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Do you have to be an end-of-life doula to do that?

4/17/2020

2 Comments

 
I heard the most amazing story yesterday. A couple of months ago, my friend Mickey was called to the hospital room of her 85-year-old aunt who was severely ill with chronic respiratory illness. As her aunt struggled to breathe, she kept expressing the wish to just go home. She was highly agitated and expressed this to the hospital staff who were at wits end to calm her down. The young physician who was treating her was adamant that she needed to undergo a treatment plan that consisted of indefinite hospitalization, tests and monitoring. Her aunt wanted none of it. She was scared, she was extremely uncomfortable, and she felt she wasn’t being heard. Things escalated to the point where the doctor told her that if she left the hospital, she would be leaving “AMA” (Against Medical Advice) and would possibly have to foot the bill.
Thankfully, Mickey was able to advocate for her aunt. “It seems we have a communication problem,” she said to the doctor. “My aunt doesn’t know you, she doesn’t understand you, and she hasn’t had the time to build trust with you. Would you be willing to speak with her primary care physician, in whom she has confidence?” she asked. The hospital doctor said yes, and they spoke, and also included her aunt on the call. This made everyone feel better; it created a sense of teamwork and shifted the focus to her aunt’s needs. It also became evident that although the paperwork concerning her aunt’s end-of-life care wishes was sitting at the bedside, it had not been filled out, and the care team did not expressly know which life-saving procedures she did or did not want. Mickey read the documents aloud to her aunt and ascertained her wishes, which included a preference that no extraordinary measures be taken to prolong her life. Her aunt signed the documents in the presence of a hospital chaplain and her wishes were made known to the entire care team. Brilliantly, at this point, it occurred to Mickey that, rather than simply refusing the type of treatment plan the hospital doctor wanted, they could choose a different type of treatment plan that focused on comfort, like her aunt wanted. Mickey knew to involve the hospital social worker in order to ask if her aunt could go home on hospice care. This is when the real shift occurred. The social worker advocated for this, and everyone agreed. Plans were made, and even though her aunt died before she could get home, she died peacefully in her sleep, knowing that going home was the eventual plan.
You are reading this because you are participating in a massive paradigm shift. You want to prevent scenarios like the one in this story. You want to be there for your people and for your community. Mickey’s aunt, fiercely independent all her life, was too sick to orchestrate the end of her life the way she wanted. She needed Mickey to speak up, pivot the discussion, and not be afraid to mention the h-word.
The end-of-life doula role encapsulates this. The movement is growing at an incredibly rapid pace because we are in a specific point in time where the skills that doulas learn are very needed. Doulas are available, they show up, they listen, they use problem solving skills, they bring in all available resources, they have knowledge. Does one have to have taken end-of-life doula training to do what Mickey did? No, in fact, she didn’t. Thankfully, she had other life experiences that came to the fore and equipped her with the ability and the confidence to be there for her aunt. But end-of-life doula training, like no other single one profession, focuses on these specific skills and brings them together in a systematic approach, equipping graduates to help in moments such as her aunt’s hospital crisis. And it is immediately accessible, affordable, and achievable.
You are called. You are needed. Answer the calling and be an end-of-life doula. It’s a great way to help change the way we die at this point in time. It gives you a community of game changers to learn with and gain energy and inspiration from. The world doesn’t really know about us yet, but it will, as we take these skills and this drive to be of service into our communities in whatever way we can. My goal is to help you discern that, to hear your stories, to pass them on, and to be a resource to you as you change the world. Let me know how I can help you. 
2 Comments
Kitty Downey
4/21/2020 05:39:37 pm

This is a very inspiring story. It shows us that everyone can play a part in bringing a positive death to others!!

Reply
Diana Cramer
4/22/2020 09:41:03 pm

Thank you for sharing this enlightening story. I have a question Mickey's aunt signed the paperwork in the presence of the hospital chaplain. It is my understanding that hospital staff may not serve as a witness for end of life documents. Is a chaplain able to serve as witness? That is good to know.

Reply



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  • Home
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