Facing End of Life Challenges: The Unique Service of a Death Doula

Death Doula LA is “a unique in-home service offered to help patients and their families who face the overwhelming challenges at the end of life,” according to Jill Schok, founder of Death Doula LA. Death Doula LA provides a patient at end of life, and a family, a comprehensive range of interconnected and customized services.

What is a Death Doula?

If a person is at least somewhat familiar with a doula, that individual probably thinks of child birth and not end of life issues. DONA International defines a doula as:

A trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible.”

The more commonplace definition of a doula serves as a meaningful foundational explanation of a death doula. In basic terms, a death doula is a trained professional who provides continuous physical, emotional and informational support to a patient and family in regard to dying and death, with the objective of achieving the healthiest experiences possible.

Why Hire a Death Doula?

In the 21st century, there are a variety of options available to assist people facing end of life. One of the common courses is hospice care. Hospice provides clinical services, either in a specialized facility or in a patient’s home. These are important services. However, people at end of life need more.

Engaging the services of a doula extends a more holistic approach to end of life – for both the patient and loved ones. Each client has individual needs and desires when approaching death, according to Jill. Indeed, a person at end of life may have a keen vision of how that individual would like the final passage to occur. A doula helps discern and facility end of life objectives.

About Jill Schok

Jill is a native of Los Angeles. She is a spiritual multi-faith minister, but not religious. She focuses her ministry on tending to the needs of those facing end of life, including patients and family members.

Jill graduated from Vanderbilt University with a master’s degree in ethics and theology. After receiving a bachelor’s degree in history, and before heading to graduate school, Jill worked at Mordecai Historic House in Raleigh, North Carolina. Mordecai Historic House is the site of what was the largest plantation in that part of North Carolina. It is also the older house still at its original location in North Carolina.

During her time at Mordecai Historic House, Jill faced the impact of death for the first time. She explains that its was this experience that motivated her to seek a master’s degree and then a career in end of life care. She is described as having a “benevolent work ethic.” Her unique personal background, coupled with her clinical work, make Jill uniquely suited as a guide to those who face end of life.

Home Funerals and Green Burials

Death Doula LA works with people facing end of life with making decisions about funerals and burials. Two options available to people at end of life are a home funeral and a green burial, according to Jill. A person an end of life, or his or her family, can select to pursue one or both options.

A home funeral is fairly self-explanatory. This is a memorial service that takes place in the home of the person who has died. Oftentimes this is done with a day of a person’s passing to allow for the elimination of the embalming process. A home funeral gives the deceased individual’s loved ones the ability to control how the body is handled and prepared for its final repose.

A green burial, sometimes called a direct burial, involves an interment without embalming, concrete burial vaults, and traditional caskets. The body is buried or cremated without going through the embalming and preparation process utilized by most people in this day and age.

Death Doula LA works with LA Undertaking when it comes to people at end of life interested in home funerals and green burials. There are three cemeteries in Los Angeles County which provide green burial space:

  • Joshua Tree Memorial Park
  • Woodlawn Memorial Park
  • Hillside Memorial Park

In addition to being more personal and earth-affirming, home funerals and green burials are less expensive than the preparation, funeral, and burial processes most people automatically follow today.

Living Funerals

“We encourage our clients to think outside the box when it comes to funerals.  You might consider setting tradition on the shelf and ask yourself what you want your funeral to be like, and we will help create it,” Jill explains. Death Doula L.A. specializes in what the company calls “Living Funerals.” According to Jill, through a Living Funeral, a person attends his or her own funeral. “Over the years we’ve noticed that the clients who take advantage of this service not only have a healthier grieving process, but they are completely at peace when their time comes,” Jill said.  “Our clients are encouraged to celebrate their time on earth and let go, knowing their life is complete.”

Grief and Bereavement Assistance and Support

No matter how prepared those around a person at the end of life may be, the grief and bereavement process remains a reality. Another of the services provided by Death Doula LA is grief and bereavement support. Death Doula LA makes it clear that the grieving process is different for all people. Jill recognizes that the grieving and bereavement process may even seem to “get weird.” In the end, everyone grieves in his or her own way – and may need support in that process.

In regard to grief being a unique process for every individual, Jill has spoken about even being something of an interactive process. In this regard, she referenced the Bio Urn. “Bio Urn’s big innovation was building a biodegradable urn that could keep the ash and seeds separate during the plant’s gestation period. The cone is split into two chambers: The bottom chamber holds the ash, while the top chamber contains crushed up coconut shell and vermiculite, a mineral that helps plants retain water. When the root system grows strong enough—generally after a week—water will dissolve the top of the second chamber, allowing the roots and minerals to mix with human ash,” according to the manufacturer.

Jill herself has used Bio Urn to intern her cat and dog in a plot located next to her father’s grave. Bio Urn technology has developed to the point that a person can receive push notifications that the time has arrived to water the plant contained in the urn. Jill believes this exemplifies the manner in which people connect with their deceased loved ones. The connection is no longer just about visiting a cemetery from time to time. Rather, with 21st century technology people can create interactive mausoleums and similar living, vibrant memorials.

Advance Healthcare Directive

Death Doula LA assists its clients with the preparation of an advance health care directive. The Advance Care Directive is a multipart form that addresses a variety of issues associated with healthcare, including how decisions are made during what is expected to be a person’s final illness. The California advance healthcare directive includes:

Power of Attorney

Technically, this is element of the directive is called a durable power of attorney for healthcare, according to the American Bar Association. The power of attorney “names another person as agent to make health care decisions for you if you are unable to make your own decisions. You can also have your agent make decisions for you right away, even if you are still able to make your own decisions,” according to California law.

Instructions for Healthcare

The second element of the California advance healthcare directive permits you to set forth more specific instructions for your healthcare. These instructions are designed to guide the individual designated to exercise your power of attorney, as well as healthcare provides, in providing or withholding care for you. In California, you are not required to provide specific instructions. Rather, you can leave this decision making in the hands of the designated attorney in fact (the person who you designated in your power of attorney).

Organ Donation

The California advance healthcare directive allows you to delineate what you would like to see happen with your organs and tissues following your death. “One person can save eight lives and enhance 75 others through organ, eye and tissue donation,” according to Donate Life California. Approximately 22,000 Californians are on donor waiting lists at this time.

Designate Primary Care Physician

Finally, the directive includes a form that permits you the ability to designate a specific physician to serve as your primary care doctor. Many people find it comforting to know that they are able to identify a physician they trust to oversee their healthcare in a situation in which they may not capable of making decisions for themselves.

Navigation of Healthcare System and Patient (and Family) Advocacy

In addition to assisting with the completion of a healthcare directive, Death Doula LA is also able to assist in the navigation of the healthcare system. Death Doula LA can serve as a powerful advocate for a patient, and a family, when it comes to the oftentimes complex healthcare system.

In recent years, the U.S. Department of Health and Human Services has been proactive in encouraging people to consider the importance of a healthcare advocate. According to HHS, “a health advocate is a family member, friend, trusted coworker, or a hired professional who can ask questions, write down information, and speak up for you so you can better understand your illness and get the care and resources you need – giving you a peace of mind so you can focus on your recovery.” Death Doula LA is a prime example of the type of patient (and family) advocate envisioned by the nation’s top health policy agency.

The Institute for Healthcare Improvement has delineated the important role of a patient (and family) advocate like Death Doula LA:

An advocate is a “supporter, believer, sponsor, promoter, campaigner, backer, or spokesperson.” It is important to consider all of these aspects when choosing an advocate for yourself or someone in your family. An effective advocate is someone you trust who is willing to act on your behalf as well as someone who can work well with other members of your healthcare team such as your doctors and nurses. An advocate may be a member of your family, such as a spouse, a child, another family member, or a close friend. Another type of advocate is a professional advocate.

Conclusion

Jill Schok has succinctly stated her work: “I am a doula for the dying. In my many years of experience at bedside during the eleventh hour, I can honestly say no two deaths are the same, and it’s never what you expect.”

The best way to sum up Death Doula LA, and its life and death affirming services, is something its founder wrote in the summer of 2017:

Perhaps the perfect death is something that must be accepted and created within ourselves, throughout the course of life. It is up to us as individuals to take control of our eventual endings by planning ahead, embracing mortality, and bringing an honored sense of ceremony to life’s final graduation.