Compassionate End-of-Life Care

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While we often work from the three-phase model, you are in charge. You can choose to do any part or all the work in this model. You can also decide you want to create your own approach. The doula’s role is to support you in discovering what works best for you and your loved ones.

At the heart of the Summing Up & Planning phase is work on life meaning and a remembrance project (sometimes called a legacy project). Life meaning and a remembrance project are closely intertwined. They offer extremely rich and deeply meaningful opportunities for a dying person to engage with their life, address unfinished business, and leave behind something that helps loved ones continue to

connect with them long after their death.

During this phase, the doula will also help the dying person and loved ones express their wishes about the surroundings and interactions they would like to experience during the active dying time. This plan for the last days is shaped by considerations of culture, ethnicity, family traditions, gender, spirituality, social connections, and any other aspect of importance to the people involved.

Conducting Vigil, the second phase of the doula model, centers on holding space for the plan that the dying person and their loved ones worked out in the first phase. The doula provides emotional, spiritual, and physical support. They will use music, touch, guided imagery, ritual, and more to help the dying person have the kind of death that honors who they are, how they lived their life, and how they hoped the

final days and hours would unfold. Those same tools help loved ones cope with and embrace their experience as caregivers and witnesses to this final process of dying.

In this phase, the doula also provides reassurance and explanations regarding the dying person’s symptoms as they occur. In addition, the doula gives loved ones the opportunity for rest. And, if possible, the doula will be present for the dying person’s last breaths.

In the third phase, Early Grief & Reprocessing, the doula helps loved ones, after the death, to review and process the feelings and experiences they had during the Conducting Vigil phase—and perhaps prior to that as well. This kind of reflection can give loved ones the chance to gain a different perspective on their experiences, as well as to hear about someof the beautiful and touching moments the doula witnessed.

In this phase, the doula will also explain the nature of grief, and they will guide loved ones through the early days of the grief process, using many of the same tools employed in previous phases of their work. The reprocessing work can take one long session, several sessions spread out over weeks, or even months.