‘It’s not all doom and gloom’: End-of-life doulas support people near death

End-of-life doulas find themselves providing anything from practical help to emotional support

End-of life doula Sinéad Ryan tells of one instance of a woman near death who wanted to confide in her: 'She wanted to express how she felt to somebody who wasn’t connected to the situation'. Picture: Patrick Browne

It was a Zoom call Sinéad Ryan will never forget. At 92 years old, one of her most beloved clients wasn’t ready to die, and used the online chat with Sinéad to confide her darkest secrets.

Even for an end-of-life doula, with a background in nursing, the conversation was extraordinary and also deeply moving.

Sinéad says it is the sort of experience that encouraged her to pursue this career path in the first place at a time of increased demand for the service.

Sinéad is a member of the Doula Association of Ireland, and trained with the peaceful presence programme in the US state of Oregon.

One of dozens of end-of-life doulas in Ireland who entered the industry in recent years, her job is to offer non-medical support to those nearing death — including any practical requirements that may need fulfilling.

One of the most valuable parts of the service for many is the companionship she offers.

'It was lovely that she trusted me' 

“I had this one very elderly lady who was absolutely remarkable,” she told the Irish Examiner.

“She was very organised and had her think-ahead planner all filled out. The practical work was all done, but her daughter rang me with a request from her. She wanted to express how she felt to somebody who wasn’t connected to the situation.

“The lady didn’t want to burden her family with the fears and worries she had. She wasn’t within driving distance, so we organised a chat through Zoom.

"I was blown away that at 92, this lady, who was on continuous oxygen, was able to do Zoom calls without any difficulty. 

"She had kind of lost faith and wanted to talk through things without upsetting her family.

It was just lovely that she trusted me the way that she did. 

Sinéad, who hails from the Cork/Waterford border, said she also worked with some people who avoid the subject of death until their last breath.

“I had one man whose family got in contact with me to see if I could help. He was dying, but never accepted it.

“Never once did he speak about it, because he just couldn’t bring himself to. He couldn’t even talk about his own funeral. Some people will go their whole lives without facing up to the fact that death is an inevitability.

End-of life doula Sinéad Ryan. Picture: Patrick Browne

“We are all going to die someday, but some are less accepting of this than others.”

Sinéad said that, while the term ‘doula’ may be relatively new in Ireland, the service she offers has been around for generations.

“Basically, we’ve had this for years. But it was just the wise woman in the community who did it back then.

“There was usually a person called upon to aid the those approaching the end of their life, much like the old-fashioned midwives who went from house to house to deliver babies.

“I think the skills required to be an end-of-life doula are back on the horizon, but unfortunately they got lost over time.”

'The core concept of a good nurse'

Simon Palmero, from Donabate, Co Dublin, has been working as an end-of-life doula for less than a year.

Nonetheless, his experience caring for the terminally ill dates back much further. The 54-year-old has been nursing for 27 years, 13 of which were in palliative care.

Simon Palmero who works as an end-of-life doula.

“I am a clinical nurse manager, looking after children with complex needs and life-limiting conditions. Outside of this, I am an end-of-life doula. 

"What this does is enhance aspects of being a palliative care nurse so the focus is mainly on the social, psychological, and spiritual.

“It’s like you are taking away all the medication and being left with the core concept of a good nurse.”

Much of Simon’s work includes helping with what he terms “unfinished business”.

From making dinner to witnessing baptism

“There will often be stuff they are not happy with and things in their lives they want to sort out. This could be writing letters to their friends or forgiving somebody. They may want to write multiple birthday cards for their children or do videos and voice recordings.

“They might have a spiritual conflict, in which case you are just there to listen.

“There can also be a practical element to the role. Someone might express worries about their partner skipping dinner because they are exhausted from caring for them. In this situation, I’ll make a meal for them. 

"This is a minor one, but there are some very touching requests. 

One person asked me if I could be with them while they were being baptised and I was deeply honoured by this.

Simon is keen to stress why end-of-life doulas can be vital for those facing death and their families.

“End-of-life doulas are part of a massive jigsaw puzzle which also comprise of hospices and home care.

“The Irish Cancer Society, Jack and Jill — there are so many organisations doing great work supporting people, and end-of-life doulas are now also playing a part in this. The thing is they can’t be there all the time, and this is where an end-of-life doula comes in.”

Simon said joy can be found in life up to the end.

“It’s all about sitting back with the person you love and holding their hand, and stroking their hair, whatever you need to do to support them in their final days.

“Even during this time, there is a lot of laughter and reminiscing. 

"It’s not all doom and gloom, because life is full of happiness. That’s important to remember right up to the end.”