The first person I served in my role of end-of-life Doula taught me the power of listening and led me to trust that just being with the dying step-by-step was enough. She taught me that the opportunities to connect with presence and wonder are all around and that it is when we engage with the dying holding the intention to
make meaning, that we can serve most effectively. I also learned that the body, mind, and soul know what to do, people just need space and a companion or two to offer support as they play out the dying role.
I first met this woman when she was already admitted to a local hospital. At the beginning we moved slowly in getting to know each other and building trust. This involved lots of space and lots of listening. Over a few days, we became familiar with one another and spent time together with ease.
I waited as she took the lead. I had no agenda other than to meet her in the moment, to listen, and to attend to her senses. She was transferred to Hospice shortly after we met, so opportunities to plan for treatment, or provide education on end-of-life options and resources were limited. She was within weeks of her death. Her family was unable to be with her in the afternoons so I was called on to spend a few hours a day at her bedside. My goal was to assist her to find connection, meaning, presence and pleasure.
If she was awake when I arrived I would pull up a chair, and simply say “good afternoon” and offer a warm smile. It was an honour to be invited on to her island, companioning her as she lay in her narrow hospital bed. Death beds are sacred places, where what is not important falls away. A place where so much has fallen away, social roles and responsibilities, daily news and happenings. These islands are most often places inhabited by what is truly important, almost always relationships, they are usually places centred around love. Egos, ambition, to-do lists, possessions, all become awkward company when people are on the end-of-life journey.
As the days went on, I would find her asleep more often than not, when I arrived. I would quietly walk in, close the door to the busy, over-lit hallway, and silently attend to the room. I would open the curtains to reveal the garden and allow the natural light to fill the room. I would tidy the bedside table, refresh the flowers, arrange the framed photographs on the windowsill. This is how we tend to sacred spaces, and rooms where death awaits are always sacred spaces. With the room tidied and ordered, I would sit quietly and wait for her to wake up.
I offered simple interventions with the intention of bringing comfort. Some days she would freely offer up needs or share stories, sometimes she spoke of regrets or fears that burdened her. Other days we would just sit in silence, breathing together was enough. If it felt right I would ask a question, and sometimes it would lead to conversation, other times it would just hang in the room. I accepted and trusted that she was the expert in her dying and to companion her appropriately the best practice was to take her lead.
During one visit she was bubbling with energy. She went on and on, sharing stories of her childhood and of her family. She enthusiastically talked about her love of playing piano, her dream of being a concert pianist, and how she loved horseback riding as a young girl. Reminiscing like this enlivened her. She became animated as she recalled meaningful moments and talked about the things that mattered most. I sat there, inspired, and caught her stories.
One day we were talking about music and she mentioned a love for Spanish guitar songs. I pulled out my phone and found a sampling. We sat and listened to the elegant music while she stared out the window seemingly transported to some far off place.
One day she shared her biggest fear. She worried that her three adult children would drift apart after she died. I sat and listened. I knew that a shallow reassurance would not minimize her worry. I held her fear and we sat with it. She continued to speak about her kids as I listened, intentionally pulling the threads of love, beauty, and connection to the surface. I shared these reflections with her offering true statements such as “Wow, aren’t you lucky to be surrounded by your children who care so much.”
She was comforted by the companion of touch so most days I would offer her a hand or foot massage with her favourite rose essential oil. Some days I would sit in the chair beside her bed and hold her hand, my palm up, offering agency to place her hand in mine and remove it when she wished.
I did my best to communicate her needs to her family and to the nurses, care aides and doctors at the hospice. I sat in the chair across from her witnessing her gentle dying. I was touched by wonder by simply being so close to her as she journeyed off trail, somewhere I couldn’t go, yet. I read her poetry, played bird sounds over her wireless speakers, and we often sat in silence together.
Then she began to labour, restlessly twisting in her sheets, hot, then cold, and always thirsty. This reminded me so much of the delivery room, her body doing what it was designed to do as she was transported into a liminal space, she seemed to be straddling worlds, one foot in this one and one foot in the next. In the last couple of days she kept reaching her arms up to the ceiling, calling “Mom” with a look of peace on her face. It was wonderful. In this experience I was filled with awe and so deeply honoured to be present for her gentle dying.
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