Doulas help bring death, grief out of the shad­ows

Saskatoon StarPhoenix - - FRONT PAGE - JEN­NIFER ACK­ER­MAN

REGINA El­iz­a­beth George was “tick­led” to see what came af­ter death.

She knew what she wanted her death to be like and she wasn’t afraid.

Di­ag­nosed with colon can­cer in 2010, El­iz­a­beth told a friend she wanted three things to hap­pen when she died: A singing cir­cle, for a few se­lect peo­ple to be present, and for her body not to be “whisked” off right away.

“El­iz­a­beth really wanted to have a good death,” re­calls one of her close friends, Ruth Blaser.

A child­hood ex­pe­ri­ence with death may have been what made El­iz­a­beth so par­tic­u­lar about her own pass­ing. She lost her mother at age 11.

“She felt like the fam­ily re­sponse had been ex­tremely un­healthy,” says Emily Wil­son-George, one of El­iz­a­beth’s two daugh­ters.

“They ba­si­cally took ev­ery­thing that had be­longed to her mother out of the house within the week and never spoke about it. She didn’t want that or any­thing re­motely sim­i­lar.”

Three days be­fore she died, El­iz­a­beth met with two death doulas. To­gether, along with friends and fam­ily, they en­sured her death would go as planned.

A home vigil was or­ga­nized. El­iz­a­beth’s body was not whisked off to the morgue or a fu­neral home. Rather, she was moved to her dear friend Joyce Bethune’s house, gently placed on a mas­sage ta­ble in a room full of trop­i­cal plants and a wa­ter foun­tain — a place where she found peace.

El­iz­a­beth’s fear­less and ac­cept­ing at­ti­tude to­ward her own mor­tal­ity is of­ten the ex­cep­tion.

“When you talk to peo­ple about how they feel about their own death, it’s a bit of a mood killer,” says Wil­son-George. “It’s not really con­sid­ered an ac­cept­able topic of con­ver­sa­tion.”

But an emerg­ing co­hort of death doulas in Regina is bring­ing death, dy­ing and grief out of the shad­ows and into the light.

“There seems to be more heal­ing when we can be shar­ing through grief, shar­ing through death,” says Denise Seguin Horth, one of the death doulas who met with El­iz­a­beth. “So many other cul­tures em­brace death more.”

Seguin Horth trained to be­come a death doula in 2016, through Be­yond Yon­der Vir­tual School for Com­mu­nity Death car­ing in Canada.

Dur­ing a 14-week on­line course, par­tic­i­pants learn ad­vanced plan­ning, home fu­ner­als, post-death body care, end of life fi­nan­cial con­sid­er­a­tions, grief, cel­e­brant skills, death care rit­u­als and more. A practicum is rec­om­mended, but not re­quired.

“I feel that peo­ple have been so dis­tanced from death that grief is heav­ier. It’s al­most like a se­cret … It weighs on you and it just keeps you an­chored down,” says Seguin Horth. “When we can talk more about death and talk more about grief openly with­out the ta­boo, ... it seems to help that en­ergy flow else­where so that we can move on.”

Sharon Pul­ver­ma­cher — who also met with El­iz­a­beth — did her train­ing in 2014. She has been fas­ci­nated by death and the stages of grief since Grade 12 when she wrote a pa­per on death and dy­ing.

Pul­ver­ma­cher says be­ing a death doula not only gives the dy­ing per­son and their fam­i­lies a safe space to ex­press them­selves, but it’s also an op­por­tu­nity to share with them their end of life op­tions.

She says many peo­ple don’t even re­al­ize it’s within their rights to take the body of their loved one home for a vigil or home fu­neral, if that’s what they want to do.

“It’s ... giv­ing them a few more ideas, a few more tools, that they can imag­ine a lit­tle bit more largely than what they would do oth­er­wise,” says Pul­ver­ma­cher.

Def­i­ni­tions vary, but the core role of death doulas is to pro­vide com­fort and sup­port to the dy­ing and their fam­i­lies. Death doulas do one-on-one ses­sions, home vig­ils, sim­ply sit with the dy­ing per­son in the hos­pi­tal hold­ing their hand, and more.

“All death doulas have dif­fer­ent niches. For me per­son­ally, I feel drawn more to ac­com­pa­ny­ing those who are deal­ing with grief,” says Seguin Horth, who vol­un­teers at Regina Was­cana Grace Hos­pice.

She works with a va­ri­ety of peo­ple — those who may have lost a limb or a pet, re­cently di­vorced or, like El­iz­a­beth, some­one who is in the last days of their life.

Be­sides the prac­ti­cal ser­vices death doulas of­fer, such as plan­ning home fu­ner­als or help­ing with liv­ing wills, they also act as a sound­ing board for peo­ple to ex­press their fears and mus­ings about death, the af­ter­life and more.

A death doula brings no emo­tional or per­sonal bag­gage that a friend or fam­ily mem­ber might and al­lows peo­ple the free­dom to ex­press them­selves fully.

Phyl­lis Far­ley, a key U.S. fig­ure in the birthing cen­tre move­ment, at­tended an end-of-life care con­fer­ence in 1998.

At the time, she was a chair­woman at the Ma­ter­nity Cen­ter As­so­ci­a­tion, an or­ga­ni­za­tion de­voted to pro­vid­ing high qual­ity ma­ter­nity care. She re­al­ized the same hand­son help and emo­tional sup­port women re­ceive when giv­ing birth is just as im­por­tant dur­ing death.

“We’re more than will­ing to, and very happy to in many cases, cel­e­brate the birth of a child. While the po­ten­tial of con­nec­tions and the won­der­ful things they might do is al­ways there, we don’t know that, but yet we cel­e­brate it,” says Charisma Thom­son, a pro­fes­sor at the Univer­sity of Regina whose re­search cen­tres on the anthropology of death.

But we deal with death dif­fer­ently.

“Here we have an in­di­vid­ual at the end of their life, who we should be cel­e­brat­ing be­cause we know what they’ve ac­com­plished,” Thom­son says. “Yet it’s that mo­ment when ... peo­ple just turn their back on them and really kind of si­lence their voice.”

At 80-years-old, Far­ley founded an or­ga­ni­za­tion called Doulas to Ac­com­pany and Com­fort the Dy­ing. The pro­gram taught doulas how to lis­ten and re­late to the dy­ing per­son, as well as do more prac­ti­cal things like help­ing with a liv­ing will.

The field grew and made its way to Regina, where there are about 10 death doulas.

Some charge for their ser­vices, some don’t. Ev­ery death doula is dif­fer­ent, and ev­ery per­son who seeks their ser­vices is look­ing for dif­fer­ent things.

For El­iz­a­beth’s daugh­ter, the death doulas were in­valu­able.

“I think that hav­ing the death doulas not only pro­vided the rit­ual that al­lowed us to process (her death) bet­ter, but it re­lieved a lot of the pres­sure,” she says. Not hav­ing to worry about the prac­ti­cal and pro­ce­dural as­pects of the vigil meant she could fo­cus on be­ing with her mom and get­ting clo­sure.

But for many, the re­sponse to death may be much like when El­iz­a­beth’s mother died — push­ing death away.

Thom­son traces so­ci­ety’s shift — from di­rect in­volve­ment in what hap­pens to the body af­ter death, to the cur­rent, very in­sti­tu­tion­al­ized process — back to the Amer­i­can Civil War, when em­balm­ing be­came com­mon prac­tice.

“You have Dr. Thomas Holmes dur­ing the civil war start­ing to use em­balm­ing to send the sol­diers back home ... Once we start to add this clin­i­cal as­pect to it, peo­ple I think be­lieved it was be­yond their abil­i­ties,” says Thom­son.

As em­balm­ing be­came more pop­u­lar, fam­i­lies sought pro­fes­sion­als to do it — tak­ing af­ter­care out of the hands of the fam­ily.

Around the same time, so­ci­ety de­cided priests were not qual­i­fied to de­clare time-of-death and from then on only med­i­cal spe­cial­ists could. Thom­son says this shift also pushed death closer to the clin­i­cal realm rather than a per­sonal one.

“We view death, or in North Amer­ica any­way, ... as though it is an ill­ness or a dis­ease or some­thing that we can over­come with tech­nol­ogy and sci­ence,” says Thom­son.

And to­day, death hap­pens in a hos­pi­tal more of­ten than not. When some­body dies, their body is typ­i­cally moved to the morgue or the cre­ma­to­rium swiftly, giv­ing fam­ily and friends lit­tle time with the body.

Bethune re­mem­bers a dif­fer­ent time when home vig­ils were com­mon. “There was time for peo­ple to say their good­byes and the whole process was a nat­u­ral process,” she says. “I think we’ve just got­ten so far away from that.”

She says hav­ing death doula ser­vices to help with things like home vig­ils or sim­ply talk­ing peo­ple through death is es­sen­tial.

“It means that we don’t push our grief down into our sub­con­scious, into our bod­ies. It means that we deal with it, that this is a nat­u­ral part of life,” says Bethune.

El­iz­a­beth wanted her fam­ily to have the time to say good­bye. So in­stead of deny­ing the in­evitable, she met it with play­ful cu­rios­ity.

“I know it sounds strange, but I’m a bit tick­led at what’s com­ing next,’ El­iz­a­beth told Seguin Horth, who de­scribes that ap­proach as beau­ti­ful. “She went past the fear.”

MICHAEL BELL

Denise Seguin Horth says speak­ing openly about death can help re­move the taboos so­ci­ety has built around it.

Sharon Pul­ver­ma­cher

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