Doulas Listen For Unmet Needs

What grows from a beginner's mind, and how does having this attitude serve at the end of life?

An EOL Doula is present to create an atmosphere of safety and trust for the client and family. We ask questions and listen deeply, in a non-judgmental way, without expectations or need to fix. Nothing is broken. We respect their experience, understanding, and ability to make sense of what's happening. We're not trying to figure out what's best for them. We listen with an ear to what is being said as well as what isn't. What do they know? What don't they know? What do they want to understand more fully, and what don't they want to know? What's most important for them right here and right now? Are there unmet needs? Often it is not what we think.

I was visiting with a woman that I will call Mary, who I knew from church. She had been diagnosed with cancer years ago, and it had spread to her lungs, and she was having difficulty breathing. Six months earlier, I had visited her in the hospital before a procedure. I showed up to pray with her. At that time, I had just started my End of Life Doula training, so she had questions about it, as did her daughter. Since that day, I have often prayed for her.

She had questions about my EOL Doula Training

Fast forward to a few weeks ago, during the pandemic, her daughter contacted me, concerned about her mother as she was having more difficulty breathing and the procedure she'd had twice wasn't working. I listened carefully as she shared. Mary wasn't ready to stop treatment. She was growing weaker and lived alone. Her daughter felt it would be difficult for her to get to her doctor's office. Though she lived nearby, she worried about her mom being alone and what could happen. She expressed relief and gratitude when I offered to visit. Mary smiled when I arrived and soon after asked me to share more about my training, so I did. I mentioned talking with people about death and dying. She quickly responded by shaking her head: "I'm not comfortable talking about dying." I responded that it was okay with me if she wasn't comfortable and asked what she would like to talk about. Her face lit up as she began to speak. "I'm looking forward to moving into my daughter's new house when it's finished. I'll be living with her family. I'll have my own space there." In the moment that was most important to her. She needed some assurance that she would live to have that experience. I listened and joined in her excitement and hope. I stayed in contact with her daughter; however, I did not get to see Mary again. Within two weeks of my visit, she was receiving in-home hospice care. I listened for her daughter's needs, sensed her anxiety, and answered her direct questions honestly and authentically.

I practiced being fully present, compassionate, which in that moment significantly helped alleviate her distress. She accessed her inner courage and strength. The morning of the day her mother died, I had sensed she was nearing death, reached out to her daughter, and we texted back and forth. I listened and answered her questions. I supported her emotionally, mentally, and spiritually. She shared that the day before, her mom told her family she was ready to go. It was a great relief for everyone.

I kept her mom and the family in my heart and my prayers. She died peacefully 2 hours later, surrounded by her loved ones. I was in service as a companion and guide for Mary, her daughter, and her family from a distance. They were empowered and prepared to show up and participate fully as their beloved passed away peacefully.

No One Deserves to Die Alone

Doulas may begin serving their client from the time of diagnosis or after months, weeks, or days including the final moments after death and bereavement. Either the client or a family member can initiate the contact. In Mary's case, it was her daughter who contacted me. They lived close by. That's not always the case. Some family members are hours away or in another country. We serve as a companion and guide for our client and their family as they navigate the unknown, often chaotic, sometimes messy journey of death and dying. Our service is non-medical, family-centered, and includes collaborating with our client's healthcare team. Whenever possible, our goal and our mission is that our client has a "good death'.

Do EOL Doulas provide service during this time of COVID-19? Yes! More than ever, it's so important to show up and be creative. Loneliness is a form of suffering. From my observation, death and dying is hard work. No one deserves to die alone.