Often while we are living the illusion that we have “everything under control” and have a game plan for keeping it all together, Life Itself Happens, and the unexpected takes you on a “Hero’s Journey” into the deep caverns of your mind, body and spirit.
Facing death, talking about it, or writing about it is uncomfortable. I’m young. I’m healthy and death seems a remote possibility right now. I am called to become an End of Life Doula and yet find this resistance to begin my homework. Like birthing or parenting, no matter how much you buy in, you still must endure the physical labor with all its uncertainty, the struggles and messiness. The curriculum with the institute is intense, and beginning my homework as a Doula means resurrecting feelings around death that I have avoided. In all the ways I could look at death, it hasn’t always been kind or welcomed, and yet it came. Pursuing my training to become an End of Life Doula is the first time that I intentionally chose death.
“Are you willing to pretend something for a minute?” asks Greg Lathrop, a local end-of-life activist. “So, let’s pretend this. March 27 will be your last day here. In this game, we know that you’re going to die March 27. Now, how’s your life? See, it’s a simple perspective shift. Perspective is just a choice. You shift the perspective just that much, and it opens a door. We’re getting somewhere. Now it’s like, ‘I hate my job,’ or ‘I’m in debt up to my eyeballs.’ What would it look like, in these last three months, to live the best three months of your life? It gives us an opportunity. It’s more than a bucket list. What’s your life’s purpose — why are you even here?”
What calls us to want to serve at someone’s bedside as an End of Life Doula? In my case it is death itself. My mother died of breast cancer one month before my seventh birthday. Although she passed with dignity and grace, I can only imagine how she must have felt on hospice knowing that she was terminally ill and would be departing at the young age of thirty-four with two children and a husband that she loved dearly. She did not have an End of Life Doula, nor did she have any rites of passage for her next journey, in this case death. Not only would my mother have benefited from having a special person to sit with her and help her with this transition, but also us kids and my father too. Perhaps becoming an End of Life Doula started a long time ago.
After being blessed with the opportunity to be a part of Phase 1 of the Sacred Passage Doula course in Vancouver, I watched several videos of Dr. Elisabeth Kubler-Ross. I came across an interview that Oprah Winfrey had done with Dr. Elisabeth that had been recorded just before Dr. Elisabeth passed on. Oprah and Dr. E spoke of 'guardian angels' and Oprah asked Dr. K-R if she believed everyone had a guardian angel.
To walk this path, I must die into this truth: . no matter how special, how loved, how young, how old, how close to me, how important, how simply regular anyone is in my dying care or circle, my call is to hold both the universal beauty and mystery of death and the celebration of life in equanimity and balance.
To walk this path, I must die into the truth of these words, this mighty concept: no matter how special, how loved, how young, how old, how close to me, how important, how simply regular anyone is in my dying care or circle, my call is to hold the both the universal beauty and mystery of death and the celebration of life in equanimity and balance.
For many years I worked in palliative care. My patients were those who had gone home to die. Some incredibly special times were shared. I was with them for the last three to twelve weeks of their lives.
People grow a lot when they are faced with their own mortality. I learnt never to underestimate someone’s capacity for growth. Some changes were phenomenal. Each experienced a variety of emotions, as expected, denial, fear, anger, remorse, more denial and eventually acceptance. Every single patient found their peace before they departed though, every one of them.
When questioned about any regrets they had or anything they would do differently, common themes surfaced again and again. Here are the most common five:
The trainings for Death Doulas that are available through institutions such as The Conscious Dying Institute are necessary. They teach attendees and give them an experience that provides them with a working knowledge of how to be present when there is loss. The attendees gain benefit because they learn about themselves and can translate what they have learned to be a utilized when others are dealing with loss.
Jerry was 61 years old. He was a tall man with pale blue eyes. His hair, although grayish, hinted at having once been blond. Finnish/Irish he was. He successfully managed a large real estate firm. He had also created a remarkable family. Jerry and Joyce had two exceptional sons, Mike, 35 and Pat, 31. Both were married and Mike had a baby girl. Both were slender and tall like Dad but they had the dark Spanish eyes of their mother. I was Jerry’s nurse.
Jerry had a history of glomerulonephritis that resulted in chronic renal failure. During the last couple of years he had been managing his own peritoneal dialysis and enjoyed the freedom this method allowed compared to hemodialysis. He came to the ICU after suffering a ruptured abdominal aortic aneurysm, which was repaired emergently.
I soon took a personal interest in Jerry and developed a privileged bond with him and his family. Jerry was in my care day after day, stretching into weeks. I worried about him on my days off and hoped that upon returning I’d find him faring well.
I recently certified with Conscious Dying Institute as a Sacred Passage Doula. Some people asked me why I took the course since I am already a registered nurse certified in Hospice and Palliative Care. I work at a fifteen bed inpatient hospice unit and have done so for over seven years. My answer is thoughtful and measured. Working in the inpatient hospice setting I feel comfortable giving medications, managing symptoms and educating the dying and their families. I am also comfortable with integrative therapies such as Healing Touch, Mindfulness, Aromatherapy, and Guided Imagery. I hold certifications in Healing Touch and Focused Awareness Meditation. And yet, I felt there was more I could learn about working with the dying and their families.
I was right. The Sacred Passage Doula program gave me tools, insights, and practical information to bring back to the hospice unit.
Since the class I have found myself even more present and aware with the dying and their families. I look forward to bringing more of the class ideas into the inpatient hospice environment.
I was terrified. Even though I knew I had received great training, even though I have worked as an in- home care provider for the disabled and knew I could handle physical care. Could I live up to the standards of the people that trained me. In part at least foolish as they had expressed nothing but confidence I me.
As a hospital and hospice chaplain, I am finding the tools and perspectives explored in the Death Doula training to be very helpful. While I have clinical perspectives that are at the forefront of my connections with patients, they are ‘rounded out’ by the existential and practical insights of the training. For example, a few days ago I was visiting with a palliative care patient in the hospital. He has a new prognosis of less than a week to live, although he has been living well with cancer for years.....
“Everything’s important and nothing really matters.”
This is the message relayed to me by my dear friend and brother before he died. A paradoxical statement creating a still point where we sit and witness. In my attempt to give him merely a glimpse of how his life is reflected in mine, I produced a song.
Composed by singer and songwriter Jay Brown [another dear friend and brother]. In his composition he carried the message a step further…
In less than two months, I will take my first steps to join the growing numbers of conscious-death practitioners in North America. I will enter this privileged position as a Sacred Passage End-of-Life Doula trained and certified, by the host of this blog, the Conscious Dying Institute.
Like those before me, I come to this rich opportunity to serve the dying and their families through life experiences that are distinctly my own. Yet, with this training, I am joining a collective of peers and future colleagues with whom I imagine I already share something quite profound: a comfort with mystery.
Creative ways of exploring death and dying in our community was the theme of the gathering where I met Grigsby and Anne a year ago. They were a notable couple: Grigsby, a tall, slender, intelligent, poised male - a Yale-trained historian and Jungian philosopher and Anne, a beautiful, eloquent and thoughtful woman – a former counselor. Recently, I had the honor of bearing witness to Grigsby’s dying process, an experience that has deeply impacted my thoughts about end-of-life care. Grigsby chose to consciously approach the end of his life with strength, equanimity, courage, honesty and mindfulness, with little medical intervention from the time of a terminal diagnosis until his death in his own home seven weeks later.
How do we communicate in our culture about the end of life?
A leading Hospice Society – “Hospice is about living. Hospice strives to bring quality of life and comfort to each patient and their family. Our successes are in helping a patient and family live fully until the end. Often patients will feel better with good pain and symptom management. Hospice is an experience of care and support, different from any other type of care.”
A leading Cancer Society – “Learning that you have advanced disease growing and not responding to treatment – may make you feel lost and afraid. At this point, you know that the cancer is not going away and the time you have left to live probably is limited. But knowing what to expect and being prepared to deal with it can enable you to get the support and care you need so you can have the very best quality of life possible.”
These expressions of how to be supportive at the end of life from both organizations is very closely aligned. At the Conscious Dying Institute, we recognize that the end of life is a special time whose depth can transcend all involved regardless of training and approach.
In last week’s blog, we explored the concept of practicing for death …. a concept we present in the first segment of the Conscious Dying Institute’s End of Life Doula Certificate program. The name of this first segment is: Conscious Dying Practices For Awakening NOW! Along with a focus on awakening, awakening to our innate healing gifts and talents, awakening to the power of bold inquiry, awakening to the gift of presence, there’s quite an emphasis on practices, and not only our own practice for death meditation featured last week.
In keeping with one of the Conscious Dying Principles developed by Founder, Tarron Estes, “Honor other’s beliefs while staying true to your own,” our death doula training program introduces practices from many traditions. Read on to lift your spirit with words and practices from other wisdom traditions.
In the first segment of the Conscious Dying Institute’s End of Life Doula Certificate program, students experience an immersion in preparing the self as a healing environment. As such, we focus on self-care and nurturance, connecting to individual healing gifts, establishing and re-establishing a sense of purpose, and deepening awareness of our own desires, wishes and beliefs about end of life….. and in particular, our own end of life. We do this through practice…..lots and lots of practice, with students participating in breath practice, communication technique practice, movement practice, and many other tools of the trade.
I’ve been asked many times what it was that sparked my fascination with all things deathly since 2012. Everyone has a different answer to this question – some begin exploring when they, because of age or perhaps a diagnosis, become face-to-face with their own mortality. Others, because they were left feeling unsettled after a bad experience with the death of a loved one. Still others intrinsically know that we need to retrieve the “old ways”, the knowledge and practice of folding death back into the arms of a family or community.
For me, it was a gradual waking up to realize that we had it wrong in North America.
To be trained and certified by the Conscious Dying Institute places you as a participant in the movement to Restore Death to its Sacred Place in the Beauty, Mystery and Celebration of Life, Create a New Wisdom-Based Culture of Care and Healing and Contribute to the Evolution of Human Consciousness.
Training represents a prime opportunity to expand your knowledge and skills. Skills that will be useful-- as we are all destined to be touched by death. Through shared learning and practice, End of Life Doulas elevate the experience of deathing. They learn to surrender and trust deeply in each moment. The rich, intensive, life-evoking training graduates receive prepares them to be supportive end of life companions who offer comforting healing care guided by what people want and need most.
My father died when I was seventeen years old. I was young and the thought that my dad would die never entered my mind. It might not have entered his and it certainly did not enter the minds of anyone who knew him. He was healthy, handsome and hearty.
When he died of a heart attack there was shock. He was forty three years old with a wife and two children at home. He passed in the middle of the night with EMTs, blinking red lights and a neighborhood that was awakened from its slumber. Walls were punched, screams were let loose and tears flowed.
I am about to celebrate my seventieth birthday and have survived my own heart attack.
This week we continue with the conclusion of Dr. Matthew Wilburn King's story about learning from death and illness as a teacher. "Death and disease are not enemies; both can be great friends on our journey through life. We should embrace them." We publish this with gratitude for Matthew, and for all the caregivers serving those walking with death.
The trainings at the Conscious Dying Institute offer the possibility of facing our own fears of death and gaining skills to be really present and helpful to others and their families as they pass through their last days. This is a healing path, the sacred work of being an End of Life Doula. Trainings offered in Boulder, Vancouver, Asheville, Gainesville.
I knew I was going to meet the angel of death prior to his visit.
At first I felt trepidation and angst. I didn’t know what to expect from such a powerful spirit, but I knew that he might be coming to collect me, even if I wasn’t ready to go.
I had been diagnosed with Stage IVB of a rare blood cancer, and although my oncologist couldn’t state if I was going to live or die, he made clear that I had a 15 percent chance of survival. In other words, 85 percent of the people diagnosed at the same time as me with this rare blood cancer are now dead.
There is a lot for me learn about who I am. Part of that learning comes from looking back in time and exploring how I feel about the loss of loved ones.
My dad died when I was seventeen. For the last fifty three years I have carried a memory of who he was and wondered what we could have become together. My Uncle Max, who was his best friend, and I had some wonderful conversations about who my Dad was and what he meant to both of us. I am indebted to Uncle Max for giving me a fuller picture of the man who was my father. I cherish those conversations, memories and have some understanding about how they have shaped my present day thoughts and behaviors. Understanding that I needed someone to answer my questions about my father, and how helpful it was, had a bearing on the step that my buddy Mike and I recently took.......
The Sacred Passage Doula Certificate Program prepares caregivers from all disciplines and care settings to befriend death, surrender and trust deeply in each moment and restore death to its sacred place in the beauty, mystery and celebration of life. It builds communities of care and healing, benefiting all those involved in care and healing during critical illness and at end of life.
End of Life Doula Education supports achieving the "Triple Aim" in Healthcare by focusing on Care and Healing at End of Life
The IHI Triple Aim is a framework developed by the Institute for Healthcare Improvement that describes an approach to optimizing health system performance. Conscious Dying Education and Care answers the national, ethical, and cultural imperatives to develop new designs for health at end of life --simultaneously pursuing three dimensions identified by IHI-- called the “Triple Aim”:
Improving the patient experience of care (including quality and satisfaction);
Improving the health of populations (systems, cities, organizations, families, communities)
Spike entered our course with an enormous depth of heart, excellent communication, authentic loving healing presence and years of life experience in the realm of Spiritual Awakening. Even before we knew he was dying, he became our class Beloved as he shared his truth, understanding, and personal experiences during our time together. It was not until our last day together that we discovered that Stephen's heart, his physical beating heart, may stop beating in less than 2 years.
Read this beautiful story of his journey, of the courageous and remarkable task of self-healing before death, and what it was like for a man with a terminal diagnosis to receive the end of life care and education offered in this course.
Most of us have had the raw and devastating experience of The Diagnosis: the harsh news that Death is coming to claim our loved one. In an instant our lives are turned up-side-down. Our stress level blows the top off the meter. We may be frozen in shock or in the free fall of tumultuous emotions which challenge our mental and physical health and make it impossible to carry on with daily life.
The human being on the other side of the desk, the doctor--the one tasked with delivering the horrible news--is also suffering. Besides not having had much if any training in end of life conversations, the average doctor is scheduled to see the next patient in less than 15 minutes.
“We are supposed to see more patients in less time and provide much more documentation. We work daily with human tragedy, illness, death, and loss. Many of us don’t take time off or debrief after adverse events or patient deaths. Instead, we move on to the next patient. It’s no wonder that more than half of physicians report being burned out,” said Joan M. Anzia, MD.
Burnout is characterized by exhaustion, cynicism, and reduced effectiveness—unhappy, stressed out doctors. Physician burnout has been shown to negatively influence quality of care, patient safety, and patient satisfaction.