Pathways to non-medical care and support: Death doula as option-giver

27th December, 2023, 8:15 pm

Death doulas operate within medical, health and social services systems, but tend to be community-anchored with a focus on providing non-medical and often time holistic end of life expertise and support. Our expertise is rooted in a toolkit of complementary and alternative mind and body practices, with former set of practices used alongside medical interventions and regimes, and the latter used instead of.  While the evidence for the efficacy of some of these practices is still evolving, they are increasingly recognised as valuable components of comprehensive end-of-life care. These practices as not new in themselves and neither are they new to those working in the palliative and end of life sectors. A recent systematic review on this subject spotlights some of the more common practices  that has been shown to provide short-term pain relief, promote relaxation, and improve overall well-being and they include:

·      Breathing/ breathe work

·      Acupuncture

·      Hypnotherapy

·      Massage

·      Aromatherapy

·      Music therapy

·      Reflexology

·      Reiki

There are others, of course such as:

1.     Lamenting: Lamenting, which involves the expression of grief and sorrow, can be associated with music therapy, a common practice in palliative care. Music therapy has been shown to reduce stress and improve the emotional well-being.

2.      Sound baths, a form of sound therapy, can be linked to music therapy, which uses sound to promote relaxation and alleviate symptoms such as anxiety and pain in patients receiving end-of-life care and those who are dying.. The use of sound therapy, particularly vibration sound baths utilizing crystal singing bowls and other instruments, has been shown to create beautiful sounds, frequencies, and vibrations that help ease muscle tension and facilitate relaxation.

3.     Crystal Therapy: While specific evidence linking crystal therapy to end-of-life care is limited, it is considered a form of energy therapy that can be considered as part of a holistic approach to care.

4.     The use of herbs is a part of aromatherapy, a practice that involves the use of plant extracts and essential oils to promote physical and emotional well-being.

https://vimeo.com/581593102

What’s in my toolkit?

Is this the point when I say I can do all the above and that they are my core set of services?

Well, I can’t!  

My practice is evolving and at this early point the key focus is knowing that there is a huge array of practices that can be suggested to those who are dying and their families. Part of my work will entail opening options and opportunities for those who are dying to experience relief or try something new, based on their stated desires.

Part of my offer is the offer of having options.

That said. I have been gifted over the last few years.

In tandem with my exploration of death doula work has come an exploration and immersion in photography and crystals. Both are gifts from my lover who has shared his insights and knowledge. He is both a skilled photographer and craftsmen, with a specialist interest creating jewellery. My photography is rooted primarily in the spaces between the sharpness of a focused image. I am fascinated by the peripheral, by what occupies the unfocused, off center spaces, and by the micro exploration of a vein in a leave, the bubbles in a brook or a sliver of shadow. What this has come to mean is that I am mindful of the energy fields, of auras and of the spiritual domains of life and death.  

Again.

The focus and role here is not to proffer these personal preoccupations but to have them to hand as potential offerings to my clients based on their stated desires and needs.

Importantly, the toolkit is set to provide me with ways of holding space and for keeping vigil. Part of my role will involve keeping vigil during the dying process and my use of practices such as massage, music therapy, crystals and meditation, could all be offered as ways to promote comfort, relaxation, and emotional support for both the patient and their loved ones.

Ok. What could this look like?

A possible set of rituals

Context: Last week of life, when loved one is showing clear signs of the body closing down

Directive:  I have been told by the client that they would want me to be involved in the vigil and that touch (gentle massage), sound (playlist of favorite songs and sounds), open windows to see the light and fresh flowers are important. I also know her favorite colours.

Ritual preparation: I will ask that the lights be changed so that they are not glaring (soft yellow). I will bring her favorite flowers and essential oils that are closest to the scent (if possible). I will check on the sound system and play with the sound so that it can be heard but is not too loud or intrusive. I will check (if that is possible) with the loved one to see if any changes need to be made and if my planned ritual is okay. I will have her written wishes to hand and discuss the proposed ritual with the family.

Ritual:  The aim will that each person who visits (based on her listing) picks out two songs to play and share memories around them. Also, to share briefly what can be seen outside from the window and an update on the weather. Family and friends can bring small bunches of flowers (not too many as the smell can be overwhelming) and to have them around the house.. There will be an album of images can be viewed by those visiting and used to help share stories as the vigil take place.

Ritual for me to follow: Every time I visit, I will announce myself. I will wear her favorite colors and my role will be to gently stoke her arms, hold her hands and rub her feet. I will rub her feet as the last thing I do before I leave. I will always say goodbye and thank her for the time we have shared. Before each visit, I will meditate to ground myself and send a prayer to my ancestors and spirit guides to help support the space I am seeking to provide.

Like the end of life 'walkers' in my tribe and linage, I will offer myself.