Another aspect to having good boundaries as an end-of-life doula is simply knowing when to hold back and not to say or do anything. Recently, my good friend died. During her illness I realized early on that I would have to try really hard not to try to be her doula because I was her friend first. Looking back, I did a lot of doula things, but it was always on the fly, spontaneous and mixed in with friend things. She never asked for a sit-down doula consultation, but we did talk about end-of-life issues and decisions as part of normal conversation when she asked about my work and teaching. She quietly took it all in and then she moved on. Did I want to tell her more? Did I want to meet with the family, or at least her partner, and “be a doula?” Yes, but I did not. I held back. I waited and tried to be available to her when she needed me.
Note: Jon Underwood, the founder of the international Death Cafe, died suddenly on June 27. Read more about it here.
I first heard about Death Café in the spring of 2012. I can’t remember where, but I think it was from someone in the National Home Funeral Alliance (NHFA). I was on the board of directors at the time. I thought, “What a brilliant idea! I’m already kind of doing that,” what with a natural death study group I had been leading for two years, and the inevitable discussions that people would stay for after community home funeral presentations. I knew that people need to talk about death and that there wasn’t enough opportunity. So, I began to look into what this Death Café thing was all about.
In 2014, the National Institutes of Health published the landmark report Dying in America in which they made several recommendations regarding end-of-life care, namely, that we need:
- Comprehensive person-centered, family-oriented end-of-life care;
- More education and better standards for doing Advance Care Planning;
- More end-of-life care providers of many disciplines who are better trained; and
- Better policies and payment systems to support high-quality end-of-life care.
What the Future of End-of-Life Care Looks Like
Recently, Next Avenue Blogger Denise Logeland published a summary of interviews with experts about What the Future of Caregiving Looks Like. They stated that in the next 10 years there would be:
- Maintain good professional and personal boundaries. Sometimes we feel like chameleons, but even as we blend in, we remain separate and strong. Don’t make promises you can’t keep. It’s not appropriate to become friends with clients, no matter how long or mutually rewarding your professional relationship has been. It is too difficult and muddy to transition from this role. Unless you are acting as end-of-life doula for family or close friends, you will say good-bye to them after your services are no longer needed and that is as it should be.
The work of being with the dying and their family is intense and can be very draining. It is essential to take good care of yourself to be sustainable. Here are some suggestions….
(1) Pay attention to your spiritual or inner life to stay grounded and personally fulfilled. This means figuring out how you fit into the bigger picture. Whether you are part of a larger congregation of like believers or a lone wolf, adopt practices that fill your soul and give you hope, and do them. The word “practice” is important here.