Preparing for Death in Life...The Three Most Important Things You Can Do
Death is something everyone will eventually experience...
You know the old saying...In this world nothing can be said to be certain, except death and taxes? Although it’s often an uncomfortable subject to discuss, death is something everyone will eventually experience…(insert dramatic organ chords here). Sorry, we had to lighten things up a bit as this isn’t meant to be a looming dark statement, it simply just is, and this article will explore the three key things anyone and everyone can do to ensure their “affairs” are in order so that they can get to the best part about death...the wonderful life that leads before it.
It never hurts to be prepared and most of us have no idea when we’ll die, so, why not get everything together so that you can live your best life. Before we get into the three most important things you can do to prepare for death...I want to introduce our group as we do this very thing from start to finish so that you can get on living. There are many steps and this group walks you through all of it, whether you’re very young and a type-A planner or if you are a loved one or someone who is entering the active dying stage of life, we have services that fit everyone.
How do you begin to prepare for death?
Read below to learn about the Three Main Focuses for Death so you can Live Life Fully.
The Gentle Passage Doula Collective (GPDC)
There are certain feelings you are born with and those that you grow into. The feeling of being loved can be all consuming as well as finding that passion that just comes, well, naturally. That’s kind of how this group, The Gentle Passage Doula Collective, came to be. After more than 150 years of collective experience in the healthcare industry, specifically around end of life care, these six women kept finding that this love of creating a death positive environment was actually a passion, not just a job. These women came together to create this group...The Gentle Passage Doula Collective.
We share many stories that involve loss and joy, tears and laughter, missed opportunities and sacred moments. We want to ensure that each person can have a life that has a special and meaningful ending. By doing this, we offer the support for three main areas in accomplishing this necessary and important outcome, a gentle and fulfilling death. These are preparations for this event, active dying, and after death care. Each area is unique and we can help provide the tools to make it a smooth transition as well as a purposeful one, while giving you and your loved ones support during this very important and emotional time. This is something everyone can prepare for at any time in their life, it’s never too early nor too late.
When we set up our company, one of our top values is education. And as you’ll read, we are extremely passionate that to be educated on issues and topics allows one to make an informed choice. So, in every aspect of our process, our first goal is to educate, to ensure that you and your loved ones are informed.
FOCUS #1 -- PREPARATION FOR DEATH
It’s all about getting ready for the unfortunate inevitability of death. We may not have a crystal ball, but some have an idea and some are completely unexpected. In both situations, having a plan for this is ideal so you can truly live your life fully! The goal of The Gentle Passage Doula Collective is to be a resource for anyone and everyone interested in learning more about death and preparing for it. Whether it’s your own death or a loved one’s, we have a number of courses, seminars, blogs, and other resources, including personalized offerings, to ensure you are informed and prepared when it comes to this all so important, yet, sensitive topic. We have some recommendations to get the ball rolling on preparing for this event. Join us as we begin the journey of better understanding our services and how you can take an active step into this preparation.
First and foremost, it’s important to not only know your wishes upon your death or incapacitation, but to share them. Advanced Directives are the written instructions for end-of-life wishes along with the names of who your Health Care Durable Power of Attorney is/are. These only go into effect when you cannot make decisions on your own behalf and they terminate upon your death. It is best to have a conversation to get your Advanced Directives in order and this is done through Advanced Care Planning.
Advanced Care Planning is for all adults. It is thinking and talking about future healthcare decisions if you have a sudden, unforeseen event like a car accident or a sudden onset illness, and become unable to make your own healthcare decisions.
These documents allow you to determine what you do and don’t want done medically, to the best of the healthcare agent’s ability. These directives are extremely valuable to inform everyone -- your loved ones and the medical care, of your wishes and how to honor you at the end of your life, it’s a final roadmap to your care. This gives the dying peace of mind and alleviates additional stress for loved ones surrounding the dying during this already difficult and emotional time. However, Advanced Directives are not a medical order and therefore, you need to fill out a legal form.
LEGAL MEDICAL DOCUMENTS
Legal Medical documents grant consent and provide information of an official nature. Medical documents can give someone authority to make medical decisions for another, direct medical personnel if life saving treatment is wanted, clearly stating the wishes of the person whom it is written for or by.
These documents are important because they give a chosen agent the ability to speak as if they are you. They can make important medical decisions, like starting life sustaining treatment or choosing comfort care for the person that has authorized them to do so. They can obtain important medical information to assist them in making decisions. These legal documents go into effect ONLY when one is without “capacity,” meaning they are unable to make decisions on their own. Some of these legal forms are also known as Physician Order for Life Sustaining Treatment Form or POLST form, Healthcare Power of Attorney, Health Insurance Portability and Accountability Act (HIPPA).
It’s valuable to have these legal documentations in place so that your wishes may be carried out as you request. It also gives those making the decisions and family members a roadmap for what you want. Your family will not have to guess what you would have wanted. This helps prevent heightened emotional decisions and causes less stress, while also increasing unity for family members and loved ones.
We have several members who can assist you in getting these medical documents in order as well as connect you and your loved ones in conversations to discuss these, talking with a lawyer or legal assistance, and answering many of your questions you may have, as we are all medical professionals here to help you and your loved ones along this path.
An estate is the dying’s assets and debts they have collected over their lifetime. Having an estate can bring up the good, the bad, and the ugly in family and loved ones, especially after the dying has been laid to rest. Having a plan in order before that day comes, can bring a sense of calm as well as peace to the living and reduces the chances of things like disputes or ill will amongst the living.
Estate planning is a comprehensive plan that includes documents that are used during your lifetime, such as Power of Attorney and Living Will, as well as other documents that are in effect after death, such as disposition of remains and Executor of the Estate (a person or institution named in a will to carry out its instructions).
Estate planning is important because it allows you to control and protect the assets that you have during your lifetime. It allows you to control your assets, control who receives said assets, when and how after you die, and expedites desired medical decisions if you become incapacitated. It also allows for minimum payment of legal, tax, and estate fees which can be very burdensome and in some cases, causes people to go into financial turmoil.
The value of estate planning is having these decisions made, taking control over the financial and medical aspects of your life, and freeing up any unnecessary hurt feelings amongst your loved ones living, much longer after your death. It also allows you to distribute your assets as you see fit, not as the probate court decides. It allows you to leave the legacy of your treasures and talents, everything you collected your entire life, exactly as you wish. The cherished family heirloom can be left to the very person that will value and treasure it. This also greatly reduces any disputes over material or monetary inheritance. It’s the love letter left to your family.
PLAN OF CARE
A Plan of Care is the process of how you want to be cared upon entering any medical treatment or the dying process. It should be very specific and account for many different scenarios. It outlines the recommended steps and interventions you will take to live your best life possible based on your current condition and state of health.
This outline, Plan of Care, creates a Care Plan. A Care Plan is the document that medical professionals, family and friends, and support companions (such as death doulas), can understand how you would like to be cared for, what cues you may exhibit if you are unable to verbally communicate your wishes, and helps answer questions about you such as your favorite beverage in the afternoon (plus it provides key details that can assist if anything special is needed such as a straw or wiping your mouth after each sip).
Creating this process can be both confusing and overwhelming, so having professionals like GPDC take you through and create this plan with the patient and/or your representative can provide the best results for your care plan. This Plan of Care and Care Plan is flexible and dynamic, ensuring it is up-to-date and offers the patient to be supported in many scenarios.
The value of this plan is that it keeps you focused on living your best life until you take your last breath. It helps you to prioritize your needs and wants. It can help you think about and plan for the “what if…” situations. For example, “if this treatment fails, what are my other options and how would I proceed?”
Knowing you may be coming to the end of your life, this approach can take some of the anxiety out of that situation, and help you to prioritize what you need to do so you don’t have to worry so much and can plan out your life and live to the fullest extent possible.
A family meeting is where we gather together with you, the patient, and your family and people who will be walking with you through this health care crisis and/or end of life experience. As a family you will meet with your health care providers to discuss your situation and ask the health care team about any questions or concerns you have. This is a very important meeting that allows for all parties to be on the same page as you move forward with the plan of care. During this meeting you can establish and change goals of care that you want as well as keep everyone on your team informed of the plan moving forward.
In these meetings, it’s a chance to talk openly and honestly with your care providers about what you want to do as you move forward and your condition changes for the better or for the worse. You’ll hear about the potential risks and benefits of the options you have and the decisions you make and your loved ones will also be aware of these events. In these meetings you can go over your advanced directives, legal documents and your plan of care. This meeting is geared to support you and your loved ones answer questions in a safe and honest space. One of the key services of GPDC is connecting with the people you want to, to get all this information discussed as well as planned.
A living funeral is somewhat of a memorial service for someone expected to die while they are still living, still cognizant, but declining. The purpose of this is for the dying to say goodbye and allow others to say goodbye before death comes. This type of farewell can be done in a celebration, bringing in stories, pictures, videos, and giving everyone the chance to celebrate your incredible life and share with you all the warmth and love you deserve to give everyone those lasting memories to hold onto.
Our collective has noticed that the American culture is moving away from many traditions that have been held such as traditional funerals, but it also at times, moves away from celebrating our loved ones in a powerful way when death starts approaching. Some people and families literally will not say goodbye leaving a huge void. This can foster further resentment as well as leave so many unanswered questions and internal turmoil on the heart.
In a living funeral, this party-like event offers an opportunity to open up the creative process in addition to giving the dying individual the control over their own death. Inviting family and friends to celebrate the dying person’s life opens up the channels to say goodbye and express their own feelings of love to each other and offer the gift of completion. This living funeral makes the statement that dying and death are a natural process and offers others to experience this part of life, acknowledging and accepting death in a positive way. Often the declining perks up and really enjoys this party in their honor and it provides a beautiful lasting memory for everyone.
We can help you create this celebration, connect you with ideas, people, and options. We are here for you in this joyous moment too and want to make this both a meaningful experience for you, your loved ones and friends as well as create a positive impact on this natural process of death and dying.
BEST THREE MONTHS
The Best Three Months is an end-of-life-fulfillment, educational class that opens up a conversation on death. This is a great five-week course to take when you are thinking about your future, regardless of death, but death is the absolute end thought process. It asks the question “If you only had three months to live what would matter most? What are your dreams, wishes and priorities?” This is completed using reflection questions and guiding you through the five domains of life. The domains are the Physical, Emotional, Mental/Legacy, Spiritual, and Practical.
This is a “living laboratory” that allows you to explore your fears and beliefs surrounding death. It also gives you the opportunity to establish priorities, asking “what is most important in your life?” This approach is useful with terminal diagnosis, as well at any stage of life. It helps establish where you are currently and a vision of where you want to be in your life at this very moment. This incredible series helps initiate a conversation on death and ways to support you in comfort as well as provide a discussion around difficult topics that surface toward the end of life.
This truly is a life changing experience by being a transformational process, increasing awareness in your life, encouraging curiosity in areas and situations you ordinarily would not examine. One of the most important outcomes when taking this, is that the Best Three Months assists identifying what is most important to you, right now in this present moment and how to navigate that thought.
We have a professional photographer on staff that can help create memories for a lifetime while capturing these sacred moments of being with each other, capturing a moment in time to reflect upon, providing lasting memories, and remembering celebrations to share with friends, families and loved ones. In these photos, it gives you the ability to pass down visual moments and create a legacy of life events. These pictures, these frozen moments of time, can bring a sense of peace, comfort and healing touch to the living as well as tell a visual perspective to honor the sacred moments and continue the story. This gives the person viewing, a sense of belonging as well as remembering just what occurred.
A picture is worth a 1,000 words...you’ve heard it a thousand times before and that statement is not only true but quietly powerful. Just think about showing your child your grandparents wedding photo. The clothing, the black and white picture, how different it truly was back then, how in love they were (or not) and what was going on during that moment in time. So many questions and so many answers in one picture. Imagine creating this for your loved ones and for yourself, surrounding yourself with photos of your loved ones. Imagine how that can truly fill up your heart.
This is fully customizable and can include anything from individual photos to family photos to large group photos and events. It can also be an opportunity for legacy work, such as photo books, sharing family secrets and memories to support preserving individual history.
Grief coaching is compassionate guidance through the emotional roller coaster of grief and loss. It offers the tools to help you manage the loss you’ve had or are having and an opportunity to express how you feel while being supported in this moment. There is no timeline to express grief, nor is there an expiration date on it as we don’t all grieve at the same time. Some people grieve on their own, and some grieve with others. We offer coaching sessions in this same way, one-on-one as well as group settings, and there is also no timeline, meaning, you can have the opportunity that suits you and your loved ones best in whatever stage you are in for however long you may need it.
A death cafe is a group discussion around death and dying with no agenda, objectives or themes, it’s a conversation rather than a grief support or counseling session. This is a type of meeting to increase awareness of death with a view to helping people make the most of their finite lives. It is usually with strangers, who gather to eat cake, drink tea and discuss death.
This meeting helps create a safe place to discuss death, loss and share personal stories among each other, while shifting to a death positive focus for others to connect, ask questions and feel more comfortable about the pathway we are all on. It helps take the burden and fear away from death and allow each person to find a path they feel comfortable with and hopefully allow them to take charge of their matters around death and dying so they can live their life fully. This is a safe place where we are here to hold space for you.
Every month we offer a free online conversation (via Zoom) about death, this is called a Death Cafe. If you’d like to join our next meeting, please register here.
FOCUS #2 -- ACTIVE DEATH
Active Death is when the body starts to shut down. The signs can begin weeks to days before death. At this point the person is often non-responsive, breathing can be shallow, rapid and irregular. Their blood pressure is often very low, their heartbeat is weak and irregular as well as difficult to count. A person’s hands and feet are very cold and purplish looking. They may be calling out for a loved one, frequently not making sense, and are confused. Each person dies in their own way as unique as each individual birth.
For some, the event of active dying can be a slow process but it can allow each other to connect, ask questions, and have an opportunity to say goodbye. It also means that the dying can have a fulfilling death.
We are here to hold space, allowing you to express your emotions, feelings, thoughts and fears while we listen, not here to ask questions or judge. We are here for you and your loved ones, ensuring that you feel supported and comforted during this time. We can help arrange for necessary support and communicate with you to hold your wishes at the front, while educating and helping manage expectations of the dying process. Dying is a natural transition not a medical event. At times, the dying process is one in which we feel helpless. However, just being present and holding space is the gift we bring to the bedside.
FAMILY END OF LIFE COACHING
Family end of life coaching is where we guide the dying and their loved ones and family on death and dying. This can be sharing the dying wishes, educating about the dying process, offering suggestions to help ease pain, providing comfort and/or incorporating other goals. This is also great to reassess the Plan of Care and make any changes, if necessary, as well as update legal documents and any other documents.
The goal is to achieve the best experience possible as you and the dying move through the grieving process. This focus can also provide a better understanding and ways to support through these difficult transitions, addressing necessary steps to move through the loss while preventing any misunderstandings, uncertainty as well as suffering.
These coachings are available for family, friends and the dying. It can help provide support, reconciliation, guidance and relief to move through this transition with more ease toward a thoughtful plan for one approaching end of life. This can provide peace of mind and optimize a positive transition so everyone can experience support, love and understanding.
RESPITE AND COMPANIONSHIP CARE
Respite and companionship care provides the loved one or caregiver a break in the emotional intensity of End of Life Care while being with the dying and providing a compassionate and warm care setting environment for the dying. Being a respite and companion acknowledges and ensures the dying person and their loved ones are not alone during the dying process and can assist in support services.
Oftentimes, during active dying, the family, friends and loved ones are both emotionally and physically exhausted and by having a much needed break from caregiving, helps reduce the feelings of isolation, anxiety, fatigue and resentment. Having respite and companionship care can be the key to survival during this time so you can run errands, go on a walk, take a shower, meet up with friends, take a nap, or anything that you may need to handle your life. This space away from the dying, can enhance the caregivers emotional and psychological well being as they care for their dying loved one while providing a sense of ease while being away.
Those providing respite and/or companionship acknowledge the need for loved ones to recharge in order to continue caring as the loved one is moving in transition to death. It is necessary for the primary caregiver to rest and renew so they can cope with the stages of active dying, thus creating the opportunity to be fully present for their dying loved one. The important takeaway and outcome results in the caregiver understanding the importance of taking breaks and creating space for processing their feelings and providing self care. Respite and/or companionship is actually priceless and reaffirms the dying person and their loved one are not alone.
We offer several packages and hourly rates to support you and the dying so you can be fully present, renewed and supported during this very emotional and exhausting transition.
RITUALS & VIGILING
A ritual is a ceremony or action performed in a customary way. These rituals may be similar to some religious or cultural ceremonies or can be customized and unique to the individual. Rituals can also be grounding to both the loved ones and the dying, bring a sense of peace, and tradition, provide connection with the preferred religion, culture, and/or spiritual calling.
To vigil, means setting aside medical concerns to create a quiet, loving and peaceful setting to accompany the dying person. Vigiling provides companionship for the dying person as they approach death. Vigiling can also include rituals per the wishes of the dying, family members and loved ones.
An End of Life Doula is not only focused on the dying person but provides emotional support to families and loved ones. By sitting vigil quietly at the end of life, a Doula observes for signs of emotional, spiritual and physical discomfort, while creating sacred space as the dying person journeys towards transition and death. This vigiling ensures, as feasible, that no one dies alone, that both the dying person and their loved ones are not alone. Talking softly and in a gentle manner provides emotional and spiritual support as well as decreasing fear and anxiety. This knowledge that you have done all that you can to provide your loved one with a sacred death and created a loving and peaceful environment that empowers the dying person to transition, to let go, is priceless and often forgotten.
Our collective offers a wide range of specific rituals and packages for vigiling. We also can connect you with a priest, pastor, shaman, spiritual healer and guide you while we support you and your loved ones during this transition to death. We can provide blessings with or without oils, read meaningful poems and passages, create an altar, provide flowers, music, photographs and aromatherapy specific to the dying to create the physical and emotional space to be at peace as well as achieve the goals for a gentle passage.
We offer many packages from time intervals like 30 minutes sessions to up to four hour sessions, with multiple group sessions or packages available.
FOCUS #3 -- AFTER DEATH
The body has stopped, the heart has quieted and no longer beats, the exchange of oxygen to carbon dioxide has ceased, there are no longer brain waves firing. The dying is no longer dying, but death has occurred.
Care for the loved one after they have departed is just as sacred as when they are living. Making necessary arrangements for the body is extremely important. It allows the family and loved ones to grieve...to fully feel this emotion, work through it and enter a new chapter of life...living without your loved one.
We are here to support you and your family during this heavy time. The feeling of calm may come up, as well as intense sadness, guilt, and anger. All of these are perfectly normal as well as frustrating. The long journey has ended for your loved ones, but there are still ways to grieve, provide ceremony, and celebration.
But first, what do we do with the body? What are the basic practical arrangements to consider and have stated in your legal documents?
Care for the body after death is essential in honoring the loved one who has passed. It’s also important for families to know what the wishes of their loved one were for the body. There are vessels to cradle your loved ones in their final disposition. The following are basic practical arrangements to be discussed and set-up in advance, ensuring these stages are picked out and supported for the living ones.
A more common green practice is a pine box which is usually a simple and humble nature box made out of pine wood, made with menial hardware, usually perfect for green burials or natural burials. These can include biodegradable materials, linen interior lining, regionally-sourced pine, sturdy rope handles and solid wood construction.
A casket, which is a container usually decorated, it can be elaborate with precious metals and gems, soft and luxurious interior for a final resting place for the body.
Cremation is a method that uses combustion to burn the dead body. It usually leaves behind an average of 2.4 kg (5.3 lbs) of remains, known as “ashes” or “cremains.” This is not actual ash but unburnt fragments of bone mineral, which are commonly ground down into powder. They do not constitute a health risk and may be buried, interred in a memorial site, retained by relatives or scattered in various ways.
A method common in certain religious and cultural practice is wrapping the body or shrouding. This is usually done using a simple plain cloth, colors, style and material varies but this can help bring both closure and connection to the body and the final stage of life.
Some of the last practical arrangements include funerals, the act of gathering friends, family and loved ones to connect and say their final goodbye, see their deceased buried or ashes spread or the body wrapped in the shroud. This style of goodbye can be supported and the last wishes of the dead see the circle of life in its fullest form.
Having these practical arrangements figured out and chosen, allows the family and loved ones to know exactly what needs to be done to honor the wishes of the deceased. When these arrangements have been arranged, the family and loved ones can grieve and have peace when the time comes to proceed with body care.
RITUALS & CEREMONIES
Rituals themselves mark and clarify significant life changes. Ceremonies are just as important and can be religious, spiritual, and/ or cultural.
In the final stages of death, come personal, cultural, and religious rituals or ceremonies. We are here to help support, facilitate, and guide you and your loved ones wishes. There are certain rituals and ceremonies that can take place shortly after the spirit leaves the body. Some of these rituals are for the dying and their families, and some decline any kind of ritual. Specific rituals can be created according to the dying person's wishes and beliefs. Playing music, lighting candles, and creating an altar with objects that are specifically meaningful to the dying person. Some rituals may include anointing the body with oil and saying prayers, this can be done before and after death.
There are many religious and cultural practices that involve washing the body. This can give loved ones the opportunity to participate in this practice. Some cultures do this in such a way where they use warm water, adults of the same gender and say prayers. Some cultures only allow certain people to wash the body and some morgues take this service on. Either way, this can be a very sacred ritual that may include oils, prayers and deep spiritual focus to achieve. Other rituals may be as simple as putting sage in their loved ones coffin and/or casket.
Providing both rituals and ceremonies, can also increase a loved one's ability to process and cope with changes in their life as they grieve, it can allow someone to say their final goodbye and it can give the living the ability to acknowledge and honor this sacred death. By gathering together to participate in a ritual, loved ones can receive, give love and support one another. The ritual of telling and sharing stories help all those present to laugh, cry, and grieve together.
These can be religious, spiritual and/ or cultural. In grief ceremonies, altars can be created, use of scarves or fabrics with color can be draped on the body. Candles lit, a small bowl to represent the holding of tears. Ceremonies honor the dead, acknowledge the rite of passage and the initiation into a new life. The value in ceremonies is acknowledging feelings, behaviors and experiences, a chance to release our deepest feelings with tears. It can bring communities together and restore death to its sacred place by giving a ceremony to the recently departed.
We can help guide and arrange for services after death; care of the body, creating memorials, and a legacy to hold and remember. We also are here for you and the loved ones managing grief and sadness. Some cultures grieve for two years, some for four days, either path you choose is correct and exactly what you need.
When your loved one has parted from this Earth, we can offer options to support both their body and spirit. We also have options for you and your family. Know, you are not alone in this process, we are here to guide you to honor your love.
GRIEF AND BEREAVEMENT SUPPORT
Grief and bereavement is any loss and/or sorrow following the death of a loved one. We offer support, coaching sessions and care during this period. We help guide you and your family, services can include rituals and ceremonies as well as group and family sessions. We even have workshops and networks to connect with others going through similar grief.
As you better understand how to live more fully, Gentle Passage Doula Collective is here to guide you on the top three focuses for death: Preparation, Active Dying and After Death. All of our services are available at any time during the dying process. We are here for you and your loved ones and we want to ensure that the end is just as positive and filled with love, light and laughter as the beginning of our journey on this Earth.
If you would like to inquire about a specific class, workshop or webinar, please reach out and we will create something or guide you to one we already have. We are ready for you and your loved ones to fully live a meaningful and full life so that the end is just as powerful and joyful. Thank you….thank you for being here as we connect and dive a little closer into this path we all take so it isn’t scary, hopeless or lonely. We are here for you every step of the way.
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Gentle Passage Doula Collective
The tools, resources and information does not provide medical advice. It is intended for informational purposes only, not advice or guarantee of outcome. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the Gentle Passage Doula Collective Website, downloaded resources and/or educational material, or misinterpreted the information/context/educational sessions. If you think you may have a medical emergency, immediately call your doctor or dial 911. Gentle Passage Doula Collective and it's members are not responsible for errors and omissions in reporting or explanation. No individuals, including those under our active care, should use the information, resources or tools contained within to self-diagnosis or self-treat any health-related condition. Gentle Passage Doula Collective gives no assurance or warranty regarding the accuracy, timeliness or applicability or the content.