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Clarification
of new terms:
After winning the right to continue to use
the term 'death midwife' in the lower Supreme
court (CMBC
vs MaryMoon),
it was lost in the appeal (CMBC/AGBC
vs MaryMoon).
Although
we are continuing to explore ways to reclaim
the term 'death midwife', we are legally
bound (in BC) to use new terms for the time
being. The terms we are currently
using are:
Practitioner
of death midwifery:
someone who is practicing the philosophy
of midwifery applied to deathcare, through
the pan-death continuum.
Pan-death
guide: someone who offers death midwifery
support in a continuum of pre-death (EOL/death
doula role), immediately after death (home
funeral guide role), and funeral/memorial
ceremonies (celebrant role).
For
the most part on this site, 'practitioner
of death midwifery' and 'pan-death guide'
will be used interchangeably. We
realize that this may be a little confusing.
However, we felt it was important
to retain the connection to 'death midwifery'
(philosophy), as well as have a term that
describes 'what they do' (approach in practice)
— as 'death midwife' did both.
Disclaimer:
Practitioners of death midwifery/pan-death
guides are not conventional (birth) midwives
or health professionals, nor are they members
of any of the Colleges of Midwives in Canada
Once
Upon A Time — A Family Undertaking
Once
upon a time — actually up until the
20th century — death was a family/community
undertaking. The Death Journeyer
most often died at home, surrounded by family
and friends. The community-at-large
provided for their practical needs; clergy/shamans/etc.
supplied spiritual support; and the local
midwife often provided both practical and
spiritual support at the bedside throughout
the whole of the pan-death journey. A
family member or friend may have made the
coffin or shroud. The local
spiritual advisor helped the family plan
the funeral service. Vigils,
lying-in-state and wakes were arranged by
the family or community — according
to their traditions.
Family
and close friends washed and dressed the
body — often under the guidance of
the midwife. Members of the
community dug the grave, and filled it in
again once the body was placed within it;
or built the open-air funeral pyres which
the body would burn on. And
the community-at-large offered on-going
grief support — both individually (and
practically — by preparing food, taking
care of chores, etc.) and within
the community's traditions, or according
to the Death Journeyer's specific wishes.
With
the modern advent of hospice and palliative
care, the facilitation of pan-death providers,
and green burials and supplies, this kind
of family/community-based approach to the
pan-death experience is once again possible.
Those who wish to do pre/post-death care
themselves may do so (and
are legally allowed to) — CINDEA
offers instructions for the whole of the
process on its Post-death
Care/Home Funerals page.
Especially
in an urban environment, where the Death
Journeyer may not have a large family or
community available — and this is often
particularly true in Victoria, as a retirement
city — the support of a Practitioner
of Death Midwifery can make it possible
for smaller groups of family and friends
to do all of the pan-death care themselves.
Although
Journeying Beyond endeavors
to support the wishes of the Death Journeyer
and their family, its focus is towards natural
and ecological options throughout the pan-death
process (environmentally-friendly
supplies, Green Burial, etc.) wherever
possible.
[Note:
for those who would like to see a modern
'Family Undertaking', see PoV25 trailer
of the movie "A
Family Undertaking".]
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CINDEA/Journeying
Beyond
terminology
| Death
Journeyer |
| |
—
the person who is making the journey
through life-threatening illness, terminal
diagnosis, active dying, death, and
beyond (however they
understand 'beyond') |
| |
| Family |
| |
—
includes blood and marriage family members,
but also any individual or community
members that the Death Journeyer considers
to be their chosen or functional family. |
| |
| Pan-death
|
| |
—
includes the three major stages of dying/death |
| |
|
before
(life-threatening illness
and terminal diagnosis) |
| |
|
during
(active dying and death),
and |
| |
|
after
(post-death care, final
rites, burial or cremation, funeral
or memorial, bereavement) |
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| DWENA |
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—
new acronym
for Deathcare Wholistic, Ecological,
and/or Natural Alternatives |
| |
|
a
term that includes any and all options,
and kinds of care, that fit into the
above 'alternatives', avoiding confusion
over the meaning of 'Death Midwifery'
(as umbrella, or specific
role, term) |
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| Practitioner
of Death Midwifery/Pan-death Guide |
| |
 |
CINDEA
only recognizes and lists Practitioners
of Death Midwifery who have successfully
completed the
CINDEA-recognition process.
The symbol to the
left designates someone who has been
formally recognized. |
| |
Pashta
MaryMoon is a member and one of the
co-directors of CINDEA;
as well as one of the developers of
its Death Midwifery recognition program.
She is also a CINDEA-recognized
Pan-death Guide — evaluated by
a non-CINDEA
medical practitioner, to avoid bias.
|
 |
A
more detailed description of Journeying
Beyond 's approach to Death
Midwifery can be found at the CINDEA
pages on Pan-death
Movement, Death
Midwifery, CINDEA
Recognition, and Post-Death
Care. |
|
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A
'Good Death'
All
of us hope for a good death — although
that means very different things to different
people, depending on their medical conditions,
family traditions, and lifestyle. Part
of a Pan-death Guide's role is support the
Death Journeyer to explore what a 'good
death' personally means to them, and then
help them find ways to achieve it in their
remaining time.
A
'good death' might simply mean accepting
that one is dying; and integrating this
sense of transition — that may bring
significant changes to their priorities
and choices, and which can also lead to
a sense of empowerment that they might not
have experienced before. As
well, it may mean choosing less pain medication
in order to be conscious throughout most
of the 'active dying' stage as possible.
Strangely
enough, Death Journeyers are sometimes intensely
alert and focused just before their death,
and able to reflect upon their life in ways
not possible before. In a sense,
they may end their life finally having a
clear sense of who they are — all the
facets of their life woven into a single
3-dimensional tapestry. Death
Journeyers often have very meaningful insights
at this time — about their reality
in that moment or about their life in the
past — but may articulate them in very
strange ways. It often requires
some considerable 'teasing out' to discover
the meaning of these statements (see
the book 'Final Gifts' for stories about
these strangely-worded insights or requests).
It
is also a time for last significant connections
— sharing hopes/dreams/blessings for
one's loved ones, and/or making amends and
forgiveness (of both self
and other). As well,
a good death includes the dignity of the
Death Journeyer being able to make choices
about their remaining life, including practical
decisions (as much as they
desire to do so).
However,
we must not assume that dying in a coma
or with dementia is a 'bad death'. For
some Death Journeyers, letting go of consciousness
and resting in the cradle of a coma or dementia
can be a good death. We can
continue to support them in this last resting
place before death — with their favourite
music or poetry (or other
writings), bedside singing, blessings,
giving them permission to die or join other
deceased loved ones, and/or simply talking
honestly and openly to them. There
is a huge amount of anecdotal evidence that
people can hear what is said to them in
a coma; and even occasionally, people with
end-stage dementia 'come back to us' (temporary
improved cognitive ability) just
before they die. The environment
we create for them can make a significant
difference to the state in which they die,
although we may never specifically know
what that means for them.
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Mandate
of Journeying Beyond services
Journeying
Beyond 's mandate is to provide
a continuum of DWENA support to the Death
Journeyer and their family/friends throughout
the whole of the pan-death process. Our
primary focus is on supporting those who
choose to die at home, and/or have their
family/friends be directly involved with
the post-death care and arrangements.
However, Pashta will also work collaboratively
with funeral directors — if that is
the family's wish, and/or the particular
circumstances (unexpected
or questionable death) require the
services of a funeral home. [Note:
the law does not require the body to be
taken to a funeral home: families and friends
are legally able to handle all of the post-death
care on their own, or with the support of
an alternative death-care provider. However,
in some circumstances, a funeral-home-based
post-deathcare may be more appropriate]
Like
CINDEA,
Journeying Beyond
is committed to supporting personal choices/values
and meaningful alternatives in pan-death
care — with concerns for the sustainability
of our planet — throughout the whole
of the pan-death process.
Here
in Victoria, we have an excellent hospice/palliative-care
program, which allows for many more people
to die in the comfort of their own homes.
However, there are restrictions
on time and availability of services in
a city which has a higher population of
elderly and dying than most others in Canada.
Although in some cases, funeral-home
services are appropriate (or
possibly, necessary), many people
are questioning the conventional services
they offer as not necessarily relevant to
their values and lifestyle. Many
have concerns about the conventional ecology
of death (ex. embalming,
cremation, traditional burial) —
all of which have a significant carbon-footprint.
| Other
people may be more focused on the emotional/spiritual
side of dying — both |
| |
a)
|
for
the Death Journeyer |
—
dying at home; surrounded by a familiar
environment; cared for by those they
love; addressing their particular emotional/spiritual
needs (elements of a
'good death'); and knowing that
their personal wishes will be carried
out after their death. |
| b) |
for
their families |
—
participating directly in caring for
their loved one, and healthy grieving
through a direct 'hands-on' approach
before, during and after the death;
being able to organize vigils/lying-in/wakes
according to their own values and timing
at home; being able to involve children
who might otherwise be left with long-term
confusions about death and their responsibility
for it; and generally being directly
involved/in-control-of their last offerings
in honouring their loved one. |
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Details
of A DWENA/Death-Midwifed Death
A
DWENA/death-midwifed death allows for the
Practitioner of Death Midwifery and family
to explore options (especially
those that most people don't know about)
that may be particularly meaningful to the
Death Journeyer and their family throughout
the pan-death process.
This includes making it possible for the
Death Journeyer to participate in plans
for their death (and afterwards),
should they choose to do so. The
continuum of the Pan-death Guide's involvement
means that these explorations can generally
be made earlier on, and revised as necessary
over time — without having to re-explain
the family traditions/values and history
to multiple servicers.
Such
explorations are done with regards to the
particular time-frame and needs of the family
and/or their religious or cultural traditions
— with a focus on both the emotional/spiritual
and practical aspects of the death, including
exploring and planning for whatever a 'good
death' means to them. A Pan-death
Guide is also generally able to organize
their schedule to suit the family's needs
— whether during the day or evening/night.
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Practical
Pan-death-care Issues
All
of the post-death care can be legally done
at home — although some individual
funeral-home services might be required
(such as transporting the
body, if family/friends don't have an adequate
vehicle). The washing
and dressing of the deceased loved one can
actually be less complicated than when they
were alive — and can easily be done
by the family (with some
general instructions — see CINDEA's
'Post-death care' page): in many
cultures (both ancient and
modern), this task is considered
the final act of respect and love for their
loved one. A Death Journeyer
can also be brought home from the hospital/hospice
or a residential care facility shortly after
death, so that the family can control all
aspects of any vigils/lying-in-honour/wakes
that they wish to have.
Properly-placed
dry ice or Techni-Ice
will keep the body at the temperature required
by law (again, see CINDEA's
'Post-death care' page for instructions).
Simple coffins can be built
or bought and decorated — in a personally
meaningful way — at the home, and allow
for family and friends to personalize them
with artwork and/or written blessings/farewells;
or personalized shrouds can be hand-made
(for green burial or cremation
— CINDEA has 6
designs available with graphic
and written instructions). Journeying
Beyond has copies of most of
the documents required to register the death,
and can inform the family of where to get
the others (through the BC
Consumer Protection agency).
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Journeying
Beyond
's DWENA/Death Midwifery Services
Pashta
MaryMoon is committed to offer a continuum
of support to the Death Journeyer and their
family/friends through the pan-death process,
via the following Death Midwifery services
— according to the specific wishes
of the Death Journeyer and family. [Note:
although Pashta is Canadian-born and unilingual
in English, she is quite open to working
with Death Journeyers/families from other
cultures.] She offers:
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A
|
general
support through the dying stage —
developing a 'death plan' (exploring
what the Death Journeyer and family
would wish to happen and pre-planning
to fulfill those wishes), supporting
the Death Journeyer's spiritual advisors
(if appropriate),
processing anticipatory grief, exploring
and supporting whatever a 'good death'
means to the Death Journeyer, etc. |
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B |
access
to alternative support therapy (such
as Bedside Singing — Pashta was
a founder and trainer for the Bedside
Singing program at the Victoria Hospice
unit at the Royal Jubilee hospital —
or other non-medical/non-traditional
therapies) |
| |
C |
support
in negotiating hospice/palliative care
services |
| |
D |
arrangements
for life-story telling (written,
audio, video) and/or preparing
for a memorial pamphlet |
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E |
family
meetings (to ensure that
everyone's needs are being met),
or initial mediation re internal family
issues (Pashta is also
a trained mediator) |
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F |
'gatekeeping'
(helping the family to
arrange visitation, according to the
needs of the Death Journeyer and family) |
| |
G |
education
on post-death care (washing
and dressing the body, and ensuring
that it remains at the legal temperature
for preserving a dead body),
enabling the family to do it themselves
if they so choose |
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H
|
support
in accessing the chosen coffin or shroud
— including ecologically-friendly
coffins used for green burial and/or
simple ones appropriate for decorating
(as well as blueprints
for families who choose to make the
coffin themselves, or shroud patterns
for those who wish to sew them) |
| I |
planning
whatever services/ceremonies are wished
for during the pan-death process (a
'life celebration' or 'last farewells'
before death, death vigil, lying-in
vigil/visitation; as well as the funeral
and/or memorial ceremonies and possibly
a wake) |
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J |
writing/coordinating
and leading the funeral and/or memorial
service (unless the family
chooses another Funeral Celebrant, Clergy,
etc. to lead) |
| |
K |
general
support with arrangements with a funeral
home, if that is necessary in the particular
circumstances of the death or the family
choose to use one; and/or negotiating
individual services (such
as transport of the body if the family
does not have access to an adequate
vehicle) |
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L |
helping
the family make final arrangements for
cremation or burial, writing an obituary,
and/or using an online memorial guestbook |
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M
|
providing
or accessing all required official documents,
and helping the family to fill them
out before filing them |
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N |
initial
post-death grief/bereavement support
— as well as support to access
counsellors who specialize in this field
(if necessary or desired) |
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O |
initial
plans for the scattering of ashes or
visitation of the burial site (sometimes
done at the first anniversary of the
death), and/or initial plans
for a first anniversary gathering |
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|
For
clarifiation of contract details and fees
for Journeying
Beyond Death Midwifery or Advance
Care Planning services,
contact Pashta directly by
email or phone 250-383-4065.
Note:
the initial meeting with the Death Journeyer
and their family/friends is free of charge.
The first payment of fees for Death
Midwifery services will be due at the signing
of the contract.
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7
Stages of the Pan-Death Process
Journeying Beyond
provides support for all of the
CINDEA-identified
7 Stages of the DWENA/Pan-Death Process
— although it is likely that a Pan-death
Guide would be called in close to the actual
death. It is entirely up to
the Death Journeyer and their family/friends
what is done in any stage — a Pan-death
Guide's responsibility is to inform them
of the range of options within each stage
of the pan-death process, and help facilitate
the fulfillment of their wishes.
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1. |
'End
of life' —
advance-care planning with comprehensive
and personalized Advance Directives
and Representation Agreements; support
considering both health and personal
care choices; writing a life-story;
caregiving needs/plans and available
support-systems (see
also the CINDEA
page on Advance
Care Planning)
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| 2. |
Immediately
after terminal diagnosis
— support to plan for 'quality
of life' for the Death Journeyer's remaining
time; beginning to write an initial
obituary (especially
if the Death Journeyer wishes to participate
in this); facilitation of family
meetings to plan for eventualities;
dealing with anticipatory grief (the
grief of knowing that time with your
loved one is limited); and supporting
plans with hospice/palliative care agencies
[Note:
Pashta is also a trained mediator, and
offers mediation sessions for families
who need extra support to resolve issues.] |
| 3. |
Active
Dying —
support with planning appropriate visitation
by friends (including
'gatekeeping'); vigils; finding
alternative pain relief practitioners;
and emotionally/spiritually processing
the imminent death |
| 4. |
Death
Transition
— support for the continued upholding
of a death vigil (using
prayers, poems, music, etc.);
and soul release (if
the Death Journeyer believed in this),
and contact with any officials (doctors,
hospice, coroner, etc.) |
| 5.
|
Immediately
after death
— support for the continuation
of any vigil or soul-release process;
information on washing/dressing and
otherwise dealing with the body's needs;
ensuring that all required documents
are accessible and filled out; finalizing
an obituary and funeral or memorial
services; informing other family and
friends of the death and planned services |
| 6. |
Final
Arrangements
— support to finalize the funeral
and/or memorial services and ensure
that they are as the Death Journeyer
wished for; and planning for transportation
of the body to cemetery or crematorium;
and acting as Funeral Celebrant, or
helping the family find someone (spiritual
leader/etc.) to officiate at
the service |
| 7.
|
Initial
Grief and Bereavement support —
support to the family/friends in dealing
with the emotional/spiritual aftermath
of the death; helping to plan a first-year
anniversary or time/ceremony to scatter
ashes (or — for
example — plant flowers on a green
gravesite); finding an appropriate
long-term grief/bereavement counsellor
(if needed) |
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By
My Own Heart and Hand home funeral workshops
By
My Own Heart and Hand
workshops
are offered
'in person' on the Pacific West Coast
(based in Vancouver Island,
BC, Canada),
or by Zoom (anywhere)
Please
contact Pashta for further information
—
including potential dates of planned By
My Own Heart and Hand workshops,
or to request a workshop in your area,
or to schedule a Skype version of the
workshop.
Check out the new By
My Own Heart and Hand
page for photos and further
information.
Phone: 250-383-4065
Email: contact@beyonds.ca
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