Turning Points: Navigating Mental Health

Episode S4E5 — Embracing the End: The Role of End-of-Life Doulas

Host: Frances Leese | Guests: David Duffin, Dawn Walsh
Date: October 16, 2024

Episode Overview

This season finale of Turning Points explores the growing role of end-of-life doulas in supporting individuals and families as they navigate the emotional and mental challenges of death and dying. By sharing personal experiences and insights from guest David Duffin (who recently lost his sister) and end-of-life doula Dawn Walsh, the episode sheds light on how these professionals provide comfort, guidance, and create meaningful, peaceful transition at the end of life—challenging the often clinical or isolating perceptions of dying.

Key Discussion Points & Insights

1. David Duffin’s Story: Navigating Loss with a Doula (00:21–09:51)

• Background:

  • David Duffin discusses the recent loss of his sister, Colleen, after a cancer diagnosis.
  • Shares that their relationship was complicated and somewhat fractured, making end-of-life support particularly important.
  • David sought help beyond what he alone could offer and was introduced to Jill McClellan, an end-of-life doula (01:02–01:18).

• First Encounters with Doulas:

  • Initial confusion over the term "doula," usually associated with birth, not death (01:33–01:44).
  • Jill provided comfort, facilitated challenging conversations, and offered Colleen a safe, non-familial support space (01:44–02:44).

• Emotional Support for Families:

  • David reflects on the intense guilt and self-questioning that comes with supporting a dying loved one.
    • Quote:

      “You always second guess yourself...just to get someone to give you some type of affirmation that you're doing the right thing...”
      — David Duffin (03:47)

  • Jill’s reassurances and presence helped him cope and feel less alone (03:47–04:28).

• Difference from Traditional Settings:

  • Jill’s conversations felt more real and less clinical than what’s offered by many institutional caregivers (05:27–05:50).
  • Doulas can raise and address topics more honestly, without sugar-coating (05:50).

• Advocating Early Doula Involvement:

  • David urges families to involve doulas sooner, not just at the very end, as late involvement limited his sister's ability to benefit (06:25–08:07).
    • Quote:

      "Bring in the doula, bring in, get them involved earlier. It helps both the patient and the family... There was a weight lifted off of my shoulders."
      — David Duffin (06:25)

• Lasting Impact:

  • Colleen’s positive feedback (“it was good, which means it was great”) reflected how Jill connected with her during her last days (08:12–08:47).
  • David’s view of end-of-life care fundamentally changed, wishing he had known about doulas during his mother’s illness (09:03).

2. Dawn Walsh: A Doula’s Calling and Practice (10:16–25:29)

• Personal Motivation and Pathway:

  • Dawn shares that her journey started after the sudden, tragic loss of her mother (10:55–14:17).
  • Later experiences, such as caring for a dying friend as part of a group, brought profound healing and revealed her “calling” to this work (12:27–14:17).
    • Quote:

      “You feel compelled to do this work… it’s really profound and beautiful. The work itself, of course, and to do this with other people who have a deep soul spiritual connection… it bonds us…as human beings on this planet who have found each other in a calling.”
      — Dawn Walsh (13:50)

• What Does an End-of-Life Doula Do?

  • Distinguishes doulas from hospice: Non-medical, holistic support encompassing emotional, spiritual, social, and sometimes logistical help (14:47–16:35).
    • They can provide education about dying, help with paperwork, support families, or even just run errands or provide a calm presence.
    • Each doula’s approach and services are unique.

• Making Death Less Isolating and Taboo:

  • Describes helping families through hands-on support, conversation facilitation, and, when appropriate, guiding home funerals (16:51–19:55).
    • Example: Assisting a family whose dying mother was worried about her daughters. By being a neutral presence, Dawn could help both the dying and loved ones achieve peace.

• Supporting "Full Living" Until Death:

  • The Lily House’s philosophy: supporting people to “live as fully as possible until the time of death” (20:22).
    • Regular, normalized conversations about death can reduce anxiety and bring a sense of gratitude for life.
    • Emphasizes historical shifts: Most people now die in institutions, but doulas are part of a cultural return to community-oriented, home-based death (20:22–23:10).

• Practical Tips for Families:

  • Start talking about doula services early, seek them out intentionally, and think about specific desired supports (23:16–25:29).

    • Recommends the National End of Life Doula Alliance as a resource.

    • Encourages approaching death collectively as a community, preventing people from dying alone.

    • Quote:

      “Think about this as an opportunity to engage with end of life collectively... so we don’t feel that we’re alone at probably the most sacred moment of life, next to being born—dying.”
      — Dawn Walsh (25:00)

Notable Quotes & Memorable Moments

• David Duffin on Doula Support:

  "To the best of her ability, she put my troubled mind at ease." (03:47)

• Frances Leese on Acceptance:

  “At the end of the day, you know, that person does have the free will to make their own decisions and go on their own journey, no matter how difficult...” (04:28)

• Dawn Walsh on Her Calling:

  “Because to do end of life work to help people die is not something you do casually on a whim. It's something you feel called to do and calling capital C.” (13:16)

• Dawn Walsh on Cultural Change:

  “It's a reclaiming and returning to hands-on death and dying care before, during, and after, and returning this work into the literal hands of all of us as a community.” (21:35)

• Dawn Walsh on Community:

  “How we can show up for each other to do this together.” (25:00)

Key Segment Timestamps

• 00:21–02:44 — David introduces his loss, discovers end-of-life doula concept, shares initial reactions.
• 03:47–06:25 — Discussing self-doubt, grief, doula’s role in offering affirmation and comfort.
• 08:12–09:51 — Reflections on how doula support changed his view of end-of-life care.
• 10:16–14:17 — Dawn Walsh recounts her personal journey and calling to the work.
• 14:47–16:35 — Explanation of doula roles versus traditional hospice/palliative care.
• 16:51–19:55 — Real example of facilitating a family’s goodbye and introduction to home funerals.
• 20:22–23:10 — Perspectives on death, life, community, and social activism.
• 23:16–25:29 — Advice for those considering an end-of-life doula and the communal aspect of dying well.

Summary of Takeaways

• End-of-life doulas play a distinct, holistic, and humanizing role—complementing, not replacing, traditional medical care.
• Early involvement of doulas can ease family burdens and facilitate more peaceful transitions.
• Doula support is deeply personal, rooted in empathy, non-judgment, and presence.
• Facing death openly—individually and collectively—can reframe it as a meaningful, sacred passage rather than an isolating event.
• Community and conversation are vital: both to the dying and those who survive them.

Resources Mentioned

• National End-of-Life Doula Alliance (NEDA)
• The Lily House (Cape Cod, MA) — community-based home for end-of-life care

This episode advocates for reimagining end-of-life care as a compassionate, communal act and offers practical ways to support loved ones and oneself in the face of loss.