Working with other end-of-life care providers, such as death doulas, allows hospices to ensure patients receive additional nonmedical support during their final days. Launching in Minnesota, Inspired Journeys added to the growing trend towards natural death care in regions like the Midwest, engaging with hospices to bridge the gap between life and death.
Hospices have increasingly coordinated with trained End-of-Life Doulas (EOLDs) to support patients and families, providing physical, emotional and spiritual care during the process of death. EOLDs help to facilitate conversations regarding the dying process and discuss patients’ wishes in their final days. EOLDs are trained to walk patients and families through questions and concerns surrounding death, guiding and educating them through decisions and helping to ease anxieties and stress.
Recognizing the potential for collaboration between hospice and other forms of death care, Founder Angela Woosely developed Inspired Journeys after spending years as a mortician, educator, death doula and funeral guide.
“I was seeing this sort of handoff from the medical system to the death care system,” said Woosley. “But there are lots of bridges that can be formed and made between the two without anyone trying to be a replacement of the other, and instead find ways to coordinate that care. These kinds of care are connected. A really great kind of partnership can take place for all of these different end-of-life and death care providers.”
The demand for end-of-life services has grown in the region where Inspired Journeys planted roots. Residents age 65 and older comprise roughly 16% of the Midwest’s population, and 10% in the St. Paul, Minn. area, according to the U.S. Census Bureau. Minnesota is 12th in the nation for hospice utilization, with 52.7% of Medicare decedents electing hospices, according to the National Hospice and Palliative Care Organization (NHPCO). Utah leads the nation in utilization at 59.4%.
“Doulas can help families plan by finding home vigil services or home funeral guides to be able to then educate hospice staff and volunteers about what the options in their areas,” Woosley said. “Being prepared for that ahead of time is the best way to introduce that concept of death, define what their options are so that families don’t have that person whisked away if they’re not ready, and they can be as involved in that care as they would like to be.”
One area in which doulas can help is working with patients and families on advance care planning. Promoting advance care planning has remained a priority in hospice, encouraging patients and their families to recognize the benefit of these conversations and directives to receive the quality and types of care that aligns with their end-of-life goals. Oftentimes, conversations about death occur too late in dire situations, leaving families struggling not only to cope with grief, but also scrambling to put plans in place that honor their loved ones’ final wishes.
“These are very difficult conversations to have and dualism can really help foster caring conversations around that” said Woosley. “Doula services can be a great asset to hospice in general by bringing advance care planning to the forefront sooner, and not just generally as to what’s on these types of questionnaires and forms, but also being able to cultivate and curate the space around death. Coordinating this care can help give people more peace at the end of life, more autonomy, and even bring them home at the end of life.”
Coordinating with doulas also adds a layer to hospices’ complimentary services, easing the transition from end of life into death and helps to educate families about what to expect after their loved one passes, including options for natural burials. Families are often heavily involved in the caregiving process in the end stages of life, and the transition into death can be jarring with less hands-on approach to death care. However, organizations like Inspired Journeys are working together with hospice providers to change the culture of dying and death.
“People increasingly would like to spend their last days at home and that also inspired a rise of interest in natural burial, green burial, the rise in cremation,” Woosley told Hospice News. “Connecting them to their loved one’s death care is an amazing gift that you can give to the families by bringing space, power and even ritual into care for that person even after they’ve died. It’s really for the whole family system, providing an emotional supportive way that coordinates with all of the different elements of their care teams.”