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: A lot of people are terrified of death. Death doulas provide end-of-life support.

When Diane Buttons grandfather died at 85, he previously a smile on his face and a feeling of peace that made her desire to learn his secret.

Being with him in the ultimate hours of his death after watching his life looking after others as a health care provider inspired Button to obtain a masters degree in counseling and begin volunteering with hospice programs. She then trained as a death doula, wrote books about living well, and today teaches at the end-of-life doula professional certificate program at the Larner College of Medicine at the University of Vermont.

It wasnt so much to understand about dying since it was to understand about living well and ultimately dying well, Button said.

Button is section of an increasing number of so-called death doulas who provide nonmedical care and support for those who are dying. Like the dynamic between a midwife and a birth doula, your physician or hospice caregiver would provide health care by the end of life, while a death doula provides emotional and spiritual help and support to the individual and the friends and family.

Theres currently no licensing, no industry standards no insurance reimbursement for death doula services. Doulas could be volunteers or receives a commission out of pocket.

Without licensing requirements, its difficult to track the amount of people providing end-of-life support doula services. But since its inception in 2017, the National End-of-Life Doula Alliance is continuing to grow to at least one 1,350 members in 49 states (all except South Dakota) and 13 countries.

Karen Reppen, an end-of-life doula and an associate of the board of the National End-of-Life Doula Alliance, attributes the growth in awareness and amounts of doulas, partly, to COVID, when people often died alone, and also the growth of the hospice movement and the sheer amounts of people nearer to dying as seniors age.

More folks are prepared to explore options beyond a healthcare facility and what the medical system can offer, Reppen said. We no more have multigenerational homes, communities might not be as tight knit because they once were, many people are working caregiving is really a huge, huge challenge. Nonmedical support is required to survive death with some grace.

Theres incredible dependence on support when youre a caregiver as well as your cherished one is dying. Whether its to simply walk your dog, go food shopping, get a short while to yourself, get assist in navigating the medical information theres so multiple reasons to possess some support, Reppen said.

Caregivers have become strained. The necessity for compassionate, skilled visitors to hold that space inside our progressively isolating society is indeed valuable, Reppen said. A lot of people are traumatized and terrified of death. Even people who have friends and family surrounding them might need help. Really, there is absolutely no other thing which were all guaranteed to talk about than the proven fact that were likely to die.

Robert Gramling, a palliative care physician and a core faculty partner for the University of Vermont doula program, agreed that the pandemic created a chance to discuss death in ways society hadnt before.

It could be terrifying to be sick. The COVID pandemic brought into sharp relief that death is section of life. The tragedy of social distancing has sharpened our concentrate on the space to be alone and isolated. It catapulted us right into a public health crisis of loneliness and isolation. The world is thirsty because of this, said Gramling.

This program at University of Vermont, that is online, is merely one certificate program offered round the country. It attracts folks from all stages of life, from diverse backgrounds social workers, chaplains, hospice workers, family caregivers all with the central need to find out about death and dying.

You will have a tipping point where it becomes more accepted. I believe with the pandemic the planet is valuing more this notion of I wish to be known. I wish to be dignified and accepted, Gramling said. Were bubbling toward a tipping point that discussing death becomes section of life. The world is now more open.

The doulas role would be to fill the gaps any moment folks are feeling lonely or not heard. Anywhere across the course of a significant illness doulas can offer space with nonjudgment, Gramling said.

Doulas might help younger, healthy people who have advance directives, sit vigils for the dying or create legacy projects of stories to pass right down to other generations.

Button said more doctors are referring patients to end-of-life doulas once medical needs cant be met anymore.

Enough time has come for doulas to emerge. The pandemic exposed the conversation about death and dying. A lot of people were influenced by it. The pandemic opened the entranceway a crack and gave them a glimpse of mortality, Button said.

Its an honor to be invited to the bedside of the dying, Button said. Its emotional. Its deep work of the center.

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