February 4 Forum

Mitch 

Late-life doula is an interesting idea. What if an end-of-life doula or late-life doula has the expertise to help guide people through the community resources that are available? What if they’re able to identify areas where the person whom they are helping reports being dizzy and not very strong? The doula can recommend physical therapy. They know where to get that physical therapy and know what to look for. The doula also is knowledgeable about the dangers that might be found in an elderly person’s home. They can help make the house basically safe.

What if the doula can do practical things like that?  Do you need estate planning? Are you talking to your kids?  Are you isolated?  What are the community resources?  How can you begin to build relationships if you haven’t been establishing relationships outside of work? So, there’s more of a broad application potential. Because people are not always supported. You know, we’re usually talking about some pretty well supported people in this forum. What about people who are really on their own?  What about those with no family involvement?  They don’t know the resources, and they don’t know what to eat. They’re doing nothing but drink Ensure every day.

A late-life doula is someone who can take on the whole change of life thing that occurs. And they can counsel and walk someone through a lot of complicated stuff about which many people aren’t talking.  What people eat when they’re older is different.  How they connect is different. The need for exercise is a little different.  The need for sleep is a little different.  Someone is required to help. To provide information about all those things and help make the transition.

I think the late-life doulas could also be experts about meaning.  How can you create meaning in your life?  The doula can come alongside an elderly person and be a meaning-maker for this person during the late stage of their life–because there’s a lot of meaning to be had. A lot of things can be selected and learned during the end-of-life period.  And I guess my dream is that something like that could happen.

Bill B

Mitch, when I used to teach at the Wright Institute, there was a couple working there who focused on issues of gerontology.  Based on their studies, they concluded that people don’t just grow older, they also grow poorer. The statistics apparently show that as many people grow older, they have less money.

And so much of late life has to do with what happens when you grow poorer. How do you deal with it?  In other sessions of this forum, we have talked about islands of malnutrition. I would suggest that part of what you’re talking about is the situation where older people end up relying on Ensure. Maybe this is because they can’t get out of the house. However, maybe it’s because they can’t afford more expensive food. It might not be Ensure (which can be rather expensive). They might instead consume nothing but one of those packaged soups, because that’s the only thing they can afford.

Anyway, we need to thank you all. There was a fair amount of hesitant support for the idea of a late-life doula. Perhaps doulas aren’t the answer. However, I think it’s important in this Salus forum that we’re talking about domains of health and human services that are kind of new for us.