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In a year when death and grief have become a constant, the Skeleton Easily Distracted By Music And Vodka Shirt but I will buy this shirt and I will love this palliative care process has reached a new level of complexity amid COVID-19. End-of-life doulas have always strived to be a support system for those who are terminally ill, but in 2020 the people who take on that responsibility have been challenged to think outside the box when it comes to caregiving. They’ve had to help their dying clients make unimaginable choices between risking virus exposure and spending their last days alone. They’ve also had their presence questioned at a time when their skills could be most valuable. Alua Arthur, an end-of-life doula and founder of Going With Grace, has been trying to encourage clients to focus on what they do have control over, even when the world feels full of uncertainty. “Because they’re getting close to the end of life, I remind them that there are some things that are still firmly within our control,” says Alua. “[I have them] look at what it is that we’re trying to control and where the control actually exiets. She has her clients work on “cultivating presence and practicing adaptability,” along with “exercises, like finding our feet and consistently planting our feet firmly on the ground [and] becoming present.”

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Communication and connection have been the Skeleton Easily Distracted By Music And Vodka Shirt but I will buy this shirt and I will love this most challenging variables for doulas and their clients. Many in-person meetings with clients and their families have gone digital. For Arthur, FaceTime and Zoom have become essential for helping with clients’ health-related questions when she can’t physically be with them. “Family members [can] scan body parts through a video call, show me and say, ‘Does that look normal?’ Or, ‘She’s breathing like this, does that sound normal?’ And [they] hold the phone up [for me to hear] somebody’s breathing pattern.” That way, even if Arthur is not with the client, she can make an informed decision as to whether they should call the doctor. Arthur has also hosted webinars to help people experience grief and facilitate rituals for transitioning. She has helped coordinate with funeral homes to livestream funerals for clients so that more family members could participate. For clients who are in assisted-living communities or the hospital, nurses often act as a bridge on behalf of doulas. Janie Rakow, a recently retired end-of-life doula and former president of the International End of Life Doula Association (INELDA), has been raising money for baby monitors for local hospitals so that doulas can keep in touch with their clients, talk to social workers and chaplains, and even play music. “Nurses and medical staff have been integral in helping doulas make sure they connect with families and play music until the end,” she says.