Think about it, none of us gets out of this alive. Death is destiny 100% of the time in this life and yet, within families, the topic can be more forbidden than talking about finances.
Many cultures around the world have rituals that ease the passage between life and death for individuals and their families and, they include end-of-life care in the living process. And yet, here in North America, we have all the supports imaginable for the miraculous process of birth and scarce few for death. This avoidance causes fear, anxiety and stress alongside “best guesses” for many communities and families facing the death of a member.
According to a one poll “About 9 in 10 (89 percent) respondents say doctors should discuss end-of-life care issues with their patients.” However; “relatively few (17 percent) say they’ve had such discussions with a doctor or other health care provider”.
So, if the doctors aren’t talking, who is?
When a person is hospitalized, there is hesitation around discussing comfort care and the words “palliative” and “hospice” can be considered hopeless or upsetting. In the past, they were often only mentioned unless death is imminent. This lack of openness not only added to the confusion and grief but, by many, this considered a disservice to patients and families – they miss unlocking valuable supports that would lead to better decisions related to how the person wishes to spend their final days, weeks, months or even years.
Dying at home
A study by the National Institute on Ageing found that 75% of Canadians would prefer to pass at home So, what does this look like? What are changing attitudes and approaches? And, how can families be better supported by organizations, our healthcare system and what new ideas can we expect.
While there are still significant gaps, particularly in Northern Certainly the growth of palliative care teams and the awareness of hospice related services has risen in Canada as has the rise in the presence and prevalence of the Death Doula or as some prefer to call it End of Life Midwife. Having a person who is not emotionally involved (not to be confused with dis-compassionate) can be the critical key to supporting what’s referred to as a “good death”.
The role of a Death Doula
The End of Life Death Doula Association of Canada provides professional certifications for Death Doulas and has a mission to “set the standard for excellent, compassionate, non-medical end of life care through doula membership, continuing professional development, and agency partnerships within a community of practice framework”. They envision a compassionate, accessible end of life care for all in Canada.
It is important to note that Death Doulas do not administer or prescribe medication. In Canada the
industry is unregulated and does not require a license. Death doulas are simply a trained/experienced support person who is, simply put, not afraid of death.
Finding a doula: Interviewing a few to find a good match is critical since the list of potential services the doula can provide is long and goes everywhere from assistance with home organization and arranging for a ‘Legacy Project’ to knowledge about comfort care and the end stages of dying. Visit https://endoflifedoulaassociation.org/membership-roster for a list association members by region.
A person-centred approach: In a perfect world, the family would discuss with the dying person how they can and would like to be supported. Without judgement, a few options may be discussed if requested. The sooner the right person is included in the process the better the experience will be and the grief recovery post death can begin. Of course, timing of this transitional hire depends upon funds available and individual circumstances.
Theresa Albert is a Stratford based freelance writer and editor as well as an officiant and Death Doula.
Last Aid Course
Serious illness, dying and grief are profound experiences. The Last Aid is a public education course that helps raise awareness and encourages discussion on topics like palliative care, death, dying, grief and bereavement. It boosts skills and equips us with knowledge and confidence to support those at the end of life and navigate our own mortality with greater understanding and courage. It is also designed to build caring communities. chpca.ca
Photos: iStock. Canadian Hospice Palliative Care Association.
