Death Doula

I am a volunteer Death Doula for my local hospice. What is a Death Doula? I assist patients and their loved ones as they are near passing away. It is a very humbling experience and makes the family feel better. I believe people can still hear as they get ready to die, and I try to comfort them and let them know they are not alone.

Usually, I am a Death Doula at the facility, and patients at this point no longer receive anything by mouth, food, or water, but they are very comfortable, and nature takes its course. Today, I am at a nursing home, and I am both sad and appalled. The patient is an 83- year-old who had a stroke, and I was told: “actively dying.” However, she is still getting fluids by IV, being fed through a feeding tube, and presently is breathing at 52 breaths a minute! The average person takes approximately 15 breaths a minute. This woman is using every bit of strength to breathe. It’s exhausting! And this is where morphine has a role. It helps with pain and controls breathing.

And Medicare continues to pay.  Why?    Did anyone discuss her prognosis with the family? Do they understand that she is struggling to breathe? Did she have an Advance Directive? I don’t know if she is a full code, meaning, if (when) her heart stops, will they administer CPR?

We need to prepare for death as we prepare for childbirth, and my being here today is yet another example of the importance of this. When my father-in-law (post-stroke, in chronic pain, demented) was failing, my sister-in-law wanted him to have a feeding tube, among other life-preserving measures. I am “just the daughter-in-law”, but I asked my mother-in-law, “If Dad had had a crystal ball?”  (this was 30 years ago, and Advance Directives were not the standard). I didn’t need to say anything else. My mother-in-law said, “We are done; we will let nature take its course.” Two weeks later, she called me from Florida to tell me he was in bed, she couldn’t wake him, and his breathing had changed. She never called 911; my husband flew down, and he died the next day peacefully.

Make plans, and have a conversation. Maintain control. When it is my time, I don’t plan to be kept alive any longer than my body wants with intravenous fluids and tube feedings. And embrace and accept death as we embrace and accept birth. I have an Advance Directive, which I have discussed with my loved ones. We all need to be prepared.