February 4 Forum

The word “doula” comes from Greek times, actually and has to do with the role usually of women who are brought in to assist in the birthing of a baby.  It’s more than just midwifery.  It has to do with kind of the whole setting, getting so that the woman can give birth to the child in the old days, give birth to a live child and be living themselves at the end of the birth. It also has to do with the child after birth, postpartum.  Well, during the last couple of decades a new process has emerged. It usually goes by a rather brutal name.  It’s called end-of-life doula or even more roughly it’s called death doula.

What’s interesting about the death doula is that once again, much like birth doulas, they’re not just involved in the process of dying.  They’re involved more broadly in issues having to do with preparing for death.  Now, I think we need to move beyond that.

I proposed something that I’m calling late-life doulas.  I think the issues concerned with the later part of life are not just about dying.  They’re about a whole series of issues and concerns that I think often can be addressed or should be addressed over perhaps twenty years of life. And having someone who is trained and prepared to assist with the issues in later life doula, I think those things can be extremely helpful.  And I think they relate very directly to the matter of healthcare.

Obviously, the medical profession resides at the heart of late-life doula. For instance, when my mother was in her early nineties and she moved up to an assisted living facility in Sacramento, California.  And first of all, there were virtually no doctors in town that would take old folks, like my mother, except there was one doctor, part of the Sutter system, which was interesting, who worked primarily with older adults.  And I took my mother to see this woman, this doctor. And well, several things were very interesting.  One is that she was from India. And as we know, there is a real commitment to caring for those who are elderly in many cultures other than the United States,

Her nurse assistant was Mexican American.  She came from a culture also where there was a lot of assistance.  And just one point that was made that I thought was very powerful, I may have mentioned it before. I was always attending my mother there because she felt that without me being there, my father had died, that she would just be run over by the healthcare system.  I’ll never forget that when I brought my mother in once, the nurse was sitting there and kind of gave me a wink and said, “You know, the problem with your mother is that the blood isn’t moving properly through her arms.  So, her arms need to be massaged to keep the blood moving appropriately”. What it was really about is that since my father died and my mother living alone, no one ever touches her. I was to be the one who touches her.

The nurse said: “Okay, Bill, I want you to start. Now slowly move your arm down your mother’s arm, your hand on your mother’s arm”.  And I just saw my mother melt.  My mother was a very proud woman and to see that was happening. So, when I’d go to see her, I would be moving my hand on her arm as the one person who touched her. Late-life doula services are partly about basic things like being touched.  It’s also about things like what you do with your possessions.  There’s a whole new profession starting now, which is people that come in and work with someone who’s about to downsize. And they’re trained.  It’s not simple.  They’re trained to help people decide, what do I care about?  What do I want to keep?  What do I give away?  And realizing that’s really important.