GRAND RAPIDS, Michigan — The word doula is often associated with birth. At the other end of life, death can also be greeted with a doula.
Laura Hoekstra is an end-of-life doula. In the role, she wears many hats: a person to sit with someone dying, a listener, a logistical planner, respite for a caregiver or just a "compassionate presence." This is a non-medical profession.
"One of my roles is to be a companion and witness to pain, to loss, to grief," said Hoekstra.
She is a certified grief counselor and has a doula certification.
"I do many things," said Hoekstra. "From helping arrange a space for someone who is going to be dying soon. I work with folks in advance care planning if a person is diagnosed with a terminal illness, often, they may call me and will have conversations."
Hoekstra began the profession in 2021 when she got her certification. Her initial interest was sparked from reading a book by Jodi Picoult, called "A Book of Two Ways."
She said end-of-life doulas are more common now than ever before, an "expression of how our culture is coming to terms with death and dying" in a post-pandemic world.
The International End-Of-Life Doula Association (INELDA) has trained more than 7,000 doulas globally since its conception in 2015.
However, for Hoekstra, her journey with death and grief began long before her certification.
"It's not a club you want to join when you're widowed at a young age," said Hoekstra. "My late husband was 43 when he died after a bilateral lung transplant. Our daughter was two-and-a-half at the time."
She said at the time, she did not know how to navigate his death or the pain.
"I remember speaking with a chaplain in the hospital emergency room saying, 'What do I tell my child?'" said Hoekstra. "And they said,' Well, maybe the funeral home can help you with that.'"
So, later in life, Hoekstra became the person she needed all those years ago.
Hoekstra explains how end-of-life doulas can truly honor life at the end of it. She emphasized death is not something to be afraid of or taboo to talk about.
"It's sacred," she said. "Dying is a sacred act."
She said often the work can be very depleting, especially when working with a client for a long period of time. She also works as a volunteer advocate for the Kent County Sheriff's Office, where she is called in for unexpected deaths. She described those calls as "really hard."
One moment in her journey as an end-of-life doula that stands out for Hoekstra involves a woman who hired her to be with her mother nearing the end of her life. The daughter was in another state and honoring the mother's wishes to stay at home for the final days.
"When she got there, there was just a moment where her mom was lucid and knew she was there," said Hoekstra. "Really, there aren't any words for that one."
Some of the challenges of the profession include there not being many end-of-life doulas in a particular area in Michigan and having to turn some clients down due to travel distance. As with a birth doula, she needs to be able to reach her clients quickly as things progress.
Her biggest tip is for everyone to plan for their death during their life.
She said "you would be amazed at how many people" do not have paperwork together, or even have vocalized their wishes for their funeral or burial preferences. Hoekstra said these conversations should start at a young age, as death can often be unexpected, not just in older years.
While speaking about logistics, also have conversations about memory.
"How do you want to be remembered? What is the legacy you want to leave?" said Hoekstra. "Your friends, your family? If you don't think about it, then you won't have that opportunity."
You can find an end-of-life doula near you by visiting the The National End of Life Doula Alliance (NEDA). Hoekstra is also available in the Grand Rapids area.
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