Death doulas: Practical, spiritual, and emotional support at the end of days
Memento Mori - Latin for “remember you must die”
Watercolor created by Alexandra Becker Black
Alexis Everhart owns Portland based Memento Mori and serves as a death doula offering end of life services. This blog provides a Q&A between Life-cycle Celebrant Katie Melville and Alexis Everhart about death doulas, end of life services, and ritual.
What is a death doula? A death doula provides non-medical individualized compassionate care to those at the end of life or planning for it. Using a holistic approach, we complement hospice and palliative care teams, help navigate disposition options, end of life wishes and other support for each client's unique needs. Like a birth doula at the beginning of life, death doulas act as a transition guide at the end of life so that people are more prepared to go without fear and to be at peace.
How did you choose your business name? It was a delicate balance to come up with a meaningful name that was not too severe or too whimsical, and I kept coming back to the idea that we are all going to die and how can we be prepared for it? Throughout history, people accepted this fact and normalized it through art and objects as reminders called memento mori. I just like the idea of getting comfortable with death because it is coming for all of us and getting creative with it.
Who would benefit from having a death doula?
I like to remind people that anyone can utilize a death doula–it is not just the actively dying, but any point in life (pre or post diagnosis) when you are contemplating mortality and want to get your affairs in order. I often work with individuals who don’t have religion or a faith based background whose religions have death rituals and practices baked in, to come up with meaningful end of life rituals. I also find that death doulas are helpful to people who do not have a support network or live far away from family, caregivers who are overwhelmed or someone grieving a loss.
What brought you to this role?
During the pandemic it just floored me how delicate life is and how we don’t prepare for death at all in our culture. I read an article about death doulas and felt really called to this work so I went on to do a certification program through the University of Vermont.
What is important to you about the work you provide at Memento Mori?
I think it is important to normalize death and prepare for it sooner than later and if I can help a person get their affairs in order so their final wishes are honored, it not only helps the dying person but also all their loved ones. I also recognize that when you are grieving, everything feels like a mountain to climb so any support I can provide feels worthwhile.
How does someone find or choose a death doula? Are there certain things a person should keep in mind?
People can look for death doulas by state through the National End of Life Doula Alliance or International End of Life Doula Association’s directories and then from there I would check individual websites to get an idea of who might feel like a good fit and then I would contact a few and interview them. I think it is important to find a doula whose values align with your own. You can also always switch doulas if you find that one you are working with is not working out. It is such a personal thing and there are a lot of doulas working in Portland. If I don’t feel like I would be a good fit, I can also refer to other doulas. I am such a connector and a member of the PDX Deathworkers Collective where we support each other.
How do you approach your work with clients?
I offer a free initial consultation which can be in person at my office or someone’s home or on a video or phone call to see what their needs are and explain my services and how I work. If I think we are aligned and they are ready to engage, I send a contract outlining what services will be provided, whether it is weekly or daily visits or a few hours for a specific project.
When is the best time for someone to start working with a death doula?
Honestly, as soon as possible. Although doulas can be such a tremendous help in the last days sitting vigil, providing respite resources and grief support, I think even just having a few sessions early on where you have the space and capacity to create your death plan, think about legacy and do some Swedish death cleaning while not in crisis mode can be really beautiful and make the dying process a lot less stressful.
Is hospice different from death doula work?
Yes. Doulas provide non-medical support and are a great complement to the busy hospice team who have large case loads and only have capacity for short check-ins. Doulas fill in the gaps of care, offering more time for emotional and other types of support.
How do you support caregivers and family members throughout the end of life process?
I allow space for people to create their own meaning at end-of-life and make sure those wishes are honored. No two circumstances or personalities are the same and I don’t treat my approach as a one-size-fits-all process. I tailor my skills and knowledge to each individual and we learn and grow together.
Talk to me about grief and how you support those throughout the grief process.
The grief process is different for everyone and I am available whenever people are ready for outside help. It is about meeting people where they are. I am a fan of continuing bonds theory and help people find creative ways of staying connected to their loved ones though doing things they enjoyed or helping them sort through all the “stuff” and finding ways of honoring them. I connect people to the Lantern PDX and The Grief House in Portland who have a wide range of grief group support. [See resource list below for more information on these community resources].
Can you talk about the benefits of taking a pause after a loved one passes and not rushing into planning a funeral or celebration of life?
I have found that there is so much happening surrounding death that people feel pressured to figure out a memorial service or funeral quickly and then feel guilty that it wasn’t what they wanted. I remind people that death is not an emergency and you can take your time with the funeral or memorial (unless your religion dictates otherwise), but it is absolutely ok to have a do-over. You can do whatever feels good to honor your person and get as creative as you want.
What do you think is important about death rituals?
Ritual is of the utmost importance to honor something as sacred and profound as death and in our busy modern world we have gotten so far away from this. Cultures that normalize death and have death rituals to plug into make it that much gentler on the bereaved. Having space allowed for that is crucial, so if someone doesn’t have that built in, I support them finding a meaningful ritual, however that looks. Our brains need something to recognize that massive shift in our lives when we suffer a great loss, whether from a death or a major life transition.
What types of services do you provide to your clients?
Contemplative care and meaning making is what I do as a volunteer at Hopewell House and for clients. This can look as simple as sitting with someone alongside their journey, bearing witness and doing deep listening. Or it can be creating an end of life ritual to honor a life, legacy work or memorial projects. In addition, I can help with things such as creating a death plan, coordinating a care team (outside of the hospice team), vigil planning, end of life celebration, disposition options, advocating for end of life wishes, helping go through all the items after death, or before as in Swedish death cleaning, and grief support.
How to Contact Alexis
Website: https://mementomoridoula.com/
Email: alexis@mementomoridoula.com
Phone: (213) 200-4063
Additional Resources
National End of Life Doula Alliance
International End of Life Doula Association
Hopewell House End of Life Residence
Photo of fallen tree taken by Alexis Everhart on a walk with her dog. It is a memento mori symbol… reminding us that we all must die.