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Death Doulas Make It Rain...Tears

For these dignified service workers, lack of understanding, support, and financial viability makes their job even harder than it already is.

October 1, 2019

Anne-Marie Keppel
Death With DIgnity
photo by author

here is this call… Echoing through the astral plane, rumbling through the bones of our ancestors and tearing through hospitals. It beckons those privileged with life to check their gut, awaken their curiosity and look at their own mortality—to peer into the cavern of questions that we were told as children would swallow us up whole if we looked too deep.

It may be that our collective unconscious is sensing an impending doom—our earth has reached 7.7 billion and perhaps the next massive plague is not far away. It may be that we are desperately trying to find something real in a society that is severed from its root—the earth—and is increasing shallow (as in, swipe left).

Yale Environment 360 reported a study by DJ Case and Associates that more than three quarters of those in the US spend less than ten hours per week outside and that children between the ages of 8 and 12 are spending three times the amount of time on computers and tech than they do outside. Being outside strengthens our connection to the Earth, which keeps us connected to the cycles of life and death that happen every second of every day.

Or, perhaps after we get sucked into ancestral research (such as Ancestry, or 23andMe) like millions of us currently are, we have a personal desire not to be forgotten. This research may come from the desire to further connect, in a more-and-more disconnected world.

A little more than 100 years ago, before the massive hospital boom in the US, our babies were born at home, our sick and elderly died at home and the family witnessed it all. Now since the natural cycle of life is no longer modeled at home and the only deaths we see are played by actors in movies and in violent video games, maybe we, as a society, are craving the real… to see, to touch, to smell… to feel something that validates that we are, in fact, living.

Actually, there is no better, faster or more thorough way to confirm living than to spend time with a corpse.

I have had the honor of sitting with corpses in my Buddhist community. We physically care of our own deceased and sit with them for 3 days straight, around the clock. There’s a small team who cares for the corpse after death, but it takes a village — or sangha, in this case — to continue to sit in attendance. This is not strange — it’s what we believe is helpful for guiding the essence of the being through the bardo. (The bardo is a state between existence and non-existence after the death of the body while the remaining essence of “you” is undergoing a process of transition.)

During this time sitting with the body, it is impossible not to think of your own death. Later in the evening and through the night, it’s just you (alive) and a corpse (dead) in a room. There have been some winter shifts where I felt so cold in the room that I wondered if the cooling implements needed to be maintained at all. The corpse did not seem to care one way or another.

Now a movement of death is upon the living. Some will scoff as they have been studying death and dying for decades and before them: Greek philosophers like Epicurus and Socrates, and Tibetan Buddhism believe if you are not aware of death, you are not living your life. But what I am referring to is new in our time; an insurgence of young, healthy, smart, ambitious—mostly women—reclaiming deathcare and wanting to care for the dying: Death Doulas. Once, we were the family matriarchs who cared for the dying, the mothers who held their plague-sick babies as they took their last breath, the witches and medicine women who did everything they could to heal the body.

And if not the body, then the soul itself before the departure.

This new movement, of modern death doulas, end-of-life caregivers, home funeral guides, green disposition advocates, artists, musicians, weavers — we are not necessarily matriarchs, mothers, herbalists or doctors. We are your neighbor, your barista, your therapist, your former school teacher, and we hear the call of something ancient that is demanding to be reconnected: Life to Death.

And, on the other hand, some of this wave of “hearing the call” can be quite literal if you walk the halls of some nursing homes in the US. The nursing staff of long term care and those in the ICU and acute care are filled with the elderly know that they will die there, but yet, no one speaks of it. Talking about death with an individual (and perhaps a family) takes time and one-on-one attention that most medical professionals are not trained to do, nor do they have the hours in their demanding load.

Some advocates for death doulas are trying to get ahead of the “silver tsunami”, or, the onslaught of Baby Boomers (now between the ages of 55 and 75) that are about to hit residential care and nursing homes and acute care; though the majority of them may wish to die at home most of them will not. We simply do not have enough facilities or healthcare workers to care for this generation.

The grassroots deathcare movement and the call from the medical/professional field are using the same names of “Death Doula” and “End-of-Life Doula”, as if they share a root intention which could be seen as end of life care. Instead, I see a divide between the need for more care for the dying and those who wish to professionally care for them as such, and the grassroots social movement to incorporate deathcare into the value of life.

I’ve been called into various care facilities to talk about what a death doula does; in a care facility it’s a no-brainer. Hospitals, nursing facilities, residential care—they need people who are willing to talk about death as a natural occurrence- sad though it may be—and not shy away from direct talk when it becomes clear that death will be the only outcome of the hospital stay.

Death doulas can hold hands with those who have no visitors, listen to the fears of the dying one, advocate for the person, help with external affairs or paperwork so the one dying can be unburdened by concerns before their death… Death doulas offer compassion and clarity during dying without becoming overly emotional.

There are not always enough Hospice volunteers or chaplains to do this work and not all are trained, available or ready to do all that should be done. Money should be found within these facilities to compensate death doulas for their time, though I am concerned once the value of their services is formally recognized in hospital settings that they will be under compensated just as nurse assistants are.

Outside of organized care, some death doulas who have completed certificate training want to work on their own clock serving individual families and want to fill their coffers- yes, there is some room for that—but for the most part, it’s too soon.

In our communities death doulas need to be building a foundation. It is too early to be charging for services when our society has no idea what a home funeral is, what deathcare empowerment feels like or what kind of life changing benefits there are from caring for a dying loved one.

We are flying in like a swarm of locusts and disrupting the funeral industry’s crops by advocating for more at home funerals (whenever logistically possible), which reduces the profits for funeral homes. This is getting the attention of the funeral professionals but the families whose bodies the funeral homes have been taking for the past 75 years remain clueless.

Don’t get me wrong, we need funeral homes for many scenarios but we also need to reclaim deathcare as a societal value so we, the living, can begin to feel more alive. We would not fear death and dying as much if we had more exposure to the slow, natural deaths. Currently, the deaths we are most exposed to are violent and come from movies, video games, and news on wars and mass shootings. Those death doulas that are seeking a societal shift need to start the conversation closer to the ground—it needs to spread like mycelium, eating up the death-talk-taboo.

The spores have been spreading with the brilliant design of Death Cafés. We have learned that people do want to talk about death, you just have to give them an opportunity to discuss it — for free.

Death Cafés which have now been held in more than 65 countries around the world, are a wonderful model for the grassroots death doula movement. Shift the focus from the open discussions of Death Cafés to Death Doula Café—information share, compile stories, pull out advance directives, research laws together, discuss your death doula training.

This work must be free, at first, in order to build a foundation and cultural shift.

My intention is to educate and encourage others to care for their own dying loved ones as much as is possible in their life circumstances, and to spark their own innate ability to care for their dying and dead. But deathcare in governmental platforms needs to be discussed as heavily as healthcare.

Deathcare is healthcare. Without the recognition of deathcare as a societal value, we will not be able to find the financial means and emotional support needed to do this important work.

I believe the laborious and heart-wrenching work of being with your own dying and deceased will awaken and heal our society and revitalize our appreciation for the planet and all that is finite. In the meantime, I’ll keep making it rain tears for those that I am honored to attend to and educate. One day maybe I’ll fill some coffers with this work before I wrap it all up with my own ars moriendi.

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