by Leslie Kelly

Special to the Sounder

Death Cafes and death doulas. Even death midwives.

The terms may be new, but the subject matter isn’t.

And it’s evidence that, at least for a segment of the population, death is no longer a taboo topic.

“There’s just more of an awareness of end of life issues,” said Libby Garcia, a registered nurse who hosts Death Cafes. “As Baby Boomers head into the age where death is inevitable, they’re changing things, just like they have all along in their lives. It’s an exciting thing.”

Garcia will host a Death Cafe Nov. 21 from 2 to 3:30 p.m. at Emmanuel Parish Hall on Orcas Island. She came into the work after seeing death often as an emergency room nurse.

“I was frustrated watching people die in a way that was over-interventive,” she said. “Often times methods would be carried out that were futile and only increased the dying person’s pain.”

She asked herself, “what’s the right thing to do?” Her answer was to get involved by helping people plan end of life decisions prior to death. She became aware of something called Death Cafes that were popular in Europe and are gaining popularity in the U.S. She took part in some in Bellingham, and then moved to Orcas and decided to bring them with her.

A Death Cafe is a place to talk about any subject that is in the realm of death. The term comes from the setting in Europe, where folks would get together over cake and tea to talk about matters around death. The model was developed by Jon Underwood and Sue Barsky Reid, based on the ideas of Bernard Crettaz.

“Death Cafes are not directed by anyone and there are no speakers or leaders,” she said. “What’s discussed is anything anybody brings up that they want to talk about.”

It’s a running conversation, she said. Topics often include hospice care, advance directives, death with dignity and what compromises a good death and if that is even possible.

“Hopefully the participants can talk about the things that are near and dear to their heart,” she said. “It’s a supportive environment.”

And there are no rules.

“It’s not grief counseling,” she said. “It’s not therapy. It’s a time when anyone can come and address any issue surrounding death that they want to.”

The hope is that by talking about death prior to a death, individuals can outline what they want when their time comes.

While there are some strong personalities who attend the Death Cafes, Garcia said everyone’s opinion is respected. Participants are broken into small groups, about eight people to a group, where the conversations can be more intimate.

One of the positive things that happens, is that when people gather for a Death Cafe, they become a community.

“And that spreads to others,” she said. “It’s taking the negativity out of the subject of death.”

The addition of death midwives or death doulas is helping, too. Much like how midwives and doulas help at the time of birth, they can help at the time of death.

Ashley Benem, a licensed massage therapist, a death midwife and a minister, is evidence of that. For the past five years, she’s been helping those who are dying prepare for their passing. As a former birth doula, her work has now come full circle.

“These titles may be new,” she said, “but the idea of someone helping at the time of birth and death is nothing new.”

A death midwife or death doula is someone who has the expertise and skills to support the dying person and their friends or family. Care is individualized according to what the dying person desires. They are non-medical supportive companions who help with physical, mental, emotional, spiritual and cultural needs.

Their work begins when they are contacted by someone who knows they are dying, or who has a family member who is dying.

“We have a long conversation to begin with,” Benem said. “I meet with the ill person and their support team and talk about where they are at in the process. We talk about the path they want to take and then we draft a death plan.”

What they do is not medical or legal, she said. They provide comfort care. She and the other death midwives, who work with her, average about 10 clients a month.

An example, she said, is that in Washington state, family members can wash and prepare the body for final disposition.

“We can help them prepare the body, dress the body, and transport the body,” she said.