Companions in transition: End-of-life doulas offer final comfort

‘The death experience doesn’t have to be scary.’

“Nobody really knows what happens, but everybody dies.”

That’s Carolyn Reveal, a cancer doula. Though she’s sometimes bluntly referred to as a “death doula,” the preferred and blanket verbiage for her services is end-of-life doula.

In the same respect that a birth doula collaborates with expectant mothers to harbor relaxed environments during the birthing process, pre- and post-natally, an end-of-life doula offers the same services but for death.

Reveal has been a nurse for more than 45 years. She’s been trained to help patients live, but life is an ephemeral thing and will inevitably end at some point. An end of life doula offers choices — whatever the client wants — to best comfort those who are in the process of dying. These choices could be as clinical as a DNR (do-not-resuscitate) order, chemotherapy or hospice care or as simple as dying at home with a certain genre of music playing.

“The death experience doesn’t have to be scary,” Reveal said. “It can be a very beautiful experience where you get to choose how it happens.”

Her practice is in The Well: a comprehensive women’s health and wellness center in Kettering. The Well has many functions and practitioners —there’s a physical therapist, a midwife, a doula, licensed social workers, clinical counselors and psychologists, massage therapists and a nurse practitioner.

They also offer reiki, yoga, tai chi, aromatherapy and reflexology, some of which are offered in the “womb room,” an open-concept multi-purpose area on the second floor.

As Reveal says, they can take care of you from before you’re born until the time you die.

Reveal originally received her doula certification with the Birth with Spirit doula program, located in The Well. But after her daughter had her babies, and her daughter’s friends had their babies, she became more interested in death.

“I started to realize that a lot of people now are finding out that they have cancer on [the online medical records system] MyChart,” she said. “It’s not a personal thing by the doctor. It’s a very difficult thing for them to navigate.”

Reveal’s a two-time breast cancer survivor. On top of her years as a nurse, she took care of her mother and father, her husband, and her husband’s best friend, at the end of their lives. In a sense, her experience with death — the aiding and comforting of loved ones — was hands-on empathy training for helping other families.

Danny Reveal II, Carolyn’s son, is also an end of life doula, though he’s freelance and without an office. He’s also a philosopher with a Master’s in Humanities. Danny Reveal moved to Dayton from Missouri to help take care of his father, collaborating with his mother and sister throughout the process. When his father died in 2018, Danny Reveal was there with him.

“We saw what he needed at his end of life,” Danny Reveal said, adding that he wanted to help families going through similar experiences. “I took interest in it to try to help others who don’t understand that they have choices, or help people who don’t have any family.”

Danny Reveal trained with INELDA — the International End of Life Doula Association — and has guided five families through the process. Carolyn Reveal, in her four years as a doula, has guided 11.

The process can start six months to a year ahead of time, but sometimes they only meet the families once or twice. End of life doulas are not always beside their clients as they take their final breaths — often they’re not.

Though Carolyn Reveal is a nurse, the job of an end of life doula is not medical; it is a supplemental service that provides comfort and is not a replacement for palliative care. All the deaths that Carolyn Reveal has worked with have also had hospice.

“My mom and I are huge proponents of quality of life,” Danny Reveal said. “Part of being a doula, for me, is facilitating conversation … some people just want to be comfortable. Some people want any and every measure taken to help prolong their life.”

“Everyone has something that’s kind of dear to them,” Carolyn Reveal said. “Some people just want silence.”

Carolyn Reveal says that Danny is good at having his clients tell stories. It gives them a sense of remembering what their life was, and not just as they are — sick, dying — allowing them to feel that their lives were wonderful. These moments also allow families to listen to those stories, perhaps for the last time.

“There are so many things you find out when somebody dies,” Carolyn Reveal said. “We’re outsiders, so we kind of come in and see the dynamics. If we can facilitate in a calm, rational way, it’s much easier on the family.”

With a death plan, similar to a birth plan, the clients choose their ideal environments. Carolyn Reveal is adamant in explaining that these choices can be amended at any time, often with a safe word to safeguard impulsive decisions, much like a last-minute epidural in the delivery room.

“Societally, death is always pushed away until the last moment,” Danny Reveal said.

It’s a taboo subject; there’s a stigma. But if it’s going to happen anyway, it might as well be a comfortable journey — because death, the end of life, can be beautiful.

For more information about Carolyn Reveal, end of life doula, visit carecancerdoula.com. Danny Reveal, freelance end of life doula, can be contacted at drevealjr@gmail.com.

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