What’s an End-of-Life Doula?

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"Do you guys ever think about dying?" - Barbie

While many folks have heard of doulas in relation to childbirth, it's likely many haven't encountered the idea of an end-of-life doula (or death doula)—someone who assists a dying person and their loved ones before, during and after a death. Like many professions, it takes a special kind of person to walk this path voluntarily with others at their most vulnerable.

But there's much to learn and understand about the end-of-life period.

Laura Hoekstra, an End-of-Life Doula and Owner of Grace In The Leaving End-of-Life Doula Services, explained more about what her work entails.

"We provide non-medical, emotional, spiritual and practical support, as well as education about the dying process, preparation for what's to come and guidance while you're grieving," said Hoekstra, who's no stranger to personal grief.

She considers this career to be her calling, saying: "I didn't choose this line of work; it chose me."

The death of Hoekstra's husband in August 2000, when their daughter Betsy was only a toddler, changed the trajectory of her life. Later, Hoekstra was a caregiver for both her parents until their deaths in 2013 and 2020. Over the years, she's led grief support groups, book studies and shared her grief journey with others. Having been a caregiver while working full-time and parenting, Hoekstra understands a person can only stretch themselves so far to meet the demands of aging or terminally ill loved ones.

"As I moved toward retirement, I realized my life experience, gifts and skills were uniquely equipping me for end-of-fife work," she explained. "That's why I obtained my training and certifications, then opened my small business in November 2022."

End-of-life doulas work with people as early as a first diagnosis all the way through bereavement. They offer many services which can be adapted to the specific needs of the individuals and families they serve, such as: Companionship; household support; hands-on, non-medical comfort measures; life review and legacy work; logistical planning; respite care; bedside vigil; identification of community resources; and much more.

But it's true, there remains a stigma surrounding death, with many refusing to confront their mortality at all.

"Many people think that talking about death and dying will jinx them, possibly even hastening their own death or that of a loved one," Hoekstra said. "But just as we're born, we will die. And there are things we can do to make that part of life less mysterious. We need to better understand the process; know more about this inescapable and universal life event."

Hoekstra hopes people can move to talk more openly about grief and create space for caring conversations.

"As members of communities, we know how to prepare for and celebrate the birth of a child. This same level of planning for death shouldn't be rare and it shouldn't be something we leave to the 'professionals' in medical or funeral care," Hoekstra said. "It's time we become our own best advocates for the kind of care and quality of life we want if or when terminal illness interrupts and challenges our plans."

Misconceptions about this time in our lives abound.

"One of the greatest misconceptions is that hospice care only benefits someone who is within days or weeks of dying," Hoekstra explained, noting that evidence shows persons under hospice care for a terminal diagnosis have a better quality of life, and sometimes even more quantity, than those without.

End-of-life doulas, Hoekstra shared, can help fill a gap for those in hospice as it relates to non-medical needs, caregiver support, family support with anticipatory grief, organizing space and paperwork.

"I serve people in their homes, wherever that home may be: With family, alone, assisted living or even in the hospital," she said. "End-of-life doulas support clients and their families; we don't take the place of doctors or hospice professionals."

In her volunteer work as a victim advocate with the Kent County Sheriff's Office, Hoekstra sees many unexpected deaths in which families often have no idea what their loved one wanted, the location of important paperwork and how best to honor them. She works to guide them through that difficult journey.

"People often wonder how I can work around so much sickness, death, grief and loss," Hoekstra said. "For me, my life is clearly richer and deeper because I understand the beauty in each of life's seasons. Listening to life stories, sharing music and rituals, helping families care for and comfort their loved ones, celebrating life by honoring death ... there's nothing more rewarding."

Learn more by following Grace in the Leaving on Facebook, LinkedIn or at graceintheleaving.com.

Written by Sarah Suydam, Managing Editor for West Michigan Woman.

This article originally appeared in the Dec '23/Jan '24 issue of West Michigan Woman.


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