- Alua Arthur is a death doula in Los Angeles, working with people who are dying and their families to ease the transition and take care of worldly affairs.
- “We’re working with healthy people to get their comprehensive end-of-life plans done,” Arthur told Insider. “And we’re helping people who are actually sick try to conceive of what the end of life might look like.”
- She was drawn to death work after meeting a dying woman on a bus in Cuba.
- During the pandemic, hospitals are on lockdown and Arthur’s had to cancel home visits, so she’s learned to adapt.
- The grieving “can have some support,” she said. “If we can remember that our dead belong to us, that will help a lot.”
- Visit Insider’s homepage for more stories.
The pandemic has brought the specter of death uncomfortably close for many of us. But there are those who can help navigate the emotional, mental, and spiritual journey of dying and grieving.
Just as traditional doulas prepare expectant parents for the arrival of a new life, death doulas – also known as death midwives – help prepare us for our inevitable departure.
“A death doula offers all the non-medical and holistic care and support of the dying person and of the family, the circle of support,” Alua Arthur, a death midwife based in Los Angeles, told Insider.
Arthur’s services include hands-on work – addressing a dying person’s anxieties and comforting their family – as well as advising on end-of-life decisions regarding healthcare and life support, disposition of the body, and funeral and burial options. Death doulas also untangle various legal and financial affairs, including closing out bank accounts and credit cards, notifying Social Security, and providing probate support.
They can help families develop personalised rituals, wash and prepare the body, and hold home funerals in states where they are permitted.
‘What was it going to take to get us ready to die?’
Arthur, 41, founded Going With Grace, an end-of-life planning service in 2014. An attorney and ordained minister, she previously worked in property law, but became interested in death work in 2012, following a bout of depression after the unexpected death of her brother.
Her path was crystalized on a bus ride in Cuba, where Arthur struck up a conversation with a young woman dying of uterine cancer.
“Our interaction made me think about how everyone is going to die, and I wondered why we aren’t talking about it,” Arthur told Radiant magazine. “What was it going to take to get us ready to die? It suddenly became really clear that my life’s work was going to be preparing people to die.” She had been practicing law for ten years, “but it wasn’t quite hitting it for me,” Arthur said. “There were things I still hadn’t done in my life.”
When she got home, she enrolled in training at Sacred Crossings, an LA institute offering death-midwifery services.
“We’re working with healthy people to get their comprehensive end-of-life plans done,” Arthur told Insider. “And we’re helping people who are actually sick try to conceive of what the end of life might look like.”
You might expect a death midwife to be somber, but Arthur says her character “is one of joy.”
“The end of life often entails a lot of laughter and beauty, too,” she added.
Learning to separate her own views on the quality of life – and the quality of death – from the needs of her clients has been one of the hardest parts of her vocation. “I have some pretty strong views about things, but I recognise that throughout my work that everybody comes to that place through a bunch of different paths,” Arthur wrote on Medium. “And I [have] to respect everybody’s, no matter how different from mine it may look.”
While most death midwives receive training, there is little regulation and no national certification. Many operate informally within their community, so it’s difficult to estimate how many are currently practicing. The National End of Life Doula Alliance has over 500 registered members, mostly women.
“Men have taken over the funeral industry, the business of death, but women are still doing the nurture of death,” Arthur said.
Death doulas typically work in tandem with hospitals, nursing homes, and hospices, offering more focused individual care than those places can provide.
There’s a great deal of intimacy involved in the work: It’s common for death doulas to sit with the dying, read to them, or comfort them with massage.
Death work during the coronavirus pandemic
The current health crisis has forced Arthur to adapt her practice.
“I’m not doing any home visits anymore,” she said. “We’re talking on the phone, we’re talking via FaceTime. They’re holding up the phone so I can hear breathing. They’re asking about rituals. I’m showing them how to do things over the internet that I would be doing in person.”
Hospital lockdowns mean families often can’t be with their loved ones. And understaffed and overloaded funeral homes have had to limit services to graveside burials for immediate family members only.
Arthur is giving guidance on rituals families can perform at home to fully process their grief.
She also teaches others to become death doulas via online training and says since the pandemic started she’s been flooded with applications.
“There are a lot more people that want to do this work right now, which makes sense to me,” she said. “People are seeing the need for it. Some people that may have been on some other career trajectory that’s now stopped because of layoffs are now like, well, let me do this thing that I’ve always wanted to do.”
The crisis is also forcing healthy people to think more about death, a topic many of us avoid.
“While they do that, they are wondering about how they can empower others to do the same,” she said. “One of the gifts of this time is that it’s really rich for connection. The knowledge can be shared no matter where you are.”
Since March, Arthur’s been inundated with inquiries and her appointment book has been filled. She’s only taken one day off in the past four weeks.
Trying to handle her own feelings about the coronavirus while being so busy “has been a furious juggling act,” Arthur told Insider.
“When everything went down, there were a few days when I felt like, ‘Oh my god, I’m feeling a lot of [anxiety] about people’s safety and the suffering and the fear and all that,” she said. “But after a couple of days, my inbox was blowing up. So I was like, alright, I guess I’ve got to go to work.”
The pandemic is far from over, and Arthur says it’s not clear how it will ultimately impact our views on death.
For now, she encourages people to continue coming to terms with their mortality, whether through meditation or by having those hard conversations with loved ones about what they want the end of their life to look like.
“What I really hope for is that what’s happening now is a reminder that we are empowered to take care of our dead ourselves,” she said. “A lot of people are dying at home, and that means that the people that love them are the ones charged with being there with them.”
As traumatic as the loss can be, the grieving “can have some support,” she said. “If we can remember that our dead belong to us, that will help a lot.”