Category: Cultural Expressions

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Resting in Peace…

Death doula Jane Whitlock on end-of-life care, grief, and the importance of telling our death stories

Jane Whitlock

by

When her husband got sick with kidney cancer and died four months later, Jane Whitlock, having had no experience with death or grief, found that the guidance and spiritual care provided by hospice just wasn’t enough. Resolving to find her own purpose while answering for the gaps she saw in end-of-life care, she followed her intuition and became a death doula.

A death doula, or end-of-life doula, is someone trained to provide holistic care to a dying individual. There is no nationally standardized certification program, which means there are multiple training options—a process that involves a set of training classes and documented hours of direct client support, plus whatever specific assessments a particular certification program requires. Death doulas represent a growing movement toward redefining our typical approaches to death.   

A death doula’s role is as nuanced as each individual who occupies that role, and Jane Whitlock sees herself first as a companion. She provides comfort and support to the dying individual and their “tribe”—as she often refers to the circle of family and friends—through a time for which most people may not be spiritually prepared. Through intentional connection, she deciphers how she and the tribe can best serve the dying person. She abides by the slogan, “Death: it’s a collaborative event!”

This Q&A has been edited for clarity and length.

The Growler: Why do you believe death doulas are important?

Jane Whitlock: A doula helps ask the big questions so this process is as spiritually comforting as it can be. Think of your deathbed and how you want to feel—at peace, right? So, how do you get there?

A doula also gives you some sense of what’s coming and can support you through these tough situations that you may not be prepared for. You haven’t been here before and often don’t have any bank of knowledge to draw from.

Cultures have evolved to include how we care for people who are dying and have died, and while some intact cultures can trace their beliefs back very far (to the Buddha, for example), Americans don’t have those deep ties.

Since the Civil War, the standardization of funeral homes, embalming, and the medicalization of end-of-life have removed death from the home. We no longer know how to care for people who are dying, how to have home vigils, how to mark significant transition points (leaving a body for the last time, a body leaving the house).

How can our modern standardized systems shift to accommodate what death doulas have to offer?

It would be amazing if hospitals employed doulas! Wouldn’t it be great if you could transfer someone who has died to a room to clean them up, bring the family in, and have someone guide them through rituals of saying goodbye and nurturing the body?

I think a lot of times this seems like a white lady movement—like, we want to cover everything in crystals and candles and aromatherapy or whatever. I push pack against that because there are so many other ways of experiencing death. This movement needs to be more inclusive, to change a whole bunch; being a death doula is a teeny, tiny door, and there is a lot of growth ahead.

What characteristics make an effective death doula?

You have to be able to empty yourself out, to be hollow and free of judgment, of any preconceived ideas about what should be happening. You have to listen without thinking and really be with someone when they’re suffering without trying to fix it. An effective death doula is someone who is calm, quiet, and vulnerable. It’s really so much about vulnerability.

I volunteer at a hospice and often have to practice that whole “soft belly” thing, to stop before every room and become wide open. Even when someone doesn’t want to see you, you have to think, “It’s not about me.” You just kind of clear your energy, go into the next door. You have to fight being defensive in order to just be vulnerable.

 

What are some ways to go about changing our death culture?

It really starts with your stories. We don’t tell our death stories; we tell our birth stories and our family stories, but we don’t tell our death stories. It would be great to just listen to a bunch of stories about how it happens, maybe know just some weird and messy stuff, too. What was it like? What would you have done differently? What went well? What surprised you?

There’s this guy, Dr. Allan Kellehear, who says our inability to talk about death is a public health epidemic. He refers to the AIDS epidemic and how you couldn’t shut a bathroom stall without a poster on the back teaching about prevention and safety. Wouldn’t it be great if we took that type of vast approach to shifting death culture?

Another maverick in the field, Suzanne O’Brien of Doulagivers, says there should be someone on every block who knows the end-of-life basics so that when somebody in your community is dying, they are supported.

Who do you think is the best at approaching death?

Well, the Buddhists, hands down. They’ve got the saying: “We are of the nature to get old; we are of the nature to suffer; we are of the nature to die.” Imagine if that’s how we started every morning—we wouldn’t be so shocked by death! There are people who think that aging is some kind of radical punishment or who feel entitled to live in a full healthy body forever. That’s just not our nature.

I would say that to prepare for death, you have to get your spiritual house in order, whatever that means to you. Life is finite, super fragile, and you are not entitled to anything! So, spend your time wisely and be grateful.

Complete Article ↪HERE↩!

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Toronto death doula helps take the fear out of dying

By Christine Sismondo

“Everyone dies and that is OK.”

Those six words are something of a mantra for Kayla Moryoussef, a Toronto “death worker” who has spent the last six years immersed in death and dying. As the program manager of the Toronto Home Hospice Association’s “Death Café” initiative, she holds sessions for people to talk about death (more about that later) and, in addition, works to help people experience a “good death.”

What might make a death good? That probably depends on the person, but one of the main things Moryoussef works to get people to let go of is fear.

And she’s not alone. While it’s still a relatively niche corner of the death care industry in Canada, there are an increasing number of people with “death doula” or “end-of-life-worker” practices and, like Moryoussef, most are participants in the “death-positivity” movement.

“It’s not that we should celebrate the fact that people died,” says Moryoussef, who works with Toronto’s Home Hospice Association and has a practice called Good Death (www.gooddeath.ca) through which she runs “Death Café” sessions in Toronto. “But we should accept the fact that people die and, even though it’s not a good thing, it’s an OK thing that’s a part of life. As soon as we recognize that, it becomes less scary.”

In a nutshell, the theory is that we’ve lost touch with death, which used to be more a part of life than it is now. Prior to, say, 100 years ago, people often died at home and, if they lived in small communities, neighbours and family dealt with a lot of pre- and post-mortem issues. As it became more “hands off,” it also became distant, invisible and shrouded in mystery. As a result, we’ve become more afraid of it. Some people use euphemisms, like “passed,” others speak in hushed tones, as though something shameful has happened. At death cafés, people learn to talk about it more openly, in hopes of getting past the fear and awkwardness.

“People get together to talk about dying and death,” says Moryoussef. “They’re not support groups, they’re not grief and bereavement groups, they’re literally just open forum events, although, since we realize that certain populations have different needs, we started to make some population-specific, so we have LGBTQ cafés and, in November, we’re having our first death café for people with chronic illness and chronic pain.”

Death cafés (or “death salons,” as they’re sometimes called) are one of the most successful components of the death positivity movement, says Dr. Katherine Arnup, retired professor at Carleton University and author of “Family Perspectives: Death and Dying in Canada,” a report published by the Vanier Institute of the Family.

“I just looked at the most recent stats, and there have been 9,261 death cafés in 65 countries,” says Arnup, pointing out that this is pretty good given that they only started eight years ago. “I’ve been to a few and it can actually be kind of fun, with a lot of laughter surprisingly. I mean, 65 countries is pretty impressive and there are other ones like “Death over Dinner” and “Death at a Bar,” you know, those kinds of things.”

There’s obviously a demand for a different conversation about death and dying than the one most of us have been having, but public and private sessions aren’t all that death workers offer. Moryoussef has been called upon to join families sitting in vigil and help dying people settle on a “legacy” — usually letters, gifts or memoirs that are to be given to loved ones, post-mortem. This, along with dying at home (when possible), is all part and parcel of the philosophy of the good death. Some death workers even help families who want a home funeral clean and preserve the body.

There are some parallels between this and the big midwifery resurgence (circa 1960-1990s) that saw feminists objecting to a medical system that tended to keep women in the dark and gave them few choices. The modern midwifery movement worked to rectify that by giving women information, encouraging them to be active in making a birth plan and, in some cases, even empowering themselves to choose to deliver at home, instead of the hospital.

So, since birth and death — the only two inevitabilities of life — arguably faced many of the same problems, why didn’t we notice that the death care industry needed some changes, too?

Dr. Arnup says demographics played a big part in the shift in attitudes toward death.

“I don’t like the stuff around the Baby Boomers so much, how you see claims that Boomers changed everything, from the way we eat to the way we die,” says Arnup. “But I think there’s something to be said for the fact that, just because there are so many of us, some have a sense that we can do anything and control things. Certainly some Boomers pushed for medical assistance in dying, which is now the law of the land, and they’re also the people who are supporting hospice.”

Boomers aren’t alone in wanting to avoid the indignities of, say, a protracted death in a hospital, but the sheer number of people in that demographic who hope for pain-free deaths, surrounded by friends and family and, ideally, in their own home, is starting to reshape the industry by supporting alternatives like Moryoussef’s.

And, as she says. It’s still sad — for everyone. It’s not a celebratory moment. But since letting go is a natural part of life, it’s also OK.

Complete Article ↪HERE↩!

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Is there greener life after death?

An alkaline hydrolysis device

By Tom Jokinen

In Winnipeg in a January blizzard, there are few places as toasty and sheltered as a crematorium. I know this because I worked in one. When the cremation chamber, or retort, is firing at 1,600 degrees Fahrenheit (900 Celsius), the work space is balmy, like a ski lodge. The noise of the powerful gas jets is buffered by the stone and steel of the machinery. When the gear is running, all you hear is a low, soothing rumble. It’s peaceful. I used to read Eudora Welty short stories while the body burned, stopping regularly to monitor temperatures and stoke the remains with an iron hook passed through a small, eye-level porthole in the oven door. The process is conducive to reflection.

Cremation seems clinical: fire, ashes. But in fact there is enormous spiritual heft behind it. We talk about the cleansing power of fire. As a funeral rite it goes back to the Bronze Age at least. “Fire,” writes the philosopher Gaston Bachelard, “magnifies human destiny, it links the small to the great, the hearth to the volcano.” Man “hears the call of the funeral pyre” not as destruction but as a road to renewal. This is overstating the case, as French philosophers do, but it still scans. Now try saying the same about a chemical process.

Last week, I read a story about a new process called alkaline hydrolysis. In a nutshell, it’s like cremation without the fire: The body is immersed in chemicals in a cylindrical device that looks (judging from the photo, as I’ve never seen one up close) like a large telescope with an Instant Pot lid. The chemicals break down the soft tissue, which is flushed away, leaving behind bones and any non-organic residue such as tooth fillings or artificial hips. The device is called a Resomator, a Doctor-Whovian commercial euphemism for what is basically a body-dissolving machine.

Industry licensing bodies such as the Bereavement Authority of Ontario are not sure what to make of alkaline hydrolysis. Is it safe to just flush the liquefied organic material into the city sewage system? Are there health risks? Is it dangerous or just very, very creepy? Is it any creepier than cremation – or burial for that matter? For now, though, its main selling point is that alkaline hydrolysis is considered greener, or less carbon-intensive, than other methods.

According to the Ecology Action Centre, the average cemetery buries 4,500 litres of formaldehyde, 97 tonnes of steel and 56,000 board feet of hardwood per acre. A single cremation, which intuitively (and emotionally) seems so clean and efficient, uses as much fossil-fuel energy as an 800-kilometre car trip. Sulphur dioxide and mercury are released into the atmosphere, up the flue. That warm feeling on a January day in Winnipeg comes at an ecological cost.

Meanwhile, hydrolysis uses one-eighth the energy spent in cremation. There is no embalming, no casket or container. Even with cremation, there is always a container of some kind, including, in my experience, very expensive hardwood caskets with brass trimmings. So alkaline hydrolysis is marketing itself thusly: your green alternative.

When you’re dead, there are few options for what happens next. I don’t mean spiritually – that’s between you and your God or His/Her metaphysical substitute. I mean with the body. We all leave a remainder. Some more than others. You can bury it, sink it in the sea, leave it in the trees or on hilltops to be devoured by carrion birds – known technically as excarnation, a natural process of removing the flesh before earth burial (in Tibetan and Comanche cultures, known as sky burial) – or most commonly you can burn it. In Canada, the cremation rate varies by region, but in 2018 more than 61 per cent of the dead in Ontario and Manitoba and more than 71 per cent in Quebec were cremated. The national cremation rate is expected to rise to 76.9 per cent by 2023, according to the Cremation Association of North America.

For the funeral industry, cremation has always been a shoe that pinches. It’s an industry based on the pricing of intangibles: the meaning of life and death, ritual, the concept of “closure.” It has been able to translate the emotional turbulence of death into product (caskets, vaults, embalming) and real estate (cemeteries), but over the past 50 years has watched as a cultural revolution changed everything. Religion loosened its hold, and fewer people felt bound by tradition. Cremation was cheaper. People moved around – for work, for relationships – and the idea of a permanent resting place lost its appeal. Postmodernism struck the funeral industry: Meaning and ritual came down to personal taste.

So the industry reinvented itself. Funerals became “celebrations of life,” and funeral directors became event planners like those who booked weddings (and the cost of weddings, they noticed, was skyrocketing). If cremation was on the rise, it could surely be monetized: urns shaped like golf bags, garden watering cans or basketballs, depending on the hobbies of the dead in question. Cemeteries focused on marketing columbaria, the small, above-ground vaults for urns.

I once met a cemetery salesman who assured me that scattering human remains was illegal (not true) and that he himself once stepped on a human bone on a beach in British Columbia (unlikely, as most crematoria process the remains to a fine, biologically inert powder). His sales pitch was simple: Only the industry knows how to handle what we all leave behind – the rest of us are not equipped. It’s a powerful message. As Jessica Mitford, author of The American Way of Death, found out, people will pay to avoid dealing with death and will subcontract what is basically an existential puzzle (what’s to become of me?) to a professional.

But it’s possible to be too clinical. We like at least a little meaning with our rituals, especially the death rituals. “Belief in a future state,” writes Bertram S. Puckle in Funeral Customs: Their Origin and Development, a 1926 text, “presupposed a material existence after death, with corresponding material necessities. Food must be provided, weapons and clothing, and a supply of charms with which to ward off evil influences.” And so even today people are buried with iPhones or cremated with a blanket from home. This is not superstition. It is about doing the right thing, even if the thing is a complete mystery. Alkaline hydrolysis is maybe too much like a chemistry experiment to bear much meaning.

And the industry continues to adapt and innovate. An Italian company used to market the Capsula Mundi, a starch-based, acorn-like pod that calls for no headstone as it, with the body, dissolves in time as compost and produces a tree. Demand, it turns out, was slim. Now the company offers an egg-like urn for cremated remains that does the same job for US$457 – tree not included. (But again, there’s the carbon footprint of the cremation itself.)

Straight-up green burial – in a shroud, with no embalming, in a legally designated forest (the law frowns on “freelance” burial) – is sparsely available. The industry has never embraced it.

Maybe it expects greater things from alkaline hydrolysis. After all, if meaning is and always will be knit deeply into our death rituals, it ticks the right boxes: In life, we rejected plastic straws and used twirly light bulbs. In death, we were thus safely melted. Carve it into your tombstone.

Complete Article ↪HERE↩!

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A Documentary of Funeral Care for Abandoned AIDS Patients

With restrained camera work, “Departing Gesture” shows the process of a solitary funeral and burial, tended to by funeral-home staff.

By Sarah Larson

Jonathan Napolitano and Brian Bolster’s eleven-minute documentary “Departing Gesture” opens inside a suburban-style funeral home, with a long shot of a visitation room, where a white-haired man in a red necktie appears to be setting up for a wake. The casket is open, the flower arrangements generous and autumnal. The only people we see are the man in the coffin and the man taking care of him. “It happens more than you think,” a man’s says, in a voice-over. “Maybe ten or twelve deaths a year, I think, where their family would abandon them and never come back.” The film gives us a minute to contemplate this—the screen goes dark and shows a title card, and then the camera lingers on an exterior shot of the tidy funeral home. Who would abandon their late relatives, and why?

“Departing Gesture,” the first film in The New Yorker’s new series highlighting short documentaries, sheds light on this story patiently and with care. It focusses on the Sebrell Funeral Home, in Ridgeland, Mississippi, whose director, Trey Sebrell, is the person we have just heard speaking. Bolster’s camera observes the funeral home, both its public-facing rooms and its behind-the-scenes areas—offices, an embalming room—as we listen to Sebrell talk. “It’s one of those professions that, once you’re involved, you feel like you’re serving,” he says. “Even if I did not love working for myself, I still would be a funeral director and an embalmer at another funeral home in Mississippi.” As Sebrell goes about his work, in a suit and cufflinks, his movements have a calm certitude.

Sebrell Funeral Home has a partnership with a local charity, Grace House, which provides care and housing for people with H.I.V./AIDS; Sebrell cares for its dead, some of whom are ultimately abandoned by the family members who survive them. These families don’t hold a service and don’t want their relative’s remains. In the film, we watch the process of a solitary funeral, of sorts, and a burial, tended to by funeral-home staff.

Many of us have been in funeral homes like Sebrell’s and have attended memorials of various sizes—the wakes that teem with mourners, the calling hours that feel underpopulated. Either circumstance can enhance the sad surreality of death; in this case, the sadness is heightened further still. Bolster’s camera remains static, at a respectful distance, as it watches people at work: a man with flowers, a woman tending to the deceased’s makeup, pallbearers bringing the casket to the hearse. Other shots show us caskets, a lectern, the embalming room and its tools, embroidered seat covers that say “pallbearers.” The restrained camerawork subtly heightens the contrast between life and death, movement and stillness.

Bolster and Napolitano met on the film-festival circuit and have worked together on several projects; for “Departing Gesture,” Bolster shot and Napolitano edited. They met Sebrell in the course of working on a feature, still in development, about H.I.V./AIDS in the American South. The South has become the epicenter of the crisis in the United States, owing to factors including poverty, cuts to health-care funding, and social stigma. And H.I.V. infection in rural areas and smaller cities is on the rise. “I’m very interested in issues of regret,” Bolster told me. As a boy growing up in Massachusetts in the eighties, knowing that he was gay, Bolster watched reports of the unfolding AIDS crisis and the ignorance and fear that surrounded it. “Families abandoned their kids in hospitals,” he said. “I thought, This is what’s going to happen to me.” In 2019, an era of PrEP, undetectable H.I.V. viral loads in well-cared-for patients, and nationwide marriage equality, it can be stunning to see and hear about present-day ignorance that reminds us of decades past—for example, when Sebrell mentions a local funeral home that refused to collect a man’s body after learning that he was gay. “Departing Gesture” gives us a window into such stories with compassion, through Sebrell’s empathy and its own.

Complete Article ↪HERE↩!

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New program provides mobile end-of-life support to people in poverty

The new Palliative Outreach Resource Team (PORT) brings compassionate medical care and support to people living in poverty at end-of-life. Dr. Fraser Black,Island Medical Program’s associate dean of student affairs, is a team physician.

Death may be the great equalizer but the availability of good end-of-life care is rarely equitable. Now, a new mobile palliative care program designed to address that inequity is providing care and dignity to people with life-limiting illnesses who are homeless and living in poverty in Victoria. 

The Palliative Outreach Resource Team (PORT) is a collaboration of the University of Victoria, Island Health, Victoria Cool Aid and Victoria Hospice. PORT acts as a bridge between people with serious illness and their caregivers, palliative care, and other health and social support systems. 

The program is built upon lessons learned from a three-year study led by UVic palliative care researcher Kelli Stajduhar, lead investigator of the Equity in Palliative Approaches to Care program with the Institute on Aging & Lifelong Health and the School of Nursing. The study followed 25 people living homeless or barely housed while struggling with life-threatening medical conditions. The 2018 report Too little, too late: How we fail vulnerable Canadians as they die and what to do about it, found that homeless and barely housed people have to navigate many systems—health care, housing, social care—and that as their health declines, their ability to access these systems also declines. The big takeaway: despite a terminal diagnosis of cancer, heart failure or lung disease, those who were able to access palliative care actually experienced an improvement in quality of life. 

For PORT’s first year, the clinical team will be funded by Island Health and Saint Elizabeth Health Community Enterprise, a social enterprise with a commitment to end-of-life care for marginalized communities. Mirroring similar models in Toronto and Calgary, people can self-refer or be referred by their caregivers to a palliative care nurse and a physician who provide whole person care, manage the pain and symptoms related to life-limiting illness, support chosen family and caregivers, and provide grief and bereavement support. Chosen family and caregivers in this population include “street family” and shelter, housing, harm reduction, and peer and support workers from inner-city community organizations who are doing the bulk of end-of-life care for people living in poverty. 

The Vancouver Foundation is funding the UVic-led evaluation of the program, as well as the development of initiatives to increase access to and quality of palliative care in the inner city. The PORT team, which began service in July, has supported three deaths and is currently supporting seven people who are dying.

“For almost a decade, providers in our community have cobbled together resources to meet the needs of our clients who are living with unmet palliative needs,” says Grey Showler, director of health and support services at Cool Aid. “We are thrilled to see PORT come to life.”

“Over the next year, we will be implementing this model of palliative care in collaboration with organizations and people who have expertise in care and support for homeless and vulnerably housed people at end-of-life including street families,” says Jill Gerke, director of the palliative and end-of-life care program with Island Health. “We are using research and promising practices to inform the development of this model adapted to our community that bridges existing support and services.”

“Palliative care isn’t a ‘thing’ or a ‘place’ but an approach that focuses on whole-person care for the person, their family and community. This approach necessitates a community response where everyone sees their responsibility and their part in care for dying people,” says Stajduhar.

Complete Article ↪HERE↩!

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The art of doing makeup on a dead body

Applying makeup on a dead person is not much different than on a living person, one funeral director says.

A funeral director says that applying makeup on a body is not much different than on a living person.

By Terry Nguyen

Evie Vargas had always been drawn to death. That sounds morbid, or possibly extremely goth, but her interest wasn’t in the afterlife nor the aesthetics. Vargas wanted to pursue a profession rooted in service, and entering the death care industry was a calling — an inexplicable calling that, once she began work, seemed like destiny.

Throughout high school, Vargas considered attending mortuary science school, but worried she wouldn’t be able to handle the sight of a dead body. Still, she knew that a two-year program could lead to an associate’s degree, an apprenticeship, and eventually a mortician job.

To gauge her nerves, Vargas decided to go to a place that would expose her to death firsthand: a funeral home in Illinois.

There, she shadowed an embalmer, who offered her a part-time job after their first session. “He said he saw something in me,” Vargas says, still amazed at how prescient the offer turned out to be. “I didn’t have a license to embalm so I did makeup, dress, and casket.” She’s worked there since graduating from mortuary school.

Even after eight years in the industry, makeup and hair is still a special part of her job, Vargas says. As a funeral director, she does “basically everything” — administrative work, service preparation, meeting with family members, embalming bodies. But she thinks mortuary makeup work is uniquely intimate and significant.

Funeral director Amber Carvaly sets up for a viewing.

Makeup plays a starring role at many funeral services — the last time family members will physically see their loved ones before the casket is closed. These services are usually done by a certified embalmer, a person tasked with cleaning and preparing the body, who takes on the burden of replicating a person’s likeness and essence. Makeup artists — whether embalmers, funeral directors, or freelance workers — find meaning in this ritualistic work of dressing a body, mulling over the details of its presentation, and receiving input from the family. It can help loved ones grieve, artists say, in remembering a person at their best.

Embalming a body and applying eyeshadow seem to demand different skills, but the work contributes to the body’s final presentation. Embalming is typically the first step; fluids are injected into a body during the process to slow its decomposition for the funeral ceremony.

According to the Funeral Consumers Alliance, the process could give the body a more “life-like” appearance, although it isn’t always required. Amber Carvaly, a funeral director at Undertaking LA in California, doesn’t think embalming is necessary for most natural deaths, although it might firm up the skin more. She says that applying makeup on a body isn’t drastically different than working on a living person.

Carvaly has an array of products in her makeup kit — typically thicker theatrical makeup for discoloration or jaundiced bodies — but drugstore brands like Maybelline Cosmetics work fine. There are little techniques and tricks she’s picked up, for example, in applying lipstick on a dead person’s lips, which are much less firm.

She uses a pigmented gloss or mixes a dry lipstick to paint the color on. Vargas prefers using an airbrush kit for a more natural look, since it provides full coverage and is easier than applying foundation.

Carvaly doesn’t work with bodies as much as she likes to anymore, ever since cremation overtook burials as the preferred means of after-life care in 2015. While there is no proven correlation between price and popularity, cremation is cheaper than a burial. According to the National Funeral Directors Association (NFDA), the average burial and viewing costs $8,508, while the average cremation and viewing comes out to $6,260.

Post-death makeup is only a fraction of the cost for burials — an average of $250 per funeral, according to the NFDA — but the added costs aren’t worth it for some, Carvaly says. Many families struggle emotionally and logistically in the aftermath of a death, she adds. The logistics that go into the burial ceremony, especially dress and makeup, are often the last things on their minds.

A common complaint from families is that a body doesn’t look like their living relative. The embalmer might have parted their hair differently or used an unfamiliar lipstick color. Carvaly points out that family members can do makeup on their loved ones before the body is sent to a home. But if they’re uncomfortable with that, she encourages them to assist the embalmer with the makeup and presentation.

“Doing makeup with the family present is extremely rewarding,” she says, adding that family members’ input makes it much easier to capture the aesthetic essence of a person. It’s helpful for the families as well: “When you’re grieving, having a physical or artistic activity can help walk you through it.”

Years before Carvaly went to mortuary school in Los Angeles, she worked as a cosmetologist on film sets. She’s changed careers multiple times — from makeup to nonprofit work to the death care industry. Like Vargas, Carvaly is dedicated to the service aspect of her job, and she sees makeup as a physical manifestation of that service.

In her seven years of work, Carvaly’s found that most people are uncomfortable in the presence of a dead body, even in preparation for the burial. “I’m more than happy to do makeup for a family if this is something they don’t think they have the strength to do,” she says. “But I want them to know that they have options.”

On rare occasions, she brings along makeup or hair tools for families to touch up their loved ones at the service. She once worked on a woman with blonde, beehive-style hair that she struggled to recreate. At the funeral, Carvaly suggested that the woman’s daughters help her touch it up — a request they were initially shocked by.

“Allowing people to be a part of the funeral is important,” Carvaly says. “Keeping that veil of magic up prevents regular people from doing something very valuable.” Families shouldn’t hesitate to ask a funeral home if they can do their loved ones’ hair and makeup, which could reduce costs, she says.

Shifting social norms and new funeral practices, like eco-friendly burial options, have driven homes to find ways to increase profits — often at the expense of families, who are missing out on an opportunity to properly grieve, Carvaly explains.

“There is no law that prohibits people from coming into a home and requesting that they do makeup on the deceased,” she wrote in an e-mail. And while Carvaly feels that her job is a calling, the daily human interaction can be taxing. The most difficult part of being a funeral director, she says, is explaining why people have to pay for certain services that the home offers.

It’s what upsets people the most, but homes also have to pay for overhead expenses — the indirect costs of operating a business. Carvaly’s funeral home, Undertaking LA, opts to rent time and space from another crematory.

Carvaly’s funeral home co-founder, Caitlin Doughty, has found unprecedented success on YouTube under the account Ask A Mortician, a series where Doughty takes questions about her work and about death.

Demystifying death is a big part of Undertaking LA’s mission — to put the dying person and their family back in control of the dying process and the care of the body. It’s a liberal “death positive” approach, one that Carvaly likens to “breaking down the walls and windows” of a rigid centuries-old industry. Vargas feels similarly, and tries to destigmatize the death industry on her YouTube channel.

After a death occurs, families often immediately send the body to a funeral home and don’t interact with their loved ones until the ceremony. And sometimes, they’re taken aback by the body’s made up appearance. Reclaiming the makeup process can be a cathartic first step, as an unexpected outlet for grief, and eventually acceptance of the death itself.

Complete Article ↪HERE↩!

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NC Women Embrace Ancient Practice of Death Caregiving

Durham, N.C., resident Omisade Burney-Scott (right) with fellow death doula Vivette Jefferies-Logan.

By Cynthia Greenlee

Ivette Jeffries-Logan and Omisade Burney-Scott are friends for life – and collaborators in death. Three years ago when a mutual friend realized she wouldn’t survive pancreatic cancer, the two central North Carolina women were within the circle of friends she summoned.

Over the course of about three months, the women stayed at Cynthia Brown’s side, as the community activist and one-time Durham City Council member went about the process of dying.

They rubbed her head, kept a watchful eye on her pain, and helped her decipher doctorspeak. And when her spirits appeared to lag, they’d tell her jokes and sing at her bedside.

This, Jeffries-Logan says, was a good death: “If I can help someone at the end of life heal and be clear, I will. There are some things we are required to do alone, but we are not isolated. We are community people. What happens to my nation happens to me. What happens to me happens to my nation.”

Jeffries-Logan and Burney-Scott are death doulas; their form of caregiving is both old and new. The ancient Greek word “doula,” meaning “woman servant” or “slave,” was repurposed in the 1960s to describe birth workers who offer encouragement, back rubs, and other assistance during childbirth.

These days, end-of-life doulas, sometimes called death midwives, are an emerging profession in the growing death positivity movement, which urges a paradigm shift for thinking and talking about death as natural and not inherently traumatic.

They provide nonmedical support to help ease the final transition for the terminally ill. But it’s not merely about that culminating moment, “The End.” They help the dying and their loved ones navigate death with all its “before and afters” – including sickness, acceptance, finding resources for all the legal housekeeping, funeral planning, and bereavement.
For Burney-Scott and Jeffries-Logan, it’s the highest calling.

Sisters in ritual, they performed sacraments of soothing and release drawn from their West African and Indigenous spiritual traditions. Burney-Scott is African American and was initiated in the West African Ife religious practice, and Jeffries-Logan is a member of the Occaneechi Band of the Saponi Nation, a tribe rooted in the North Carolina Piedmont region.

Being a death doula “is not fun. But it’s an honor,” says Burney-Scott, a healer and longtime advocate who most recently worked as a reproductive justice organizer in North Carolina.

She stumbled into the practice when her mother’s dear friend, a hospice nurse, showed Burney-Scott what to do at her mother’s passing.

“I didn’t want to do it,” she says. “The thing I feared most, from when I was a little girl and even when my mom was healthy, was losing my mother. She was that mom that all my friends would talk to, the mom who could let you know [you] were the most special person in the world even when she was yelling at you to do your laundry.”

Near the end, her mother made her retrieve a manila envelope containing her will, insurance information, deeds – the bureaucracy of death. But without ever using the word “doula,” her friend guided Burney-Scott in ushering out of this world the woman who had brought her into it.

“Aunt Cora” encouraged Burney-Scott to whisper her love in her mother’s ear, to hold her hand, play music, and to be present in “an organic practice.” One day, when her mother struggled to breathe, Cora assured Burney-Scott that she didn’t need to fetch doctors – that nothing was wrong.

“She’s leaving,” Cora told her, a simple statement that’s also a tenet of end-of-life care: Death can’t be controlled, but you can prepare for some aspects of it.

Because there is no universal or official training, no licensing and no regulation, there is no official estimate of how many death doulas operate in this country.

But death and dying are constant. And beyond the eulogies and coffins, there’s a clear and growing need for death-related services. The number of Medicare-approved home- and hospital-based hospices, for example, rose from barely 30 to slightly more than 3,400 between 1984 and 2009. A decade later, more than 4,500 exist, according to the Centers for Medicare & Medicaid Services.

Groups such as the International End-of-Life Doula Association and others train and certify doulas, providing hands-on experience, like a practicum. Still, many death doulas enter the field as Burney-Scott did, pressed into duty by a family member’s passing.

Few can make it into a full-time, paying job. Others have a background in the clergy or are people of faith, are volunteers involved in work with the sick and shut-in, or are shamans or healers.

Still others start end-of-life doulaing because they are nurses, midwives, or health care professionals who, through experience, have come to know that end of life is more than just what happens to your body.

Merilynne Rush, a nurse and home-birth midwife, co-founded Lifespan Doulas, an organization that trains and certifies end-of-life doulas. In three years, she says, the group has trained 200 people. She sees the need to educate and vet death doulas even while she thinks that community-trained doulas are valuable and necessary.

“There are so many people who are called in their communities [to do this] that no one should tell them they can’t,” Rush says. “I’d never be able to go into every community. That’s one reason for never having any kind of regulation that imposes a state-sanctioned structure that says you are in or out.

“At the same time, when you are working within a medical organization, they need to know you are OK and there are some standards,” she adds. “Training should never be mandatory, but optional.”

A diversity consultant who focuses on Native communities and trauma, Jeffries-Logan distrusts what she believes is a move toward professionalization.

Her death doula work is grounded in Indigenous customs, and communicating with the ancestors does not happen through curricula. Heeding a call from her ancestors, she did a traveling ceremony, designed to pave a deceased person’s road to the afterlife, for an infant relative who died before he turned a year old.

As part of a common tribal custom, she won’t speak the name of the deceased aloud for a year; to do so could keep the spirit tied to its temporal life – now a thing of the past – and distract it from the arduous journey to the ancestors.

Neither she nor Burney-Scott takes money for what they do. Rather, they extend their services to family and friends based on existing connections and an understanding that death is cultural and clinical. “It’s not like I was going to roll up and do this with just anyone. I don’t do shallow-ass relationships,” Jeffries-Logan says.

She questions what happens when the training moves out of informal community pedagogy and into a classroom.

“Who’s the certifying body? Who has the funds to pay for services?” she asks. She thinks of formalizing death doula work in the same vein as yoga, an Indian spiritual system that has been co-opted from communities of color and networks of caring to be dominated by White instructors who teach a fraction – the poses, the breathing – of the whole for pay.

Both women know that communities of color lag in accessing end-of-life care – whether due to cultural beliefs, experience and well-founded fear of racism in medical settings, lack of insurance or financial resources, or misconceptions about what’s available.

For example, Black people represented 8% of those receiving Medicare-funded hospice benefits in 2017, compared to 82% for White people.

In many Southern Black communities, people won’t talk about death, Burney-Scott offers. “There is truth in our mouth. You can manifest things with your word. Don’t talk about death [lest] you invite it in.”

That goes for other communities, as well. A 2010 study comparing Latino immigrant to White cancer caregivers found that the Latinos were surprised and even disturbed by transparent talk about death in hospice pamphlets and consultations.

Furthermore, Rush says that generally when death is imminent, “most people are overwhelmed and don’t know where to turn. They don’t even know that they can get hospice earlier. And even then, they may have a nurse come in for a few hours or an aide, but they aren’t there all the time. People have to rely on their community and network.”

And that’s just what Cynthia Brown did once she accepted that she wasn’t going to beat cancer, calling on the women her family members sometimes referred to as “Cynthia’s girls.”

“She invited us into the process from the very beginning. We swung into action on the logistical things: running errands, taking her to appointments, making meals,” Burney-Scott says.

“And then she said, ‘I want to cut my hair.’ She had 12 braids left. Each one of us cut two braids. Then, she called and said, ‘Hey, will you come over and help me write my memorial?”

She summoned Jeffries-Logan and another friend to help her assemble and bless her ancestors’ altar. With trademark precision and humor, she even planned who would cook at her funeral repast or meal: not her many loving White friends; she didn’t trust their chops in the kitchen.

Her death doulas and friends, in turn, called on each other, their own histories of loss, and their ancestors to help guide Brown through her own departure.

And when the end came, the friends all rolled to the hospital one last time. Burney-Scott donned her trademark white head wrap and packed a bag with crystals and Florida water, a citrusy blend believed to have calming properties.

Jeffries-Logan carried tobacco as an offering; red cedar to represent blood and life force; water from the Eno River, which courses through her tribal nation’s territory; and a ceremonial turtle rattle, used by tribes in special ceremonies.

“Cynthia fed me, I laid up on her couch, we carpooled to anti-racism trainings around the state,” Jeffries-Logan says, her eyes moist and a catch in her voice. “And when we did a ritual for my mother [who died from Alzheimer’s disease] in the ocean, Cynthia told me, since she had lost her parents at a young age and had to be like a mother to her younger siblings, she knew what it was like to be a motherless child. I was going to do whatever I could for her.”

She didn’t want her beloved sister-friend “scratching and clawing to stay here.” So she stroked the soles of Brown’s feet – which got cooler and cooler as death approached – not to bring back sensation, but to help untether her from this earth.

When Brown took her last breath, Burney-Scott’s and Jeffries-Logan’s hands were among those resting on her body. It was a fitting end: a social death for a community advocate who told her friends, “You continue to fight the good fight, and you have to promise me that you won’t leave anyone behind.”

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