A healthy body, mind and spirit are essential to a good life. But when the end of life approaches, how should we nurture the body, mind and spirit to ensure we have a good death?

Dying well, also known as the death positive movement, was identified as an emerging trend by the Global Wellness Summit in its 2019 report. And as the population ages—Statistics Canada predicts the number of seniors in Canada will double from seven million in 2022 to 14 million by 2068—the focus on dying well will only increase.

Having a good death requires an overhaul of our current approach to end-of-life care, including open conversations about death, advanced care planning and improving support to the dying and their loved ones.

Much of this support can be provided by an end-of-life doula. Just as a birth doula supports women during the labour and birthing process, and end-of-life doula supports a person during the dying process. By spending time with and listening closely to a dying person and their loved ones, doulas provide non-medical physical, emotional, spiritual, practical and grief support.

Having the Conversation

Many people don’t want to talk about their own death or the death of a loved one, or they don’t know how to start the conversation. The rising popularity of death cafes, where people gather to talk openly about death and dying, show that increasing numbers of people want to talk about death and assert more control over the dying process.

Involving an objective third party, such as an end-of-life doula, can help you talk about death-related issues. A doula can educate you on what to expect at end of life, outline your options and help you identify your values, wishes and beliefs. They will listen to your wishes and encourage you and their loved ones to discuss and make the important decisions required to help ensure you have a good death.

Advanced Care Planning

Having an advanced care plan in place ensures that the care you receive at the end of life and beyond is aligned with your wishes. An end-of-life doula can help you develop and document an advanced care plan that indicates exactly what you want.

For example, what are your wishes around goals of care and consent for treatment? Would you want to be resuscitated? Intubated? Kept on life support?

Other advanced care planning decisions include who would make decisions about your care if you cannot. Who will be your Power of Attorney or substitute decision-maker?

Where would you prefer to die? At home, in a hospice or hospital?

What do you want to happen after you die? Burial or cremation? A funeral? If a funeral or memorial service, how would it unfold? What music or spiritual readings would you like?

While much of the dying well trend is focused on support for those nearing the end of life and their loved ones, an advanced care plan is also important to have in case of sudden illness and death, as it lays out medical care and after-death wishes.

Supporting the Dying and Their Loved Ones

End-of-life doulas complement and augment other types of care while respecting the roles of everyone involved. Because doulas are with you and your loved ones before, during and after death occurs, they can act as a bridge among various care services to ensure continuity and make everyone aware of the wishes and plans in place. They can help you navigate the health-care system and advocate on your behalf with hospital or hospice staff.

A doula can talk to you about your life, including achievements, fears, regrets, relationships, unresolved issues and unmet goals. Dying people are often more likely to discuss these things with a doula than with family or friends. Doulas can also help you develop a written legacy, oral history, life history or letters to be read in the future. They can help the dying reach out to estranged loved ones.

They can also help pre-plan a memorial or funeral service, alleviating anxiety about what will occur after death and allowing loved ones to focus on their grieving process. 

As the final days and hours approach, a doula supports you and your loved ones by being present. They provide compassionate emotional care to ease anxiety, provide physical and spiritual comfort and ensure a personalized passage that reflect your wishes.

Death is a part of life and dying well is increasingly becoming an important health and wellness goal. Talking about death, putting a plan in place and accepting physical, emotional and spiritual support from a doula during the dying process can help you have a more peaceful, meaningful and comfortable passing. It can help you end a good life with a good death.