Talking about death can be challenging. Some of us are fascinated by the topic, finding it easy to consider the many perspectives about the natural, personal, possibly even sacred journey each of us will travel at the end of our lives. Others are nervous, or afraid of giving the subject energy and want only to address it when faced with a terminal diagnosis or a death of a loved one. Considering what a good death might look like is simply overwhelming and beyond consideration. How can there be a good death when talking about a cherished member of your family or circle of loved ones?
Last winter, as I was beginning my education as a Death Doula, I was invited to a dinner with my partner and close friends. One of the people there is a chaplain in a palliative care home. We began to talk about our experiences, and the beauty and importance of being open when we discuss dying and death. We engaged the others in the discussion, and I found the experience fascinating. Then the host said “can we stop talking about this? It is so depressing, and I want it to stop.” I had been talking about my intention to enter end-of-life care for a while and my audiences had all been very interested and aligned with my excitement, so the sudden opposition was surprising, and it took a breath to honour her request.
The role of the Death Doula is to meet you, the dying person, where you are in your journey and support you and your loved ones to achieve a good death in a manner that aligns with your wishes. The term good death seems like an oxymoron — a complete impossibility— but being able to consider and discuss what that means to you can bring peace, compassion and even joy to the end of your life for you and everyone that matters to you. A best death is unique for every dying person. It is a reflection of your life and may include legacy moments that will impact your world after your death. Ira Byock, MD, in his book Dying Well: Peace and Possibilities at the End of Life discusses many cases of unique individuals achieving a good death because each person was able to die their way. In the location of their choosing and surrounded by people (or not), sights and sound of their choosing and with the medical intervention of their choosing.
In Canada we have many options that many, perhaps even most people, may not be aware of when it comes to controlling the environment at the time of your death. There are many who may not know about the hospice options in their neighbourhood, how you might find out about Medical Assistance in Dying (MAiD), what your access to palliative care in your home can look like and many other aspects related to the end of your life. Again, Death Doulas can help with all that information. They are a practical, spiritual, emotional support for the dying and can provide support to you and your loved ones for as little or as much of the journey as you want, and protecting your wishes and your voice at all times.
Death Doulas engage in four Domains of Care: Advance Death Care, Legacy, Vigil, and Bereavement and Grief. They can begin with you at the time of a diagnosis and support the creation and communication of your advance care plans. These are the wishes you have for your care and your death. They might involve organizing paperwork, meeting with loved ones to ensure everyone is aware of your wishes and advocating for your needs. It is also common to have a Death Doula conduct a Life Review where you can look at your contributions and your perspectives on death which helps you communicate your wishes and identify the things that matter to you at the end of your life.
Doulas bring you and your loved ones together in many ways, one being in Legacy projects. Legacy projects are great ways to connect in love and create something together that captures your memory and will last in the hearts of those around you for years to come. It may be a photo collection or a craft involving materials that represent you. It may be letter-writing or story-telling. It might be a comic book creation or a practical joke retrospective. Again, Legacy projects are as unique as the people creating them.
Vigil plans can be challenging to discuss. Creating a Vigil plan is getting down to the details of what makes a good death for you. Where do you want to be and with whom? Do you want music, candles, what view do you want to look at? Upon your death, are there any cultural or spiritual rituals you wish to take place? These details are not always things you think you have a voice in, but you do!
After your death there can be expected and unexpected feelings for your loved ones. Bereavement and Grief are as personal as the dying process; unique to everyone. A Death Doula can reach out and help process these natural feelings. We are not doctors and generally not counsellors, but we are trained in death and if your feelings continue to be overwhelming, we can help connect you with the resources that will help in the long term.
Talking about death is healthy. It is positive and can help you and those that matter most to you, to share ideas, values and beliefs about death in general, as you begin to consider what a good death for you would look like.
Rhonda Garnier is a Death Doula candidate training with Home Hospice Association.
She works with the dying and their families and hosts
Death Cafes in the Brant County / Brantford area.
Comentários