Death doulas guide the way for those who face the end of life

As they face dying, some older Americans are turning to death doulas, trained caregivers who guide the dying through the spiritual and logistical challenges they face at the end of life.

The Rev. Olivia Bareham, left, comforts patient Dorothy Ballon in April 2011, in Los Angeles. Photo courtesy of Sacred Crossings

SANTA MONICA, Calif. (RNS) — Every few weeks, a small group in Santa Monica gathers to watch a movie about death.

Sometimes the group watches documentaries like “Griefwalker,” which explores the phobia around death. Other times the films are lighter, like Disney Pixar’s “Coco.”

After the screening, the five to ten viewers, connected by their shared interest in death, dying and grief, sit, share snacks and discuss mortality.

The films almost always provoke meaningful discussions, says Patricia Jauchler, director of On Bright Wings, a social service agency that provides end-of-life guidance and support.

“People have so much to say about the subject, and they are just not allowed to talk,” she said. “Once you give them permission, then they are off and running.”

Jauchler is one of a growing number of death doulas who provide both spiritual guidance and logistical support for those facing the end of life. The name is an adaptation from the more commonly known birth doula profession — rather than facilitating birth, death doulas support a person whose life is coming to a close.

Often doulas like Jauchler are trained in end-of-life planning and work with clients, many of whom are sick or dying, on their advanced directives and living wills.

Participants in a death midwifery training program, offered by Sacred Crossings, pose for a group photo with a coffin that the class built and decorated together, in Los Angeles, in 2018. Photo courtesy of Sacred Crossings

The occupation has existed in various forms for centuries, but it is undergoing a renaissance, in part, due to an aging baby boomer generation that has eschewed religion but still wants sanctity around death.

“The scene of death is sacred space,” Henry Fersko-Weiss, one of the founders of the modern death doula movement, told The New York Times in 2006. “The doula’s job is to protect it.”

Modern death doulas can be traced back to 2003, when Fersko-Weiss, who was then in charge of counseling services at a hospice in New York City, felt the hospice movement had lost its focus on the human side of death.

“Death has become hyper-medicalized, the ‘human’ has been removed from the process,” Fersko-Weiss said in the interview.

He eventually founded the International End of Life Doula Association, or INELDA, in 2015. INELDA offers certification programs for death doulas. Other organizations, like The University of Vermont and the Conscious Dying Institute, have also created death doula training programs.

Alua Arthur. Courtesy photo by Megan Hoffer

As the client approaches death, a doula’s role becomes more spiritually focused.

“I’m doing whatever the dying person wanted,” said Alua Arthur, founder of Going With Grace. “I’m singing or we are reading passages. Or sitting in silence. Sometimes I facilitate a ritual.”

Doulas are not bound by any specific religious practices.

“I’ve read the Bible, the Quran, I work with chevra kadisha in the Jewish tradition,” said Arthur. “I help the people that just want to close the chakras after death. I try to keep my personal spiritual beliefs out of it,” she added.

Baby boomers have helped drive the increase in death doulas.

While many have drifted away from the religiosity of their parents’ generations, some are opening up to spirituality, if not religion.

A study released last year by the University of Southern California’s Edward R. Roybal Institute on Aging, reported that one in five of the 599 baby boomers in the study had increased their religious or spiritual activities as they aged.

“Many people become more engaged in religion and more involved in religious activities as they approach the end of life, USC professor Vern Bengtson said in a news release about the study.

Arlene Stepputat, a Santa Barbara-based death doula and baby boomer, calls death the “last bastion” for her generation. “We have been changing things all along, and now we are changing death, too, because now it is us.”

Stepputat, the founder of Dying in Grace, a doula service, sees the trend toward doulas as a marker of the information age.

“People have more access to information about death and want a more personalized experience with dying,” she said.

The Rev. Olivia Bareham speaks to the Art of Dying Institute thanatology program in 2019, in New York. Photo courtesy of Sacred Crossings

Rev. Olivia Bareham, an inter-faith minister and “death midwife,” teaches courses on end-of-life care. She sees people of all ages taking a keen interest in death.

“There are 22-year-olds, 28-year-olds and 80-year-olds; the ages are across the board,” said Bareham, the founder of Sacred Crossings Institute for Conscious Dying.

Being around death has quieted Bareham’s anxieties about the end of her own life, for the most part.

“I’m totally comfortable with death,” said Bareham, who is 63. “When it’s my turn, I don’t know, maybe fear will creep in, but nothing keeps me awake at night.”

Jauchler said that talking about death has helped her appreciate life more.

She began her career as a drama therapist. She began her death doula work after watching a loved one die and received her doula certification four years ago.

At 65, she fits squarely in the baby boomer generation. She may have started this profession as a way to face her own mortality, but something changed along the way.

“I appreciate life and the experience of living so much more,” Jauchler said. “I say thank you to everything, even the crappy stuff; it’s all part of this life experience.”

Chace Beech is a graduate student at USC Annenberg School of Journalism, interested in alternative spirituality, religion and health reporting. She is a graduate of Kenyon College and a Los Angeles native.

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