Nicole Jowers thinks we should change the way we talk about death.
People who are dying are still living, she points out, and they deserve to enjoy their final days. Jowers said she has taken the dying to casinos and on fishing trips. She said she once set up a romantic dinner for a dying man and his wife. For the elderly women she calls “mammaws,” she said she paints their nails, buys them poinsettias, and makes sure they have their bright red lipstick, if they want.
“Everyone has a passion,” Jowers said. “Mine is the elderly. Geriatrics is just my heart and soul.”
Jowers, a Luling resident, said she is one of only three certified death doulas in Louisiana. End-of-life doulas are non-medical care providers who offer guidance to individuals who are planning for death because of old age or a terminal diagnosis, according to the International End of Life Doula Association. Death doulas help the dying, and their families, make informed decisions, and they offer emotional, spiritual, and practical support, according to INEDLA.
The practice of death doulas has increased in recent years. In 2019, the National End-of-Life Doula Alliance had 260 members in the United States. Last year, the membership stood at 1,545, according to the National Geographic.
Like birth doulas, death doulas advocate for their clients and offer companionship, education and support to their clients and families.
“Why not die with dignity and grace, the same way you’re born?” Jowers said.
Jowers runs At His Feet, a death doula service in St. Charles Parish. She offers a free 30 -minute consultation and recommends that families consult a death doula at least three to six months before an expected death.
“In our culture, death is a scary word,” Jowers said. “We don’t want to talk about it. We want to pretend that it doesn’t happen. But the reality is that death is inevitable.”
Jowers said the lack of preparation for death can lead families to make difficult decisions – about organ donation, do-not-resuscitate orders and funeral arrangements – at a time when they are emotionally overwhelmed.
“I’ve been there – you can’t think straight,” Jowers said. “The days tick by and the hours just go by so fast.”
Jowers, who was primarily raised by her grandparents, lost her grandfather quickly after a hunting accident. There was no planning, no preparation, she said. So, when her grandmother received a two-year diagnosis, Jowers helped her plan for her death.
“We went to the funeral home together,” Jowers said. “We picked out the casket. That gave her peace of mind because she felt like she still had some control.”
Jowers said one of the biggest misconceptions about death doulas is that they facilitate death. They do not. Instead, a death doula’s services can include sitting vigil with a dying client, helping the dying write advanced care directives, making funeral arrangements before the dying person has passed, and creating legacy boxes to store memories, among other services.
“Legacy boxes can be anything from recipes, cookbook, letters, pictures, stories,” Jowers said. “If someone is an avid gardener, it could include writing down tricks and knowledge about gardening for their families.”
Jowers said death doulas can also facilitate and encourage conversation between the dying and their families.
“For me to be an outside source and not be emotionally involved, I can guide and direct them and say, ‘have you talked about things you need to get off your chest?’” Jowers said.
In her experience in hospice care and as a death doula, Jowers said she finds that the elderly are not afraid of dying.
“The majority of the people in their final walk, they worry the most about leaving their families or being a burden on their family,” Jowers said.
Involving the dying loved one in their death by creating an end-of-life plan gives the dying person a feeling of control, Jowers said.
“Is grandmother not going to be here for Christmas?” Jowers said. “Okay, let’s have Christmas today, why do we have to wait? Will grandmother miss the birth of her great grandson? Okay, let’s write down what you want the child to know as they get older.”
Jowers said family members often struggle with accepting the idea that their loved one is dying.
“But they can start that healing process along the way – take off work, spend time with your beloved, ask the questions, listen to old records with them,” Jowers said.
For Jowers, the preparation for death is crucial to the grieving process. Jowers lost her sister suddenly to domestic abuse two years ago, and she said she still struggles daily with the loss.
“If I lived to be 95 and old and gray, what a blessing that is,” Jowers said. “Why do we make it such a taboo thing? What a blessing it is to not be snatched out and to know that the end is coming, and you can prepare for it.”
