How to Prepare for the Final Step: Words of Wisdom from an Optimistic Death Doula

Ruth McGill talks about death every day. She listens to her clients, all of whom are terminally ill, and helps them to decide where they might like to die – at home, in a hospice, or someplace else. She helps them to have conversations with family or loved ones that would otherwise be much more difficult or maybe avoided altogether.

A Cheery Chat about Death?

Death is often viewed as tragic and traumatic, something to be feared or ignored until it makes its presence felt. The COVID-19 pandemic has brought death closer and made discussing end-of-life wishes more important than ever.

Ruth McGill, a death doula by trade, has a different idea about death than many people. At age 15, she sat with her dying grandfather and had her first life-changing experience of watching someone dying. “It was profound, and not at all scary. I was welcomed there,” she said. This and her experience saying farewell to her mother is what helped her find her calling.

Besides being an actress and singer, as a death doula, Ruth is often referred to as a “soul midwife,” although she feels like what she does is so much more. She describes how her acting, singing, and voice coach work all tie in, in that they are about using your body – and listening to it, using your energy to find your voice, to connect with people, and helping them to find their own voices too.

As a death doula and as an optimist, McGill typically takes a positive approach to death and dying. She believes that grief and joy and love are all part of the same spectrum. She believes we are grieving because we loved someone so much.

What Does a Positive Death Doula Do?

The word “doula” comes from the Greek word meaning “woman who serves,” though most people associate it with someone who helps during the birth process. In recent years, more people have come to recognize the need for as much assistance at the end of life as the beginning. A so-called “death positivity movement“ is gaining momentum in the United States and other countries. The movement, popularized by the mortician and writer Caitlin Doughty, encourages open discussion on death and dying and people’s feelings on mortality.

In McGill’s role as a death doula and as a self-proclaimed optimist, she believes that “(e)ssentially it’s all about conversation, although it’s also about listening and silence. The role of a death doula is not a medical role, but they can enable someone to have better conversations with doctors and other health care professionals by helping the person to unravel what it is they want to say and do and find the sense of agency to communicate it.”

According to McGill, these are some other important functions she assumes in her role:

– Through expert listening, she helps a client to verbalize where he or she might like to die and their wishes for when they die.
– She can help clients to have conversations with family or loved ones, which when grief is already at play can become sad and difficult.
– She may also be contacted by a family member who is finding it difficult to deal with an impending death.
– For anyone who has been led to believe that death is a lonely process, a death doula can rebalance the focus.

Unlike hospice workers, doulas don’t get involved in medical issues. Rather, they support clients emotionally, physically, and spiritually, and they step in whenever needed. That could be a few days before someone dies, sitting vigil with them in their last hours, giving hand massages, or even making snacks. Or it could be months or even years earlier, after someone receives a terminal diagnosis, keeping them company, listening to their life stories, helping them craft autobiographies, or helping plan meaningful memorial services.

Easing Conversations about End of Life

By creating space to face something we are taught by society to ignore, McGill can help people to decide what they want, before, during, and after death, by looking at what is right for them. She can help her clients to face any fears they may have surrounding death and come to accept what is a very natural process. It is very open – as McGill says, “People want to know how to take the right steps, but there are no right steps.”

“Some people really do have an idea of ‘no, it’s not going to happen to me.’” But when something happens that brings it closer, the unprepared mind can find it even more devastating,” she says.

Talk of Death Inevitably Leads to Ideas of What a Life Well-Lived Is

At any time of year, it can be incredibly stressful to contemplate the inevitable end of life — for ourselves and the ones we love. However, although no one wants to bring stress and unpleasant feelings in the midst of holiday cheer, with the holidays upon us, now is an ideal time to have an end-of-life discussion.

This year in particular, with so much death in the world from COVID-19, the conversation may be much easier to start. And starting it is important, because even though death is all around us, having an end-of-life plan is more urgent than ever. The best thing you can do for yourself and your loved ones — especially in times when you’re made more aware of the prospect of death — is to talk about it and make a plan.

Around the holidays, there may be more hesitation to broach the subject of death, but with it so prevalent in the past two years, this is actually an ideal time for families to lean into this conversation, and it’s a beautiful thing to witness — meaningful sharing, unexpected expressions of love and care, and often a palpable sense of a deepened connection and relieved anxiety. As painful as it may seem to initiate the conversation, an open discussion with your family about how you want your death handled can actually be a very positive experience. It also saves families a lot of financial and emotional stress in the future to not have to manage end-of-life plans for a loved one during a time of loss.

How to Have the Talks

A great place to start is with yourself! Ask yourself the kinds of questions that help you consider your own meaningful legacy and then plan to share your answers with your family. These are some questions to consider that are great fodder for bringing warmth and connection to the conversation:

– What are some of your favorite memories?
– What is most important in your life? (Family, pets, friendship?)
– What makes your life meaningful? (Making art, being outdoors and in nature, being with loved ones, spiritual practice?)
– If you could choose one or two important ways you would always be remembered by those you love, what would they be?

Having an honest, life-affirming conversation about death and end-of-life planning can be a wonderful gift for the people you will eventually leave behind in this lifetime. Turning that conversation into an actual plan is the essential next step!

Make Sure Your End-of-Life Plans Are Followed with an Advance Medical Directive

After taking the steps to discuss your end-of-life planning, it’s a good time to make sure your wishes are spelled out and available for your loved ones in your legal documents. If you have not done Long-Term Care Planning, Estate Planning, and Incapacity Planning (or had your Planning documents reviewed in the past several years), or if you have a loved one who is nearing the need for long-term care or already receiving long-term care, call us to make an appointment for a no-cost consultation:

Fairfax Elder Law: 703-691-1888

Fredericksburg Elder Law: 540-479-1435

Rockville Elder Law: 301-519-8041

DC Elder Law: 202-587-2797

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About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.

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