In 2020, Between The Lines will be offering an End of Life Doula service. This service will be tailored to meet individual needs. More information shortly.
What is an End of Life Doula?
An End of Life (death) Doula, is a person who assists in the dying process, much like a midwife or doula does with the birthing process. It is often a community based and holistic role, aiming to help families & friends cope with death through recognising it as a natural and important part of life. An end of life doula makes themselves available to assist a dying individual and, typically, also the family before, during and after a death occurs. An end of life doula can provide physical, emotional, psychological and even spiritual support.
In the next 25 years, the number of Australians who die each year will double.
People want to die comfortably at home, supported by family, friends and effective services. But dying in Australia is more institutionalised than in the rest of the world. Community and medical attitudes plus a lack of funds for formal community care mean that about half of Australians die in hospital, and about a third in residential care. Often they have impersonal, lingering and lonely deaths; many feel disempowered. Seventy per cent of people want to die at home, yet only about 14 per cent do so. People are twice as likely to die at home in countries such as New Zealand, the United States, Ireland and France.
Increasingly people die when they are old. They are also more likely than their forebears to know that they are going to die in the relatively near future. But we are not taking the opportunity to help people plan to die well. In the last year of life, many experience a disconnected, confusing and distressing array of services, interventions and relationships with health professionals. Many do not get enough palliative care.
Often, this is because people do not discuss the support they would like as they die. When asked, most people have clear preferences for the care they want at the end of their life. But rarely do we have open, systematic conversations that lead to effective end-of-life care plans.
-Grattan Institute 2014
A good death gives people dignity, choice and support to address their physical, personal, social and spiritual needs. This would happen more often with three reforms. First, we need more public discussion about the limits of health care as death approaches, and what we want for the end of life. Second, we need to plan better to ensure that our preferences for the end of life are met. Third, services for those dying of chronic illness need to focus less on institutional care and more on people’s wishes to die at home and in homelike settings.
An end of life doula might offer any of the following services, among many others:
For the dying individual: Whether in the family's home, hospice, hospital or some other setting, an end of life doula often provides the profound gift of companionship. Among many things, this might comprise simply holding the dying person's hand; actively listening to his or her comments; conversing and attempting to offer answers/comfort to the individual's questions/concerns/needs; watching television or reading a book aloud; discussing end-of-life wishes; helping the dying individual resolve/find peace about real or imagined wrongs; etc.
For the family members: Whether in the family's home, hospice, hospital or some other setting, an end of life doula often provides the gift of continuity across the pan-death spectrum, i.e., before, during and after a death occurs. Among many things, this might comprise performing various basic tasks usually conducted by a home caregiver; staying with the dying individual while family members are away; facilitating supportive communication and/or conversations between all parties; assisting in the creation of meaningful goodbyes during the remaining hours of life; helping the family bathe and dress the deceased; serving as a resource for funeral/interment planning and estate settlement; etc.