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:
- A great need for alternative care providers due to an aging boomer generation with fewer children;
- Better models that don’t require residential care facilities (keeping people at home);
- Entrepreneurs figuring out how to better use cell phone technology in caregiving;
- A noticeable gap between lifespan and “healthspan” (we are living longer but not necessarily in good health)
- More conversations about a “good death” with less technological intervention, at home;
- Robots sharing in caregiving;
- Intentional, inter-generational senior housing to reduce isolation and promote interdependence (rather than independence).
End-of-Life Doulas as the Solution
These recommendations and predictions point to the widespread need for end-of-life doulas, because end-of-life doulas:
- Provide high-quality, wide-ranging, family-centered, personalized care;
- Help people stay home, which is where most people say they want to die;
- Keep costs down (by helping people stay at home);
- Are “alternative care providers,” meeting the needs of aging baby boomers (one-third of whom are single and one-quarter of whom do not have children or support systems nearby).
- Are trained in Advance Care Planning; and
- Provide one-to-one compassionate, non-medical care and support.
In the future, robots and phone apps may indeed be able to help with simple caregiving tasks and monitoring, but they will never be able to help folks talk about a “good death” and how to prepare to die naturally at home. With the development of additional technological support systems and the increasing number of “elder orphans,” end-of-life doulas are even more needed to help individuals navigate the myriad choices at the end-of-life. It just makes sense, doesn’t it? We are living longer, apart from our family members (if indeed we have any), and wanting to plan ahead and die a natural death at home. Care facilities are becoming more expensive and isolating.
Personally, if it doesn’t work out to live with one of my children, I’d like to form a group home with my friends and hire a doula or two or three to live with us and take care of us. Doesn’t that sound nice? Won’t you be my doula?
Visit Lifespan Doula Association.
- 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.