1. Be Present [2:47] – The magic is in the present moment. Be fully present - not just physically, but emotionally and mentally as well. Most of us don’t live in the present moment. Focus on what’s in front of you – what do you see, what do you hear, what do you feel in your heart? If you are fully present, you will get everything you need to know how to be of service to a person at end of life. People may say they’re fine, but if you really observe in the moment, you will know the truth. Trust your “knowing.” If your mind is all over the place, you can’t lean into your intuition properly. Ground your energy and quiet your mind before entering the room with a patient so you can be settled and truly present in the moment for that person.

1. Meet the Person "Where They Are" Emotionally [6:35] – Many people are in crisis by the time they reach out for end-of-life support services. End of life has three phases – the Shock Phase, the Stabilization Phase, and the Transition Phase. It’s in the Shock Phase – the initial period following someone getting a terminal diagnosis that everything is so intense. There could be many emotions present and there usually are. Anger, withdrawal, sometimes even humor as a defensive mechanism comes into the fold - and denial is also a really big one. So, when I say, “meet people where they are emotionally” it has to be perfect to where they are and how they’re presenting – this is not about our agenda, it’s about them. If people are angry, sad, or all over the place – just meet people where they are at that moment and work from that point forward. There is that initial space where everyone is in shock – let them go on their journey and give them time to process it. It’s really important for us to show up and be of service to people in this moment and of course through the whole journey.

1. Don't Judge [8:54] – This is a pillar of the Doulagivers practice. Don’t judge what’s happening. This is not only for the person at end of life, but also for their “nucleus” – the people in their inner circle who are deeply affected by what is going on. Everyone is having their own experience during end of life, and everyone might be having a different experience. There is no judgment at the end of life – this is a universal law I have learned from working with my patients over the decades. End of life is hard – we don’t have full context on anybody’s life and it’s important to remember that everyone is doing the best they can with where they are on their journey. Things can get really intense at the end of life, so always remove judgment from the situation.

1. Be of Service [10:57] – Set your intention to be of service. You don’t have to figure it all out or have an agenda. Simply ask yourself, “how may I show up to be of the highest service – to this family, to this work, to the world, and to myself?” When you go in, just be present and have the open heart to be of service in the whole dynamic and see what comes into you. Don’t push – flow. Be of service and bear witness to this person’s experience – you’re not here to fix it or direct and take over. You’re here to be present with no judgment, with an open heart, and to be of the highest service – that is the best medicine we can give one another. When you show up to be of the highest service, it allows for this energetic place that’s really organic for the end of life where beautiful things can be processed, accepted, brought to light, and people can find peace. If you do this, you’ll be in a great position to help somebody.

1. Practice Self-Care [12:48] – This is for you. When caring for those at end of life, caregivers can put themselves last and not want to take time off. You have to plan on the long haul – we don’t know how much time we have at the end of life. We want it to be as positive an experience as possible, and it can be. Part of that is making sure that the caregiver is getting enough sleep, nutrition, and having some down time so that they can be fully present for their loved one (or client as a Doulagiver). People are in fight or flight mode at this time – we have to prioritize our health. Having a few hours off is best - but doing as little as taking ten minutes to walk in nature or get sun on your face can do a world of good. An hour or two of respite is very important – ask someone to cover a shift for you so that you can take a nap or just have a break. Also make sure you are getting adequate water and nutrition intake. I understand that during this time people may not want to eat or have time to prepare full meals, but this is critically important for the health and balance of your body. In order to take care of others, we must take care of ourselves. If you allow yourself to burnout, you won’t be able to provide optimal care.

Memorable Quotes:

1. “If you are fully present, you will get everything you need to know to be of service to a person at the end of life.” – Suzanne B. O’Brien RN

1. “Simply ask yourself, ‘how may I show up to be of the highest service – to this family, to this work, to the world, and to myself?’” – Suzanne B. O’Brien RN

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