’re curious about what an intentional relationship with death can mean for your life but don’t want to risk getting stuck in despair or overwhelm by being in it alone.
You want to show up for your people during times of grief and loss without getting mired in your own grief or trying to “fix” them.
You are drawn to the death positive movement, and wonder what an empowered relationship with death could mean for your loved ones and community but don’t want to be isolated because you’re “too morbid”
You want to begin end of life care planning for yourself or with a loved one and are looking for support and a gentle point of entry without getting overwhelmed and shut down.
You want to come to terms with your own death anxiety and orient towards life on purpose in a time of climate collapse and global pandemic without getting stuck in your own existential collapse.
I believe folks wait to call the death doula because once they make the call they are faced with the task of accepting that death is near.
I am here to tell you that on the other side of your fear is you in seamless communion with life, in all of its hues of joy and grief.
You surrounded by meaningful care and support.
You experiencing the sacred intimacy of deep connection with life and death.
You feeling held in the vivid tenderness of your temporality.
You feeling held in belonging in the web of life and ancestry.
You feeling deep, intimate belonging with your friends and family.
You feeling deep, intimate belonging with your body.
You do not have to be actively dying to talk to or work with a Death Doula. Sometimes a simple conversation and discussing the fear around death can invite new shifts in how we live our daily lives.
“The only way death is acceptable, is because we, as human beings, live for something bigger than ourselves.”
— Atul Guwande