Death Doula Training Isn’t the “End” of It

Once you complete any death doula training you need, and you hang out your shingle to offer your services to the public, you begin to realize that what you call yourself matters.

You may have noticed the array of names for how providers in your field refer to themselves. They may be “death doulas,” “end of life doulas,” “death midwives,” or “end of life coaches.” If they focus on the journey of the family after the death of the patient, they may go by “bereavement midwives” or “grief doulas” (or any of the possible variations thereof!).

Consider the feeling, or connotation, each of these terms conveys. Each of the professional terms emerges from a different history. The term “doula” actually comes from a Greek root, meaning a woman who serves. Naturally, doulas are now both female and male, and we generally associate the term with those who help expectant mothers through labor and childbirth. Some male doulas are wittily called “dude-las.”

It matters what you call yourself, not only for how you think about your profession, but for bringing the right people your way, the people who want what you offer.

"Death Doula" vs. "Death Midwife"

In the world of labor and birth, midwives are the ones who provide medical care, while doulas offer the expectant mother emotional, spiritual, and physical care. The role of professional birth doula was born when most births moved out of the home environment and into the world of hospitals, and as family members thus became both less involved and less knowledgeable about helping with births.

Similarly, as the act of dying moved out of the home, having someone who knew how to accompany and to provide comfort and support to them and their families became central to the dying experience.

The choice between the terms “death doula” and “death midwife” conveys the subtlety of the difference between offering support and offering complete expertise across the transition. Some people who have a terminal condition may conceptualize what they need as support during a challenging time, while others consider their need to be having someone there who will accompany them on the complete journey of transition to whatever the other side holds. The term you choose should communicate well how you conceive of the services you offer.

By the same token, as you present your services to the public, you must decide whether it is “death” or “end of life” that your services center on. One advantage of a term such as “death doula,” as compared with “end of life doula,” is that it offers a clear mirror with the term “birth doula,” and, in a relatively young profession, helps educate those who may never have met—much less engaged the services of—a doula for their final period of life as to what you offer.

On the other hand, a variety of reasons may cause someone to prefer the term “end of life” to “death.” Perhaps it seems more positive, or more focused, like hospice philosophy in general, to enhancing the quality of someone’s final months, weeks, or days. Or perhaps using “end of life” enables the potential client to come to terms with the finality of their condition in a gentler fashion.   

Use the language your audience uses (not necessarily the term your death doula training used!)

We live in a culture that can be cagey about talking about death. Clearly, you’ve overcome enough of your own hesitation in order to enter this meaningful field. Of course, those you serve are facing their first death! Unlike you, they may not have given this stage of life much thought up to now, and are almost certainly approaching it with a complex mix of emotions, especially given that death feels pretty personal.
 
A reputable survey found that more people are electing to die at home than at any time since the early 1900s. And, by 2016, the number of those making the choice to die at home exceeded those dying in hospitals. The aging of our population is outstripping the younger people available to care for them, making becoming a death doula (or offering death doula training) a ripe field.
 
Pay attention to the words that your first clients are comfortable with and be willing to change your terminology to fit what your existing clients are telling you. You can adapt to a way of describing what you do that is informed by what you learn from your clients, even as their terminology changes with the times.

Incorporate your specialty as a tagline

If you offer special services such as massage or art therapy if there is an aspect of your work that you’d like to be expanding, you can emphasize that as a tagline on your website and business card, distinguishing yourself among the expanding field of those who work with the dying and their families.

Our own specialty at THE HUMAN JOURNEY® is training end-of-life doulas (or whatever name you end up choosing for yourself!) and others who work with families at points of transition to guide them in our structured process that promotes long-lasting belonging, the meaning-making that can ease anticipatory grief and bereavement, and communication about the values that matter. We’d love to share it with you.

 

Pastoral Care and Counseling in the Realm of Grief

Christians might call those who visit families going through grief or life challenges their pastoral care team or visitation ministry. Jewish congregations might call their congregational practice of visiting the sick or in need Bikur Cholim. Compassionate members of congregations and spiritual groups across Islam, Buddhism, and Hinduism, as well as other groups, also visit those who are anticipating or grieving a loss. Across all religions, illness, death, and grieving are central to the practice. Pastoral care and counseling should address grief and loss, as many turn to faith to answer these issues.

Whatever you call those members of your congregation who offer compassion and pastoral care to the those who are wrestling with difficult news or life situations, they are are a godsend to clergy who use them well.

Do you recognize yourself in the stereotype of the minister or rabbi, or imam who feels as though he or she must answer every call for pastoral care rather than to delegate?

Keep in mind that, just because a congregational member asks for you, that doesn’t mean you need to be the one to provide the care they need. The actual solution that answers what they need may be different from what they’re able to identify as the solution they want.

Do you have the resources to implement pastoral care and counseling on your own?

For a moment, compare the solution you’ve come up with—that it has to be you who makes every visit—with a saying in the consulting world. There, it’s a maxim that what the client identifies as their need is very often not the actual need, when you consider what actually works. We are notoriously bad at identifying our own solutions.

It’s natural for most congregation members to believe that pastoral care and counseling need to come from “the top,” from the person who is their spiritual leader. However, a good part of spiritual care—much as clergy may hate to admit it—actually comes from  being there with a quiet and supportive presence, something that some members of your congregation may already be providing through a bereavement ministry or care ministry. Perhaps that care could be provided more systematically by such a group that already exists by investing time in its professional development. Or if, as many rabbis and pastors say, your congregation’s care ministry has gone unnurtured for some time, maybe it is time to go ahead and ask the people you keep meaning to ask to be part of that care ministry.

It takes discipline to examine your own belief about whether you think that pastoral care can only come from you. Have you not, after all, devoted your life to religious care, leadership, and education in part because you want to foster a caring community within your midst? Consider that it may be your job to cultivate the spiritual gifts of your community by multiplying your efforts at least as much as to provide pastoral counseling directly.

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What Pastoral Training Doesn’t Teach About Grief and Loss

As a pastor, assisting the bereaved offers an important means to touch the lives of those experiencing the loss of a loved one. Indeed, regardless of denomination, this can often be one of the most essential roles that religious institutions can play in the lives of their congregants. In times of mourning, people experience grief in different ways, and grievers require particular sensitivity. The suffering deserve connection and comfort. However, what pastoral training doesn’t teach about grief and loss is essential for understanding how to best serve those in mourning.

Comforting and offering direction to those who grieve is of utmost importance. It is also some of the most challenging work a pastor can take on, and can be exhausting and disheartening. It can also leave pastors feeling underprepared.

In this post, we tackle what pastoral training doesn’t teach about grief and loss, and ways in which people can confront loss through the establishment of purpose and meaning.

Pastoral Training's Approach to Grief and Loss Today

After many months of a pandemic, many if not most of your congregants are experiencing grief in different and unexpected ways. Whether that is the loss of a job or home, a feeling of disconnection from friends, family, and communities, and especially the loss or altered lives of loved ones, grief has taken on myriad forms.

When many people haven’t even been able to be present with those they love who are sick or dying, the process of mourning has become even more fractured. What words can you offer someone who was unable to properly process the death of a loved one?

Pastoral training for grief and loss centers around the moments adjacent to death: the deathbed, the initial loss, the funeral. Yet the timeline of grief does not neatly fall into the same chain of events. Grief can often begin with a diagnosis, and reconciling a loss can ultimately take a lifetime. Anticipatory grief, as a loved one’s health shifts and worsens, or follows an unpredictable path, is critical to reckon with.

Because pastoral training around grief and loss centers on the moments around death, it neglects points during the cycle of grief that can offer opportunities for reconciling that loss. Unfortunately, once losses have been experienced without the proper attention at the right time, the event becomes more difficult to manage and process.

To effectively manage pastoral care for the dying, not just individuals, but the family system needs to be able to derive meaning from impending or past loss. While religion and spirituality may differ from one family member to the next, they are collectively experiencing many of their losses. If they can find meaning together, how much more effectively can they grow closer to each other in their spiritual lives? This is what pastoral training often doesn’t teach about grief and loss.

Yet, to find meaning, the right conversations need to be held at the right times, and with the right people there. Finding the right times to have family conversations is critical for establishing closure.

Helping Those Who Grieve Bring Meaning Forth From Loss

How you touch the lives of those who experience loss can define the ways in which people cope and ultimately provide much-needed, life-affirming care. Deriving meaning out of loss starts before death, and concludes long after. Mourning is a lifelong endeavor that requires a sensitive and perceptive approach.

Rather than focusing exclusively around the moments of death, pastoral care for the sick and dying can begin before death is even a certainty. During the final stages of life, it is often too late to have the important conversations around what one person means to another. The best conversations happen in the period before health takes a turn for the worse, while there is still time to express the things that people mean to each other. These moments are precious and often go neglected.

Starting Hard Conversations

It is important to have difficult conversations about death before it is too late. These often revolve around topics that are hard to bring up or talk about. What do you mean to me? What will you do when I am gone? Will you be able to make it without me?

These questions are hard to bring up, yet they’re at the top of everyone’s minds during the final stages of life. Answering these can provide closure and purpose – leaving them open-ended leads to longing, questioning, and uncertainty.

THE HUMAN JOURNEY® is a grief and loss training and certification program designed to start these discussions. The THJ method is used by a variety of professions centered around loss – social workers, therapists, end-of-life workers, and counselors have all trained to use it with great effect. Because it specifically promotes discussion around spiritual matters, it serves as a method to share in meaning-making, allowing people to comfortably discuss grief, release the past, and perceive a positive future for themselves that can aid in recovery from grief.

Pastoral training around grief and loss focuses on the moments directly around death. While these moments may be the most painful and memorable, failing to have the right conversations beforehand can make the process of mourning much more prolonged and difficult to bear. Learning when to help the suffering, and whom to include, are as important as the act of care itself.

We welcome you to consider joining us for one of our upcoming THE HUMAN JOURNEY® trainings. Feel free to schedule a live demo with Founder Dr. Sara K. Schneider.

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