How will you die? Preparing for the end of life with a death doula

Story and photos by ALFONSO BELLOSO

A view of the Salt Lake Valley from the historic Salt Lake City Cemetery.

The only certainty in life is death. Before a person’s essence returns to the source, some may choose to leave their final moments in the care of a death doula.

“A death doula is similar to a midwife,” said Katrina Klinge, a volunteer at Hudson Valley Hospital in New York, and a certified death doula. “The birth midwife and the birth doula get everything set up, help prepare, and can be there to bring life into the world. Well, a death doula is doing the same thing on the other end.”

Klinge works with those nearing the end of their life. She said she starts with an open dialogue between her clients discussing particulars such as: What do you want to leave behind? What do you want to be remembered for? When it comes to dying, what do you want it to look like? Do you want to be outside? Do you want to be alone? Windows opened or closed? “It sounds like little things,” Klinge said in a phone interview. “But if you’re lying in a bed and you’re dying, and you can have whatever you want, then you should be able to have it.”

Working with families of the dying has made Klinge passionate about promoting a society in which we can be open to discussing death and dying with one another. She hosts a Death Café through Zoom which differs from a grief support group because it is primarily a space for people all around the world to meet and talk about death in a safe space. “If we have a healthier relationship with our impending death, then we can probably have a better relationship with our life,” Klinge said.

The transition from life to death is an inevitability everyone will eventually have to confront. “It is one of the toughest, if not the toughest thing people will face,” Klinge said. With the support of a certified death doula, these challenges do not have to be faced alone.

To be present and hold the space with someone who is passing on can be a difficult yet fulfilling experience. The path of becoming a doula for the dying is no different.

Jude Higgins’ journey to becoming a death doula began as she was pursuing a doctorate in education at the University of Utah.

Jude Higgins, a death doula and founder of HELD, discusses her meaningful work at a local coffee shop.

Higgins, a first-generation college student, at the time taught anthropology as a tenured professor for 12 years at Salt Lake Community College. During her time as a professor, her father became ill and went to live with Higgins. She cared for her father for three years. “That was the hardest thing I’ve ever done in my life.” Higgins said at a local coffee shop. “Afterwards, it was such a transformational experience.”

After witnessing how helpful the people were who came to assist her father, Higgins volunteered at a hospice thereafter. Once her work began, the hospice volunteer coordinator suggested Higgins take a class in death doula work.

Higgins then began training under the College of Pastoral Supervision and Psychotherapy. She completed a Spiritual Care Residency at Kaiser Permanente Hospital in Vallejo and Vacaville, California.

She hadn’t imagined that her life would lead in this direction. “My first career was in dance,” she said. “A very dear mentor of mine reached out to me. I started with her when I was 17. I ended up dancing in her company and teaching at her studio. She called me and said, ‘I want you to be my death doula.’”

She had just completed the training and her only prior experience was with her own father. “So, I worked with her. I worked with her every day for six months,” Higgins said as tears began to collect in her eyes. “She taught me. She was amazing.”

Higgins would go on to work with more families and become the founder of HELD, a death doula training program located in Salt Lake City. In addition to teaching, she also works in hospice, is a spiritual care provider at Primary Children’s Hospital, and continues to assist families through the end-of-life process.

She worked with Sarah J. Jackson when Jackson’s mother received an unexpected terminal diagnosis. “Choosing to be so present and practicing ritual to help my mom transition peacefully helped me to really understand the profound magic of the work death doulas do,” said Jackson, who is a presidential associate professor at the Annenberg School for Communication at the University of Pennsylvania.

“I knew death was not something to fear but experiencing it in the context of hospice in particular and with the loving support of Jude and others who offer end of life care drove this home,” Jackson said in an email interview. “Death certainly is not something to fear, even when it is surrounded by terrible feelings of loss and grief, it is a part of our humanity, and it makes us more human to bear witness to it.”

The Salt Lake City Cemetery, the largest municipally-owned cemetery in the country.

Higgins, along with many others around the world, is making a profound impact on how people experience the end of their life by making the end of life a meaningful and transformative experience. “It’s grieving, and it’s difficult. It’s hard,” Higgins said. “Birth is hard. I think it’s a cycle. We need death doulas, like we need birth doulas.”

All that begins will inevitably end. Planning for death does not need to be a formidable task. This universal truth can be confronted in spaces of comfort.

“People can run away from it as much as they want. But she’ll get ya!” Higgins said with a laugh. “She’ll get all of us in the end.”