Grace In Goodbye. The Work Of

a Death Doula

By Mary Alden

A widower living alone, George didn’t want to leave his mounds of papers, books, maps and hobby collections for his busy adult children to handle after his death.

He initially hired me as a late-life transition specialist to help downsize and organize his family home of 50 years.

Although active and independent in his 90s, George figured he didn’t have long to live, and sadly, he was right. In the second year of working together, he was diagnosed with an aggressive form of cancer that took his life within a year.

Upon his diagnosis, my role quickly shifted to that of an End-of-Life Doula, and I spent the next year preparing him and his family for his final transition.

As George’s health declined, I helped him select the best hospice team available, guided him through the intake process and remained a key advocate in his daily care.

When observing changes in his condition, my partnership with hospice enabled me to ensure that his care team promptly addressed his needs.

Having his confidence and knowing him so well allowed me to continue advocating for his wishes, even when he could no longer communicate for himself.

George’s four adult children lived nearby but with demanding jobs and large families, a couple of them had run out of patience with their father’s stubborn nature but I was there to soften any conflicts that surfaced.

As his healthcare advocate, I accompanied him to all of his palliative care appointments, took notes, ensured his wishes were heard, and translated complex medical discussions for him and his family, especially as his cognitive abilities began to decline.

Before his cancer diagnosis, George had made it clear he did not want to suffer or live without his mental capacity. The two of us talked at length about his choices of either Voluntarily Stop Eating and Drinking (VSED) or Medical Aid in Dying (MAID).

 At his next in-person appointment, I sat with George as he shared his wishes with his palliative care doctor and formally requested MAID.

After his second mandatory meeting with another doctor to confirm his wishes and his mental capacity, his care team approved his request and arranged for the life-ending medications to be shipped to his home.

I stored them safely in the refrigerator as required, where they remained for months. George never found the courage to take them while he was still “sound of mind” and soon forgot about the option of MAID all together.

Honored that George entrusted me with helping him plan his funeral, I designed his headstone, chose an urn for his cremation ashes, wrote his obituary, completed his Advance Healthcare Directive and organized all of his most important documents.

We listed all of his passwords and valuable belongings on separate spreadsheets to ensure each child received what he wanted them to have with easy access to his accounts after his passing.

When his care needs escalated, I helped him interview and hire caregivers to support his increasing needs and help around the house as his independence declined.

A fiercely independent and practical man, George often clashed with his children, though they had his best interests at heart.

Acting as a complex family dynamic mediator, I facilitated honest and meaningful conversations so everyone in the family could be fully heard, allowing for deeper understanding, layers of healing and forgiveness before his death.

When George passed away, I stood alongside his children who honored his final hours with deep compassion. That closure, the honest conversations and being fully present in his last moments, was an extraordinary gift to his kids, sparing them much of the guilt and unresolved grief that so often lingers after a loved one’s passing.

End-of-Life Doulas (EOL Midwives), among other things, bridge the growing gap between medical care and hospice services, educating families on options, rituals and planning that traditional healthcare providers may overlook or may not have time for.

Honoring a person’s unique needs and preferences ensures a more meaningful, personalized end-of-life experience. Our presence can ease suffering, reduce fear and anxiety and lighten the emotional burden on families, allowing them to be more fully present while honoring their loved one’s final moments.

For more information on End-of-Life Doula services, please feel free to reach out to me directly maryalden.bld@gmail.com. It will be my pleasure to answer your questions and help guide you toward your next steps.



Mary Alden, Late-Life Transition Specialist and End-of-Life Doula. www.beaconlightdoulas.com

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