Beyond birthing, doulas currently offer comfort to the dying

Fortunately, a volunteer coming from the local hospice’s doula program was on hand to help the then-77-year-old resident of Ridgewood, N.J., comfortably die at home. She picked up the letter as well as read the item with compassion.

“I’m not sure I could have done of which,” said Lisa Silvershein, the daughter who helped arrange a more comfortable end-of-life experience for her mom in 2014. “The doula not only made my mom’s life easier — she made our lives easier, too.”

Doulas, an ancient Greek term of which loosely means a woman helping another woman, have long comforted women during birthing. nevertheless the definition has broadened, as well as doula programs — a combination of male as well as female volunteers as well as paid certified staff — are increasingly helping elderly patients fulfill wishes to die at home rather than in hospitals or nursing homes.

End-of-life doula specialists are currently in at least a half-dozen states, including brand-new York, Colorado as well as Texas, said Henry Fersko-Weiss, executive director of the International End of Life Doula Association, which he co-founded in 2015. A social worker with hospice experience, he first came across the idea 15 years ago, when a birth doula told him of which she was also offering comfort to the dying.

“I thought to myself: Oh my God, This particular is usually exactly what we should be doing at end of life,” said Fersko-Weiss, who has since authored a book, “Caring for the Dying: The Doula Approach to a Meaningful Death.”

In 2003, he set up what he says was the nation’s first end-of-life doula company to train people to care for the dying. Fersko-Weiss helped create the doula program at Valley Home Care in Paramus, N.J., which assisted the Gutenstein family.

The doula association trains as well as certifies professional end-of-life doulas. Certification requires 22 hours of classes of which cost about $0 for those who trust to make a career of the item. Volunteer doulas complete 18 hours of training, with costs typically paid by a sponsoring hospital or hospice.

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“Nobody should die alone,” said Ellen Rand, a longtime hospice volunteer, blogger as well as health journalist. Finding a doula is usually a proactive step for families facing terminal illnesses. “I’ve never come across anyone who has done too much end-of-life planning — the item’s usually just the opposite,” she said.

The end-of-life doula movement is usually supported by the National Hospice as well as Palliative Care Organization. “As long as they go through a training process, I think they can complement the work of the hospice team definitely well,” said John Mastrojohn III, the organization’s executive vice president. “The more people there to help a patient as well as family the better.”

While most hospice workers focus on the physical needs of the dying, doulas offer emotional as well as spiritual support. They often help the dying reflect on life’s meaning. They conduct comforting rituals, including light touch as well as holding hands. They will read to patients or play favorite music. Doulas also explain signs as well as symptoms of dying to the family as well as help them know what’s coming next.

“We work as a team with doulas,” says Bonnie Schneider, manager of social services at Valley Home Care, part of the Valley Health System, which oversaw Gutenstein’s care. Its volunteer doulas must be trained, go through criminal background checks as well as health screenings as well as offer three written references.

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Shortly after Gutenstein, a Valley Hospice volunteer, was diagnosed with incurable cancer, the hospice connected her with Fersko-Weiss.

“To be honest, we weren’t sure if an end-of-life doula could work for us,” said Silvershein. “nevertheless we finally decided, what the heck, let’s give the item a shot.”

the item turned out to be just what the family needed. In her final days, approximately eight different doula volunteers assisted Gutenstein as well as her family, with one always by her side.

“They ended up generating our lives easier — as well as hers,” said Gutenstein’s husband, Bob. “All along, the doulas helped us to know what to expect next — which is usually something most of us didn’t know.”

This particular included planning for Gutenstein’s final days, which the doula association refers to as “the vigil.” The doulas helped create a “vigil plan,” which detailed who should be inside the room at her death as well as the sounds as well as smells she wanted around her.

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Early on, Gutenstein’s volunteer doulas recommended of which the family assemble a memory book. “My mom loved the idea,” recalled Silvershein. The book featured photos, letters, writings as well as illustrations.

The doulas frequently read the memory book to Ellen because they saw how happy the item made her.

When family needed time away coming from Ellen’s bedside, the doulas frequently talked, read or sang to her. One doula sang Ellen’s favorite song: “Over the Rainbow.”

There are things end-of-life doulas can’t do — at least in most hospital or hospice settings. Because they aren’t nurses, they aren’t typically permitted to physically care for patients — whether the item’s changing bandages or giving them medications. nevertheless in private homes, doulas as well as families agree on acceptable tasks, said Fersko-Weiss.

They can do light massage, or they might brush teeth as well as help a primary caregiver change a patient’s clothes as well as bedding, said Fersko-Weiss. Doulas also can help caregivers reposition someone in bed or apply cold compresses if fever spikes.

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Unlike home health aides, end-of-life doulas are trained in emotional as well as spiritual care — not just physical care, said Fersko-Weiss.

Perhaps the most important thing doulas did for the Gutensteins was to constantly make everyone inside the room — particularly Ellen — more comfortable. “the item was the doula who kept her positive,” said Bob Gutenstein.

Doulas give family members time to sleep, which can improve their decision-generating. “The last few days, the doulas were there around the clock, which was definitely helpful for me,” said Silvershein.

The best way to find a volunteer end-of-life doula is usually via a patient’s local hospital or hospice, said Fersko-Weiss. nevertheless volunteers typically have limited availability.

To find paid doulas, his association intends to post a list on its website with contact information for member doulas across the country. Until then, Fersko-Weiss suggested directly contacting his group’s website at

Trained as well as certified non-volunteer doulas cost $40 to $100 per hour, Fersko-Weiss said. Some charge flat rates for initial visits as well as during a dying patient’s final days, when round-the-clock vigilance is usually often needed. Costs for of which end-stage service typically range coming from $1,0 to $4,000, he said.

At the moment, medical insurance does not cover paid doula services, said Fersko-Weiss. nevertheless just as some insurance companies are starting to offer partial reimbursements for birth doulas, he predicts of which families may eventually receive some reimbursements for end-of-life doulas.

Gutenstein’s doulas were volunteers, as well as the family later showed its thanks by giving a substantial donation to the hospital’s doula unit.

Knowing what they know currently, said Bob Gutenstein, they could have happily paid for the services if volunteers were not available. the item was, after all, the doulas who recognized as well as alerted both Lisa as well as Bob of which Ellen’s death was imminent.

“We wouldn’t have had This particular confirmation without them,” Silvershein said.

the item gave Bob — who had been dozing at his wife’s bedside — his final moments with his wife, which he might have otherwise missed. After the doula alerted him to Ellen’s last breaths, “I reached over, as well as she gave me a squeeze,” said Bob, “as well as then, she was gone.”

Source : Beyond birthing, doulas currently offer comfort to the dying

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