Death Doula Diary…Working with Harry & Alice*

death doula diary bookI met with Harry* and Alice* (all names and identifying details have been changed).   They are a lovely couple who are expecting their first child.   This change in their family life moved them to want to be more prepared for the inevitable, even if it is (hopefully!) a very long time off.  Impending parenthood made them want to be ready for whatever may hit them, which in my experience is very wise.

Before our meeting, I sent them a self-assessment form, that encouraged them to begin thinking about end-of-life care, funeral arrangements, and which things mattered to them.  When I arrived at their home, we got to know one another a little bit, and explored their biggest concerns and fears about Death.

Conversations like this aren’t easy, and I am always impressed by the courage of folks ready to talk about it.  However, as with most folks, once they got past the initial discomfort of discussing the ‘taboo’ they actually got really interested in talking about funeral options.  But I am jumping ahead!

Once we explored their fears, they realized that their bigger fears had to do with losing one another, of missing out on seeing their baby grow up, of feeling alone when the other goes.   Sure, they have fears about life ending and what may or may not come next, and of potential pain at the moment of their demise, but those issues paled in comparison to the others.

Then we reviewed their self-assessment.  They felt they had a reasonable amount of life insurance to help out if one or the other passed, and they were thinking of making steps toward a pre-arrangement in terms of disposition of their body – if not immediately, in the near future (they are still paying for cord blood banking for the child they are expecting, which will be an expense they choose to put before pre-planning expenses at this time, understandably).

I affirmed that even if they didn’t have the funds today, what matters most at this juncture is letting one another know what their preferences are, and ensuring they fill out important paperwork for their care, such as a DNR order if they wish, and durable power of attorney forms, living will, etc.

We spent some time talking about circumstances in which they would or would not want to be kept on life support.  I do not guide these or provide input, I just prompt them with scenarios to consider and let them discuss from there – I serve only as an informational reference.   Once they have made decisions, I coach them in terms of what next steps they need to take to make sure they follow through – and also query what could possibly impede with them taking those steps.   Together we draft an action plan for end-of-life care, based on their choices and decisions. Again, I am a non-biased party here, this is their life and their death – I’ve no business imparting my own preferences.   For instance, to me, a DNR order is highly important.   For them, not so much so, in fact, they lean the other way.   That is their right and I support them in it fully.  This impartial attitude is a key element in a Death Doula, as it should be about you, not the doula’s views.

Next we began to talk about what will happen to their body after they die.   They are both Christian, but other than Christmas and Easter, don’t actively practice their faith.  Budget and cost is a concern to them, but they want their loved ones to have a viewing and the ability to grieve and view their body.   Harry actually wants a kind of party attitude at his wake – he wants people celebrating his life, rather than crying – so long as they realize in celebrating it that they are going to miss the heck out of his awesome self and regret he is gone (his words! They are a really fun couple!).

They ask me to share with them the latest trends.  They had heard that almost half of funerals involve cremation now, but Alice says that she doesn’t want to be burned, she wonders if the body somehow still feels pain.   Again, as a doula, it is not my business to comment one way or another, but to rather ask her questions to help her follow her thinking fully.   Harry feels cremation may be better for the environment, but here I must step in and inform him of certain facts:  Cremation is actually kind of harsh on the environment, and unlike when a body decomposes and turns to dust that the earth can use again, cremation produces ashes.  This still is potentially arguably better than the formaldehyde that is released into the ground when an embalmed body eventually decomposes, which is another fact I introduce.  At this point, Alice interjects.

Turns out the reason she is hung up on how to manage her funeral is because while she doesn’t want to be cremated, she is horrified by the idea of embalming, but knows it is the law and necessary for medical safety and so forth.  At this time, I also correct her misinformation, and inform her of alternatives such as refrigeration and more eco-friendly embalming approaches as well. I also inform her of the savings. At this point I also inform them of natural burial and home viewing or home funerals, and they are fascinated.

Next we talk of other options ranging from direct burial and cremation, to interesting memorializations.  We talk about viewings and services.  Caskets – and how to save a small fortune on all these little details in ways one rarely thinks of, and certainly not when they are grieving.   We also talk about activities in the mourning period that can add to the final event, creating a send-off that fits their personalities, and feels right to them.

We still have more to discuss, we will follow up with an email or perhaps another meeting.  At the end of our meeting, though, Alice hugged me and said she never felt so alive.  That it felt better to have faced the thing that was so frightening to her.  She rubbed her very pregnant belly and said she also felt like a better mom and wife for having discussed it.

I explained that this is because they just took fuller control of their lives, by facing the fact that we do all die, and talking about how they want that inevitable event handled.  That this is taking the keys in our hands.  We can’t predict when or how it will happen, but we can at least address how we want things handled.  That is empowering, enriching.  Staring down our fears about death helps us to more fully embrace life – and again, get a bit more carpe in our diem 🙂

When I arrived home I had a thank you email awaiting me, along with some additional questions.  They again expressed how much more alive and in the moment they felt.

This.  This is what makes this work so wonderful.   You hold the keys  –  you just have to open the door to a simple conversation.    It is amazing how much a simple conversation about the end can oftentimes create a much better middle.  Birth and death are the bookends of  LIFE.   Acknowledging them honestly and moving on can often go a long way to enjoying that life so much more.  All it takes is a little bit of honest conversation and information about what options are available.