Lori Rienstra wished there was more she could’ve done for her parents when they died. She watched her father struggle with Alzheimer’s and did her best to manage her mother’s care from afar before she was moved to a hospice setting.

“I received the phone call just as she was about to pass and when I asked to speak to her, I was told that it wouldn’t make any difference,” said Rienstra, 63. “I missed that last opportunity for her to hear my voice.” 

These experiences with the decline of her aging parents led Rienstra to HopeWest, where she volunteered her time with patients nearing the end of their lives. When she retired from her career as a social worker, Rienstra set off on a second career as an end-of-life doula. 

As end-of-life doulas, Leah Cabot and Lori Rienstra help people nearing death to prepare both emotionally and spiritually.

Evolution of a doula

Originally, doulas were midwives that helped women transition into motherhood. Now the role has evolved to help both men and women transition from life with personalized support for the dying person and their loved ones. 

“We’ve come full circle,” said Mary Anne Holmes, 59. “The teaming of end-of-life doulas and hospice care is a great partnership.”

Another end-of-life doula and HopeWest volunteer, Holmes spent a great deal of her life caring for her mother and disabled brother. While keeping watch over her mother in her final days, Holmes realized many other patients had no one to be with them. 

Doulas are a calming and compassionate presence for those nearing the end of their life and their families. They provide non-medical, holistic support by helping with advance directives, vigil care, providing respite and communicating with the family and medical team on the patient’s behalf. 

“Having someone familiar and comfortable with the dying process as a companion is quite valuable,” said Rienstra.

Leah Cabot, a speech-language pathologist, earned her doula certification after keeping vigil over her grandmother, Gina. 

“Watching my grandmother die, although very sad, was an inspiration to me,” said Cabot, 43. “She died as she lived, being very much a participant to the end. She had no unfinished business and no regrets. She had a great network of friends and allowed people to support her.”

Being present in the moment is what makes life so precious, and death is simply part of that cycle, said Cabot. 

“We live in a death-phobic society,” she said. “Although this is a difficult, sad time, it’s an opportunity to restore death to its sacred place as part of life, and take away the fear and mystery.”

Services and costs

Most doulas charge for services either hourly or as part of a package while some base fees on a sliding scale. Doula services are not currently covered by Medicare or Medicaid.

Services may differ depending on a doula’s experience and expertise, but generally, they can be with a patient from diagnosis to the very end. 

“Our role is to listen to and accompany people where they are,” said Rienstra, who provides animal-assisted therapy with her dog, JoJo. She also collaborates with a friend for music therapy.

Cabot finds creative solutions for incorporating nature into her practice for patients who aren’t mobile. She uses guided imagery to help them visualize experiences they loved when they were well, such as walking on a beach, skiing or gardening. 

“Lots of things are possible to immerse the patient in nature,” said Cabot. “They may need to be near a window to be able to feel the sun on their face. A bucket of sand can be the next closest thing to putting your feet on the ground. Soundtracks or a diffuser can introduce nature sounds and smells.”

Rienstra offers life review assistance to help patients share and talk about important events and memories. She can also document these stories in various momento projects, which provide comforting memories for loved ones left behind.

Doula services don’t have to end after a person dies. They can also help friends and family members process their grief. 

Rienstra reiterated the importance of family presence during the end-of-life process. 

“It’s important to keep talking to your loved ones,” said Rienstra. “Hearing is the last sense to go. Tell them stories about memories and what impact their life has had on you. People are alive until they take their last breath, and can often hear, even though they may not show a response.” 

To learn more about end-of-life doulas, visit www.consciousdyinginstitute.com or www.inelda.org. 

To contact Rienstra with Alpenglow End-Of-Life Resource and Support, call 970-260-4388 or email [email protected]. Contact Cabot with Leah Magdelene, LLC at 970-314-0857 or [email protected]. Holmes with Aistriu End-Of-Life Doula can be reached at 970-201-2610 or [email protected].

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