“In order to understand the broader picture, you must understand that death is not a bad thing. Death is birth – there is not death, and so it is a transition.” ~Abraham Hicks~

Death is more than just a physical process. Many people who care for those who are dying report that something other than the physiological closing down of the body’s systems happens as we begin to approach death.

Understanding the psychological and social experience of a dying person

Many people associate end-of-life care with treating physical pain. While that is an important part, complete end-of-life care also includes helping the dying person manage mental and emotional distress. An elder who is nearing the end of life who is alert might understandably feel depressed or anxious. Encourage conversations, so the elder has an opportunity to talk about their feelings. You may want to contact a counselor, possibly one familiar with end-of-life issues. If the depression or anxiety is severe, medicine might provide relief.

How can a Death Doula help the dying person with social and psychological concerns?

  • Provide time and space for communication
    • Be available to listen to concerns
    • Communicate your ability to be present with the dying person verbally and non verbally
    • Clarify to make sure that you understand concerns
    • Provide clear, simple information on how person’s symptoms, problems and concerns can be addressed
    • Ask clarifying questions to make sure that you understand the person and that the person understands the end of life team
  • Communicate respect and acceptance of the dying person
    • Develop an awareness of the values and beliefs of the dying person and family
    • Allow the dying person as much control as is possible in end of life care and living situation
    • Maintain realism about expectations for the person’s needs and care, but avoid direct questioning of coping mechanisms such as denial
    • Allow the person to use coping resources even when these seem to minimize the seriousness of the situation
    • Coping mechanisms, such as denial, may be the best or only way for the person to live with a highly stressful and discouraging reality without being overwhelmed
  • Avoid withdrawing prematurely from the dying person
    • As End of Life Doulas we may have difficulty with our own grief and pain in seeing someone die
    • A natural response is to withdraw from these difficult emotions
    • It is extremely important to be aware of this response, however, and to avoid abandoning the person who is dying.
  • Accept that dying may be very difficult for the person
    • Avoid minimizing painful emotions when they are expressed
    • Avoid communicating in an overly positive view of dying, especially when it is clear that the person’s experience is not good
    • Important for health care professionals to be aware of their wishes or desires that people die a ‘good’ death
    • While working to make the process of dying better for patients, it is important to recognize that often death is not beautiful