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Death Doula

There is only one thing that we can all be certain of, and that is that we are all going to die. And even if this is so, is it not astonishing how we prefer not to talk or think about this certainty? More than that, we make it our business to not only not talk about it, we have sterilised it to the point where it is only another clinical medical procedure.

I have seen a few people die – some in hospitals attached to tubes, and others in their own beds at home. And I know the impact of the difference between dying in a hospital and dying at home. Whilst the former is often not avoidable, I do believe that we must make a bigger effort to encourage a dignified, loving death at home. Death doulas are becoming more and more common, and we should embrace their role in helping people to die.

Death is scary for most people, and perhaps the thought of suffering makes it even more so. If only we would pay the same amount of attention to letting someone die as we do to prolong life at all costs, it would perhaps be less frightening. Over the years I have been intrigued by the process of dying – not only of the physical body stopping all its functions, but also of the end of life. What happens? What is the experience for the person who is dying?

The work of Elizabeth Kubler-Ross is seminal on this topic, based on years and years of research and speaking to people who have had “near-death experiences”. And yes, I know the hardcore cynics will take me out on this one, but I do believe that we have a Soul and that the Soul leaves the body at the time of death to live on in another realm.

For people living with memory loss (or dementia), the time of death can be extremely frightening. Whilst it is often very clear that someone is ready to die, environmental factors can influence the process of dying and make it either a very peaceful or a terrible experience. Giving someone the insurance that all is well, that they are loved, that they have done their business in this lifetime and that it is perfectly in order for them to go can be hugely reassuring. Even if it seems that there is no response I believe that consciousness is never affected, not even when the person is in a coma. The verbal reassurance, physical touch, and quiet and peaceful surroundings will encourage a gentle transition.

People seem to nd it dif cult to let go. I have seen protracted deaths that linger for weeks, people suffering physically in a horrific manner because they cannot let go. Sometimes, all they need is the reassurance that all is well. That everything is taken care of, that there is nothing to worry about. And they will let go. The importance of the last days is crucial. Comforting sounds, soft sheets and light (in weight) blankets or a duvet, low light, wonderful smells, offering a favourite drink or just leaving it next to the bed can ease the passage.

I have said this before – dying alone must be the most terrifying experience. If you know that the end is near, stay put. Hold the hand of a loved one. Tell them everything that you never had the courage to tell them. And give them your blessing. They will be guided from this life by your letting go.

We must start talking about death, and finish our business. (My grandmother would never leave dirty dishes overnight in case she passed away in the middle of the night and people would think she was not a good housewife). Make it your business to discuss your wishes with those around you. Let them know exactly how – if you have the choice – you would like to die. Invest in friends who will honour your wishes. Contemplate your own mortality and live as if every day might be your last.

What really matters at the end of life | BJ Miller

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