Death midwifery helps people create their legacy

Community Apr 13, 2011 Beach Mirror

When people are anticipating a birth, there is a bustle of activity to prepare for the new arrival.

Until recently, the topic of death was not talking about until it occurred.

But more people, when faced with a terminal diagnosis or simply near the end of their lives, are choosing to have the support of a thana doula. Birth midwives help prepare expectant mothers for the birthing process; a thana doula helps people prepare for their death.

"We don't think anything of having somebody have a coach when they're giving birth and there shouldn't be any resistance to having one if the person wants one at the end of life," said Francine Geraci, a Toronto-based thana doula.

More commonly called death midwifery (pronounced mid-whiff-er-y), Geraci, along with fellow thana doula Elizabeth Lancaster, who is also a teacher, trained at the Institute of Traditional Medicine in Toronto, which includes a practicum in end of life care.

Both describe their work as deeply privileged and said they were called to do death midwifery after personal experiences.

A few years ago, Lancaster received a call from a former student saying she had just been diagnosed with end-stage cancer.

"She asked if I would coach her through the end of her life, which was four months, so we worked together for four months before she died," Lancaster said.

Geraci's interest in palliative care began in 1986 when a friend had terminal cancer and she was part of the home care team when he was released from hospital.

"It was a very satisfying experience for me. It certainly helped me with my own bereavement after he died to think I had been able to help him," Geraci said.

After that, Geraci was a bedside volunteer at Casey House Hospice for 10 years. She is currently working in publishing and is about to retire. Geraci said she plans to be a full-time thana doula.

Much like each life is individual, so are the needs surrounding someone's death. And while each thana doula has her individual speciality, Lancaster said her role is strengthening relationships and enabling conversations.

"I think the real opportunity in this work is to shift the question from, 'Oh my God, now what do I do,' which is what most of us think of, or 'how do I avoid this altogether', to questions that have deeper meaning for the individual and the family," she said.

Questions, for example, could include, "I'm realizing I'm at the end of my life, so what is it that the end of my life stands for? How do I want to be and who do I want to be through this? Who have I been through my life and what's the legacy I want to leave?"

Geraci said she also sees the focus of care, not only for the person who is dying, but also for the entire family throughout the dying process. From the time a person received a terminal diagnosis, through the course of the illness to after the death.

"I am a presence and being sensitive to the family's particular needs and being able to recommend things that might make the process easier in terms of making connections with other services,' Geraci said.

"Not to replace a social worker or a palliative care nurse or a chaplain, but the job has elements of all of that which may vary considerably because the whole process of dying and death is very individual," she said.

For those who are diagnosed with an illness, Lancaster said there are a plethora of emotions that go along with it, and quite often the person doesn't have anyone to go to to answer these questions.

"They may wonder, 'So how do I talk about my life? How do I talk about what does faith mean to me? Who have I been? What are the conversations I should have had and didn't? What are the conversations I still need to have?' These kinds of questions," she said.

Lancaster said it can be hard to have these conversations with friends or family because often times family members are dealing with their own emotions and their own fears around death.

Geraci said this is the role that death midwives try and help fill.

Recently, she came across a woman with only a few months to live and despite having a loving support system around her, the woman felt alone and needed guidance on how to talk to her loved ones about her death.

"Every time she raised the subject of death, they (her family) encouraged her 'Not to give up, you don't know what's going to happen' but her deep need was to talk about the very end and what happens in the very end," Geraci said.

Thana doulas will support their clients in several areas and besides discussing the deeper questions and giving advice, they will also offer company and support for them and their family as well as to help the dying person get their affairs in order.

Lancaster said death midwifery is really about helping clients consider all the details, make them aware of important decisions and making sure everyone is on the same page. This could include asking if the dying person has a care plan, thinking about a personalized service, asking them about the state of their will or even making sure their family knows about their no resuscitate order.

It may sound odd to some people that someone who is dying would involve a stranger so deeply into a personal matter, but both Lancaster and Geraci said attitudes surrounding death are definitely changing.

"In the way that grief is (it) has become something we talk about more easily. I think death is also, and I think that's a part of the changing demographic," Lancaster said.

Geraci said it's not only individual attitudes that are changing, but other health-care professionals such as palliative care nurses or pastors, and organizations such as hospices and funeral homes are also working more often with thana doulas.

And it's interesting to note that one-third of Geraci's graduating class at the Institute of Traditional Medicine were palliative care nurses who felt they needed to learn something more.

"Although they had been wonderfully professionally prepared, they still felt that something was lacking," Geraci said.

Lancaster said death has such an impact on those left behind. Thana doulas help make that legacy as peaceful as possible, which is a final gift the dying can give to those who have to carry on without them.

"All of us can point to a death we've experienced and talk about the way that played out and the impact it's had on our life ever since then, and that's the legacy that's left, intentionally or unintentionally, and for most us it's very unintentionally." Lancaster said

Lancaster said she remembers having a conversation with her grandfather about his readiness to die, what he had seen as the benefits of his life and what he felt he achieved, and she said it showed her what a good death can look like.

"Think about what you want your legacy to be, it's a legacy that goes beyond 'I left you a pot of money or I left you a car,'" she said.

Death midwifery helps people create their legacy

Community Apr 13, 2011 Beach Mirror

When people are anticipating a birth, there is a bustle of activity to prepare for the new arrival.

Until recently, the topic of death was not talking about until it occurred.

But more people, when faced with a terminal diagnosis or simply near the end of their lives, are choosing to have the support of a thana doula. Birth midwives help prepare expectant mothers for the birthing process; a thana doula helps people prepare for their death.

"We don't think anything of having somebody have a coach when they're giving birth and there shouldn't be any resistance to having one if the person wants one at the end of life," said Francine Geraci, a Toronto-based thana doula.

Related Content

More commonly called death midwifery (pronounced mid-whiff-er-y), Geraci, along with fellow thana doula Elizabeth Lancaster, who is also a teacher, trained at the Institute of Traditional Medicine in Toronto, which includes a practicum in end of life care.

Both describe their work as deeply privileged and said they were called to do death midwifery after personal experiences.

A few years ago, Lancaster received a call from a former student saying she had just been diagnosed with end-stage cancer.

"She asked if I would coach her through the end of her life, which was four months, so we worked together for four months before she died," Lancaster said.

Geraci's interest in palliative care began in 1986 when a friend had terminal cancer and she was part of the home care team when he was released from hospital.

"It was a very satisfying experience for me. It certainly helped me with my own bereavement after he died to think I had been able to help him," Geraci said.

After that, Geraci was a bedside volunteer at Casey House Hospice for 10 years. She is currently working in publishing and is about to retire. Geraci said she plans to be a full-time thana doula.

Much like each life is individual, so are the needs surrounding someone's death. And while each thana doula has her individual speciality, Lancaster said her role is strengthening relationships and enabling conversations.

"I think the real opportunity in this work is to shift the question from, 'Oh my God, now what do I do,' which is what most of us think of, or 'how do I avoid this altogether', to questions that have deeper meaning for the individual and the family," she said.

Questions, for example, could include, "I'm realizing I'm at the end of my life, so what is it that the end of my life stands for? How do I want to be and who do I want to be through this? Who have I been through my life and what's the legacy I want to leave?"

Geraci said she also sees the focus of care, not only for the person who is dying, but also for the entire family throughout the dying process. From the time a person received a terminal diagnosis, through the course of the illness to after the death.

"I am a presence and being sensitive to the family's particular needs and being able to recommend things that might make the process easier in terms of making connections with other services,' Geraci said.

"Not to replace a social worker or a palliative care nurse or a chaplain, but the job has elements of all of that which may vary considerably because the whole process of dying and death is very individual," she said.

For those who are diagnosed with an illness, Lancaster said there are a plethora of emotions that go along with it, and quite often the person doesn't have anyone to go to to answer these questions.

"They may wonder, 'So how do I talk about my life? How do I talk about what does faith mean to me? Who have I been? What are the conversations I should have had and didn't? What are the conversations I still need to have?' These kinds of questions," she said.

Lancaster said it can be hard to have these conversations with friends or family because often times family members are dealing with their own emotions and their own fears around death.

Geraci said this is the role that death midwives try and help fill.

Recently, she came across a woman with only a few months to live and despite having a loving support system around her, the woman felt alone and needed guidance on how to talk to her loved ones about her death.

"Every time she raised the subject of death, they (her family) encouraged her 'Not to give up, you don't know what's going to happen' but her deep need was to talk about the very end and what happens in the very end," Geraci said.

Thana doulas will support their clients in several areas and besides discussing the deeper questions and giving advice, they will also offer company and support for them and their family as well as to help the dying person get their affairs in order.

Lancaster said death midwifery is really about helping clients consider all the details, make them aware of important decisions and making sure everyone is on the same page. This could include asking if the dying person has a care plan, thinking about a personalized service, asking them about the state of their will or even making sure their family knows about their no resuscitate order.

It may sound odd to some people that someone who is dying would involve a stranger so deeply into a personal matter, but both Lancaster and Geraci said attitudes surrounding death are definitely changing.

"In the way that grief is (it) has become something we talk about more easily. I think death is also, and I think that's a part of the changing demographic," Lancaster said.

Geraci said it's not only individual attitudes that are changing, but other health-care professionals such as palliative care nurses or pastors, and organizations such as hospices and funeral homes are also working more often with thana doulas.

And it's interesting to note that one-third of Geraci's graduating class at the Institute of Traditional Medicine were palliative care nurses who felt they needed to learn something more.

"Although they had been wonderfully professionally prepared, they still felt that something was lacking," Geraci said.

Lancaster said death has such an impact on those left behind. Thana doulas help make that legacy as peaceful as possible, which is a final gift the dying can give to those who have to carry on without them.

"All of us can point to a death we've experienced and talk about the way that played out and the impact it's had on our life ever since then, and that's the legacy that's left, intentionally or unintentionally, and for most us it's very unintentionally." Lancaster said

Lancaster said she remembers having a conversation with her grandfather about his readiness to die, what he had seen as the benefits of his life and what he felt he achieved, and she said it showed her what a good death can look like.

"Think about what you want your legacy to be, it's a legacy that goes beyond 'I left you a pot of money or I left you a car,'" she said.

Death midwifery helps people create their legacy

Community Apr 13, 2011 Beach Mirror

When people are anticipating a birth, there is a bustle of activity to prepare for the new arrival.

Until recently, the topic of death was not talking about until it occurred.

But more people, when faced with a terminal diagnosis or simply near the end of their lives, are choosing to have the support of a thana doula. Birth midwives help prepare expectant mothers for the birthing process; a thana doula helps people prepare for their death.

"We don't think anything of having somebody have a coach when they're giving birth and there shouldn't be any resistance to having one if the person wants one at the end of life," said Francine Geraci, a Toronto-based thana doula.

Related Content

More commonly called death midwifery (pronounced mid-whiff-er-y), Geraci, along with fellow thana doula Elizabeth Lancaster, who is also a teacher, trained at the Institute of Traditional Medicine in Toronto, which includes a practicum in end of life care.

Both describe their work as deeply privileged and said they were called to do death midwifery after personal experiences.

A few years ago, Lancaster received a call from a former student saying she had just been diagnosed with end-stage cancer.

"She asked if I would coach her through the end of her life, which was four months, so we worked together for four months before she died," Lancaster said.

Geraci's interest in palliative care began in 1986 when a friend had terminal cancer and she was part of the home care team when he was released from hospital.

"It was a very satisfying experience for me. It certainly helped me with my own bereavement after he died to think I had been able to help him," Geraci said.

After that, Geraci was a bedside volunteer at Casey House Hospice for 10 years. She is currently working in publishing and is about to retire. Geraci said she plans to be a full-time thana doula.

Much like each life is individual, so are the needs surrounding someone's death. And while each thana doula has her individual speciality, Lancaster said her role is strengthening relationships and enabling conversations.

"I think the real opportunity in this work is to shift the question from, 'Oh my God, now what do I do,' which is what most of us think of, or 'how do I avoid this altogether', to questions that have deeper meaning for the individual and the family," she said.

Questions, for example, could include, "I'm realizing I'm at the end of my life, so what is it that the end of my life stands for? How do I want to be and who do I want to be through this? Who have I been through my life and what's the legacy I want to leave?"

Geraci said she also sees the focus of care, not only for the person who is dying, but also for the entire family throughout the dying process. From the time a person received a terminal diagnosis, through the course of the illness to after the death.

"I am a presence and being sensitive to the family's particular needs and being able to recommend things that might make the process easier in terms of making connections with other services,' Geraci said.

"Not to replace a social worker or a palliative care nurse or a chaplain, but the job has elements of all of that which may vary considerably because the whole process of dying and death is very individual," she said.

For those who are diagnosed with an illness, Lancaster said there are a plethora of emotions that go along with it, and quite often the person doesn't have anyone to go to to answer these questions.

"They may wonder, 'So how do I talk about my life? How do I talk about what does faith mean to me? Who have I been? What are the conversations I should have had and didn't? What are the conversations I still need to have?' These kinds of questions," she said.

Lancaster said it can be hard to have these conversations with friends or family because often times family members are dealing with their own emotions and their own fears around death.

Geraci said this is the role that death midwives try and help fill.

Recently, she came across a woman with only a few months to live and despite having a loving support system around her, the woman felt alone and needed guidance on how to talk to her loved ones about her death.

"Every time she raised the subject of death, they (her family) encouraged her 'Not to give up, you don't know what's going to happen' but her deep need was to talk about the very end and what happens in the very end," Geraci said.

Thana doulas will support their clients in several areas and besides discussing the deeper questions and giving advice, they will also offer company and support for them and their family as well as to help the dying person get their affairs in order.

Lancaster said death midwifery is really about helping clients consider all the details, make them aware of important decisions and making sure everyone is on the same page. This could include asking if the dying person has a care plan, thinking about a personalized service, asking them about the state of their will or even making sure their family knows about their no resuscitate order.

It may sound odd to some people that someone who is dying would involve a stranger so deeply into a personal matter, but both Lancaster and Geraci said attitudes surrounding death are definitely changing.

"In the way that grief is (it) has become something we talk about more easily. I think death is also, and I think that's a part of the changing demographic," Lancaster said.

Geraci said it's not only individual attitudes that are changing, but other health-care professionals such as palliative care nurses or pastors, and organizations such as hospices and funeral homes are also working more often with thana doulas.

And it's interesting to note that one-third of Geraci's graduating class at the Institute of Traditional Medicine were palliative care nurses who felt they needed to learn something more.

"Although they had been wonderfully professionally prepared, they still felt that something was lacking," Geraci said.

Lancaster said death has such an impact on those left behind. Thana doulas help make that legacy as peaceful as possible, which is a final gift the dying can give to those who have to carry on without them.

"All of us can point to a death we've experienced and talk about the way that played out and the impact it's had on our life ever since then, and that's the legacy that's left, intentionally or unintentionally, and for most us it's very unintentionally." Lancaster said

Lancaster said she remembers having a conversation with her grandfather about his readiness to die, what he had seen as the benefits of his life and what he felt he achieved, and she said it showed her what a good death can look like.

"Think about what you want your legacy to be, it's a legacy that goes beyond 'I left you a pot of money or I left you a car,'" she said.