Doula Helps People Navigate Dying Process
CRAFTSBURY, Vt. (AP) — What will my death look like?
If that question causes anxiety or fear or confusion, Anne-Marie Keppel can help.
Just as midwives and birth doulas help bring a new life into the world, death doulas help ease a life out.
And that kind of support is more and more in demand, as the baby boomer generation faces the deaths of their parents and their own in a society that doesn't really recognize the need for and depth of mourning, she said.
Doula is a Greek word for female servant or handmaid. A death doula is a non-medical holistic caregiver who works hand in hand with hospice workers, palliative care facilities, doctors, therapists, family members and especially the person who is dying.
"We try to weave in and out between all of those, to try and make death a safer and less fearful, less confusing situation," Keppel said.
Keppel does both advanced planning and assistance with death itself.
"If you can have these conversations in advance of somebody dying, then you have more emotional space," she said. That includes deciding: "What would I like to do with my body when I die?"
Ideally, Keppel said the doula would help a person answer the question "What would my death look like?"
Just talking about it will ease some of the fears that come up, she said.
Death doulas are also there for family members, not just the person preparing for death.
"Sometimes they want somebody to come because somebody is having a lot of anxiety," she said.
"Perhaps the one who needs the assistance is the partner," Keppel said.
Supporting the partner allows that person to better support the one who is dying, she said.
Keppel works with a group of seniors in a local retirement home. She's also worked with families who have suddenly lost younger people to accidents, suicide or prolonged early illnesses.
For many people, there's an inner belief that death will never come, whether the dying person is 40 or 80, she said.
When someone calls to plan his or her own death, she says: "Good for you! You are reasonably healthy, you've got your eyes wide open and you want to talk about this."
She helps with advanced directives that are filed with the state: questionnaires that ask if you want resuscitation, feeding tubes or other medical treatment in case you are incapacitated.
And she helps with ethical wills, a list of what's important beyond the formal last will and testament.
People can decide in advance who should receive their treasured belongings, a kind of emotional will separate from the last will and testament. Some share secret recipes or ask that special family traditions be continued, Keppel said.
It's like an emotional bucket list. She also helps people repair connections that may have frayed with family and friends.
On their death bed, Keppel said "people have more regret of not saying things . than of doing things."
"We don't all get to choose how we want to die," Keppel said.
But if it's to be a death at a hospice, what kind of music should be playing? Should the sun shine in?
"That's something people may not realize," Keppel said.
She is getting calls from people who want to help their parents. She urges adult children to try to resolve their own advanced planning first before asking their parents to do it.
"Before you ask your dad 'Do you want resuscitation?' I tell them to work it out for themselves," Keppel said.
"Then you get an idea what this question feels like."
"I try to empower people to do this themselves. I don't want to be the hero who comes in and saves the day. If parents have a hard time opening up, of course I will talk to them."
In a hospice room, the doula's role totally depends on the circumstances, whether to be there, who to help.
Sometimes it's encouraging family members to take bickering outside, she said. "Hearing is often the last to go. . That is in defense of the one who is dying."
Sometimes it's talking to young family members, or just taking the dog out of the room, she said.
A hospice death can be the ideal situation, where people have time to prepare and to say farewell.
It's incredibly difficult for family members when the death is by accident or a suicide, she said.
Family members "want to talk after without feeling judged . because there can be a lot of guilt."
"I can't remedy everything, I am not a therapist. Sometimes just being willing (to listen) is enough," she said.
A death doula does encourage people to see experts, like therapists, psychiatrists or religious leaders if that is needed, Keppel said.
She helps people through the aftermath of death.
"One woman said to me 'How long will this take to get through this?'"
She wanted to the pain of mourning to end, to get back to her life.
"This is your life right now," Keppel said she told her.
Mourning will change people, they grow with it, and then one day they will know when it's eased, she said.
Keppel became a death doula after work with elderly people in nursing homes as a licensed nurse assistant and private duty nurse. She directed Meals on Wheels in Montpelier and has trained in multiple holistic healing pathways.
She took a 300-hour course to become a death doula. Keppel said that training regimens vary greatly since the field is not regulated and there is no professional certification.
But she expects that to change as more people discover the value of the service.
Being a death doula is not a career, Keppel said. She has another nearly full-time job and a three year old, a busy job in itself.
Keppel works as a death doula out of her home, called Casa Luna just off Craftsbury Common, for an honorarium, with a sliding scale fee for hours that offers her clients a way to compensate her within their means.
"Some people traded maple syrup with me. I said thank you!"
People who are seeking help with the dying phase of life are discovering death doulas, she says.
"It's not that popular yet but I think that it's coming. Hospice is starting to find it's helpful."
"As a whole society we don't recognize mourning. . People want you to cheer up. That's not healthy. Everybody is mourning at one time or another," she said.
Instead, it's "back to work, back to work," she said.
"We used to wear all black. We used to be kind to that person, don't lay on the horn, don't get angry in the grocery store.
"We don't have that visual recognition anymore."
She wants to empower people to take care of their family members in the time of dying.
"Our communities are going to be a lot nicer to each other if we can reclaim some of this death care."
Information from: The Caledonian-Record, http://www.caledonianrecord.com
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