Editor's Note: This story is part of our Faith in Action series of stories exploring faith-based and faith-inspired works, the people accomplishing them, and the connections with the community they are creating. The accompanying artwork was created by Taylor Scamehorn. The series is supported by the Fetzer Institute.

With all beginnings come endings. From every birth comes death. Yet many of us greet the former while avoiding — and fearing — the latter. Even our health care system is based on preserving life at all costs rather than ensuring quality of life. 

Death doulas, also known as end-of-life doulas, advocate for the needs and wishes of the dying along with their families and friends. They provide non-medical care and holistic support, from respite care while giving the caregiver a break, educating about the process of death, realizing final wishes and listening to concerns and helping to resolve them, assisting in the preparation of advance directives and funeral planning, to providing a calm and soothing presence throughout and beyond those final days and hours. 

“Death is the great mystery,” says Alycia Lee, an end-of-life doula and frequent host of Death Café Kalamazoo, a group of people coming together once a month to discuss their feelings and understanding of the process of dying — whether their own or that of a loved one. The meetings are frequently held at Kazoo Books in Kalamazoo, but on occasion also at local libraries or other locations.  

Alycia Lee owns Starlight Death Doula and runs Kalamazoo's Death Cafe.“But death can also be a real blessing. My intention as a host of the Death Café is to confront the taboo. Knowledge takes the charge out of fear. Everyone’s experience is different, but it is wonderful to see that sense of relief when we can talk about it openly. It’s palpable.”

Lee started Death Café Kalamazoo in 2018, after witnessing the final journey of two close friends. She also opened her own business, called Starlight Death Doula. 
“I felt the calling,” she says. “I had previously volunteered in hospice, but I wanted to do something more. Statistically, most of us die in a hospital setting with invasive measures to keep us alive. I saw something different — dying at home, surrounded by our loved ones.”

And, Lee adds, she can also be a warm and comforting presence for those who have no loved ones surrounding them, as many age alone. 

Artwork created by Taylor Scamehorn“Hospice nurses are wonderful,” she says. “They have big hearts. But there are gaps that I can fill, and I can focus on one patient while they have many. People often want more emotional support, and I can give them that.”

Lee not only gives comfort to human patients — she also provides her services to animal patients. With many pet owners attached to their pets as family members, she has worked with veterinarians and pet owners to be alongside dying animals. 
“I recently worked with someone who had a dying Nigerian Dwarf goat,” Lee says. “We created a ritual, burial at home, gathered flowers.”

A good death, Lee says, is when a patient can die without invasive and uncomfortable interventions, surrounded by loved ones at home, perhaps with soothing music, with access to nature during final days, and with a ritual of preparation that creates a sense of ease and acceptance. 

The power of education

Debbie Eisenbise’s path to becoming an end-of-life doula came from her 35 years of experience as a pastor and as an adjunct professor at Western Michigan University, teaching in the Integrated Medicine and Wellness department. She was trained through the Lifespan Doula Association in Ann Arbor in 2018. Her business is called Through the Threshold. 

“I received some great training through INELDA, the International End-of-life Doula Association,” Eisenbise says. “When to step in depends on the individual. Sometimes I gather a group, family members, to talk about advance care planning. We talk about different types of funerals and their environmental impacts. We talk about green burials, for instance, which can require a lot of pre-planning.”

Death doulas, however, do not get involved in estate planning, which would be a conflict of interest, Eiesenbise says.

Eisenbise offers education to individual families as well as church groups and other groups to talk about how to create an individualized plan of care. Some, she says, wish to learn about a plan of care well in advance, while others call on her when death is imminent. 

“Westernized culture increases the fear of death,” Eisenbise says. “We outsource death. Doulas are trying to make a change in that culture by bringing about an acceptance of death. Death is natural. My goal is to keep people living until they die. This is about quality of life.”

Artwork created by Taylor ScamehornBy that, Eisenbise says, she means working to keep people out of the hospital while keeping pain and discomfort under control. For families, it means lowering anxiety by educating people about their options. 

“I can work with traditional funeral homes — each one offers something different in their services — but people may not realize they can also keep their loved one at home for up to 48 hours under the right conditions. I educate them about their medical options — CPR, especially for older people, can be quite violent, breaking ribs in the process. We have choices about how we leave this life.”

Restoring the sacred

A frequent partner, albeit an independent end-of-life doula, Nancy Pendziszewski came to her work in 2018 when she was diagnosed with breast cancer. 

“I was blindsided,” she says. “I had recently had a mammogram, but it came back clear. I felt ropey tissue in the shower, not lumps, and when I went to my doctor, it turned out to be stage 3 cancer.  I had always thought I would refuse treatment if that happened to me, but when I was facing my own death, I changed my mind and went through the treatment.”

Pendziszewski is now cancer-free, but her perspective on life — and death — has shifted. Her work history had been at Bronson Methodist Hospital, but after the pandemic, her position was eliminated. It seemed a nudge toward her new interest. She wanted to do something about eliminating the anxiety that so often goes with the dying process in Westernized culture. 

“I trained with INELDA and also a wonderful training program on YouTube, called Going with Grace,” she says. “These last couple of years, I’ve dedicated my work completely to being an end-of-life doula. It is how I give back to my community, by supporting my clients and their families through dying.”

Artwork created by Taylor ScamehornPendziszewski talks to her clients about their “bucket lists,” what they wish to yet accomplish before life is over. They talk about what would bring them peace and closure, and how to fully embrace the days left to them. 

“Some families need to discuss for three or four hours, while others have discussions that last weeks,” she says. “If you’re not prepared, those last days can be terrifying. Hospice is great, but they can’t spend the time that a doula can. And yes, sometimes I cry with my client. I helped a 93-year-old client, and when I cried along with her, she said it meant a lot to her — she felt cared for.”

The tears are real. A part of the job requirement is to have the ability to care deeply about another, their comfort, their wishes, their quality of life.

“We learn to be grateful for beginnings and endings alike,” Pendziszewski says. “Our mission is to embrace life more fully and to restore the sacredness to dying rather than fear it.”