Ask a Death Doula

Join the Next FREE Death Doula Global Training: https://www.doulagivers.com/monthly-free-class-register When someone we love stops eating and drinking, families often panic. Are they starving? Are they thirsty? Should I try to get just one more sip into them? I understand that fear. After more than 20 years at the bedside, I’ve seen how quickly this moment can change the way a family feels. That is why I want to tell you plainly what I teach: when someone is in the transition phase of dying, their body knows how to shut down. Eating and drinking stop. Swallowing becomes difficult or is no longer possible. The person sleeps more deeply. This can be a natural part of the end-of-life journey. In this episode of Ask a Death Doula, I share what I have witnessed with more than 1,000 people at the bedside—and what I want every family to know before they reach this moment. We’ll talk about: What is happening when a dying person completely stops eating and drinking Why this change can frighten families, and why forcing food or fluids can cause choking or aspiration How to care for a dry mouth and lips with gentle mouth care, swabs, and moisturizer What deep sleep may mean as a person moves closer to death Why this change tells us time may be short, even though no one can promise an exact hour or day Most of all, I want you to know that you do not have to respond from fear. Call your hospice nurse or care team when you see these changes. Let them assess your loved one and help you keep them comfortable. If your loved one is awake, wants something, and can swallow safely, follow their lead. If they cannot swallow, there are still loving, important things you can do—especially caring for their mouth and simply being with them. The more we understand the natural end-of-life process, the more grounded we can be for the people we love. Take the free Level 1 Family Caregiver Training: If you are caring for someone now—or want to be prepared before the day comes—join our free 90-minute training. I’ll teach you the Doulagivers framework for understanding what is happening, why it matters, and what you can do to bring comfort and confidence to your loved one’s care. Register for the free Level 1 Family Caregiver Training: Join the Next FREE Death Doula Global Training: https://www.doulagivers.com/monthly-free-class-register

Join the Next FREE Death Doula Global Training: https://www.doulagivers.com/monthly-f... What do the dying know that the rest of us have forgotten? After more than 25 years accompanying people at the end of life, I’ve been with over 1,000 people as they approached death. Again and again, I heard remarkably similar insights about love, connection, forgiveness, and what matters most. In June, I shared some of those teachings in my course The Wisdom of the Dying. The conversations were life-changing, and the responses reminded me how deeply people are longing for a place to explore these questions. One student shared: “Suzanne’s emphasis that dying patients say there is no death ~ has changed my entire life.” That is why I’m beginning Death as a Spiritual Experience: a new series on Ask a Death Doula, with more to explore through blogs and conversations in our Life Café community. This first episode is an invitation to listen to the wisdom of those crossing the veil—and consider how it might change the way we live now. In this episode, I introduce the seven pillars we’ll explore: There is no death: How my experiences at the bedside have shaped this belief, and how it may help us live with less fear and greater presence. We are all connected: What people at the end of life have shared about our connection to one another, animals, the planet, and the cosmos. There is no judgment: How compassion can soften our inner critic and change the way we see each other. Forgiveness is transformational: What it can mean to release pain and make room for peace. Life is a place of learning: How we might find meaning and growth, even while honoring the reality of painful experiences. We are human beings, not only human doings: Why tending to our nervous systems can help us find calm amid personal and collective challenges. We each have gifts to share: What it might mean to live with greater intention, purpose, and connection to the universe. In future conversations, we’ll also make room for end-of-life experiences, grief, sudden and traumatic death, and the death of children. We’ll approach these tender subjects with care and an open heart, and the truth of them as shared by the dying. You don’t need to have all the answers to join me. Bring your questions, your experiences, and your willingness to listen. Perhaps one idea will plant a seed. Perhaps one story will heal a wound. Perhaps the wisdom of the dying will change your perspective and help you live more fully today. Join the LIFE CAFE Community here: Here Download your {ULM} Universal Life Mastery Guide here: Here Follow Ask a Death Doula for the series, share this episode with someone who may need it, and join us in Life Café to continue the conversation. YOU ARE LOVED!! Xo Suzanne

Join the Next FREE Death Doula Global Training: https://www.doulagivers.com/monthly-f... For the last hundred years, we have slowly moved away from one of our most important human responsibilities: community taking care of community. Today, millions of family caregivers are expected to carry an enormous responsibility almost entirely alone. They are overwhelmed, overburdened, exhausted, lonely, and scared. Many are forced to put their own health, relationships, careers, and basic needs aside while caring for someone they love. This cannot—and should not—be done by one person. In this deeply heartfelt episode of Ask a Death Doula, Suzanne shares a new way forward for supporting family caregivers, inspired by Dolly Parton’s honesty about caring for her beloved husband and allowing her own health needs to go unattended. Suzanne hears this same story from caregivers every day: “I don’t have time to go to my own doctor.” “I can’t leave my loved one alone.” “I haven’t slept through the night in months.” “No one understands how hard this is.” Caregiving has become a silent crisis—but it does not have to remain this way. A Return to Community Taking Care of Community For generations, caregiving was shared. Families, friends, neighbors, and communities understood that everyone had a role to play. It is time to return to that understanding. Through Doulagivers Communities for Aging and End of Life, certified Doulagivers are creating local hubs where caregivers and families can come to: Be seen, heard, and supported Connect with others who understand Find trusted aging, caregiving, grief, and end-of-life resources Learn practical skills for caring for someone they love Receive tools for protecting their own health and well-being Remember that they were never meant to do this alone These community hubs represent a new—and deeply familiar—way forward: people caring for one another at the local level. If You Know a Caregiver, Show Up Now Do not wait for the caregiver to ask for help. Most caregivers are too overwhelmed to identify what they need, coordinate assistance, or reach out. Simply show up. You can: Bring them a meal Drop off groceries Bring flowers or a cup of coffee Sit with their loved one while they rest Drive them to an appointment Walk the dog Help with laundry or household tasks Make a phone call on their behalf Check in and truly listen Offer one specific thing you can do consistently Small acts become powerful when they are shared across a community. Download and print the Doulagivers Support System Scheduler linked below. Invite family members, friends, neighbors, coworkers, and members of your faith or community groups to each choose one way they can help. When many people do a little, no one person has to carry everything. In Honor of Dolly- and so many more! Dolly has given so much love, joy, and generosity to the world. By courageously sharing the reality of caregiving—and the ways caregivers can neglect their own needs—she has helped shine a light on a crisis that has remained invisible for far too long. Thank you, Dolly, for raising awareness. Let this be another beautiful gift: a reminder that caregivers need care, too. Let’s honor Dolly by changing how we support the caregivers in our own lives. Let’s see them. Let’s hear them. Let’s show up for them. Let’s bring back community taking care of community. And let’s do it for Dolly. Resources Download the Doulagivers Support System Scheduler: https://doulagivers.com/support-system-scheduler/ Find or start a Doulagivers Community for Aging and End of Life: https://doulagivers.com/wp-content/uploads/2026/08/Creating-Doulagiver-Communities.pdf Take the free Doulagivers Level 1 Family Caregiver Training: https://www.doulagivers.com/monthly-f... Share this episode with a caregiver—and with everyone who can help support one Please Remember Caregiving should never be carried by one person alone. Supporting caregivers is not merely a kind gesture. It is our

Join the Next FREE Death Doula Global Training: ​​​In This Free Training, You’ll Learn: 1) The 3 Phases of End of Life How to recognize the Shock, Stabilization, and Transition phases and what each one needs. 2) What Families Can Expect Common physical, emotional, and spiritual changes as someone approaches death. 3) How to Provide Real Comfort & Support Simple, non‑medical comfort measures and how to be a steady, calm presence. What would you want if, one day, dementia took away your ability to recognize your loved ones, communicate your wishes or make your own healthcare decisions? It is a painful question—but avoiding it does not protect us or our families. In this deeply important episode of Ask a Death Doula, Suzanne B. O’Brien, RN, welcomes back Lisa Pahl, LCSW, creator of The Dementia Deck, for an honest and compassionate conversation about dementia, caregiving and the importance of planning ahead. Dementia is not one specific disease. It is an umbrella term describing symptoms that affect memory, thinking, behavior and a person’s ability to manage everyday life. Alzheimer’s disease is the most common cause of dementia. The number of people affected is growing rapidly as our population ages. In 2026, an estimated 7.4 million Americans age 65 and older are living with Alzheimer’s dementia. Nearly 13 million family members and friends are providing unpaid dementia care. That care can be relentless—physically, emotionally, psychologically and financially. It may eventually require supervision 24 hours a day and can continue for many years. Although someone with Alzheimer’s lives an average of four to eight years following diagnosis, some people live as long as 20 years. Suzanne and Lisa explore the two urgent challenges before us. Challenge One: Supporting Today’s Dementia Caregivers When a family is already living through dementia, we must show up. One person cannot—and should not—be expected to carry this responsibility alone. Families need to “share the care” by bringing together relatives, friends, neighbors, community organizations and professional resources. Support may include: Creating a care team and using a support-system scheduler. Assigning specific, manageable responsibilities to different people. Arranging regular respite so the primary caregiver can rest. Helping with meals, transportation, appointments and household tasks. Providing companionship for the person living with dementia. Offering emotional support without judgment. Connecting the family with local dementia, hospice and caregiver resources. We often tell caregivers to ask for help. But overwhelmed caregivers may not have the energy to identify what they need, organize everyone or repeatedly make requests. Sometimes the most compassionate response is to offer something specific: “I can stay with your mother on Tuesday from 1:00 to 4:00 so you can rest. Would that help?” Caregiving cannot be sustained by one exhausted person. It requires a community. Challenge Two: Making Our Own Choices Ahead of Time The second challenge is more sensitive—but equally important: What have we learned from today’s dementia experiences about the choices we would want for ourselves? Dementia can eventually take away the cognitive capacity required to make and communicate healthcare decisions. By the time a crisis occurs, it may be too late for the person to explain what quality of life means to them or which interventions they would—or would not—want. That is why these decisions should be considered while we are healthy and able to make informed choices. Questions to consider include: What does an acceptable quality of life mean to me? Under what circumstances would I no longer want life-prolonging treatment? Would I want CPR, hospitalization, a ventilator or a feeding tube? How do I feel about antibiotics and other treatments during advanced dementia? What would I want if I could no longer recognize my family, communicate or care for myself? W

When a family hears the words “hospice care,” they often believe hospice will come into the home and provide all the daily, hands-on care their loved one needs. Sadly, that is not how home hospice usually works. The word care means providing what someone needs for their health, comfort, safety, and well-being. It sounds like someone will be there doing the caregiving. The word consulting means giving expert advice, teaching, guidance, and support. That is much closer to how routine home hospice works. The hospice team checks on the patient, manages symptoms, orders equipment and medications, answers questions, and teaches the family what to do. But in most cases, the family provides the daily care between hospice visits. In this episode of Ask a Death Doula, Suzanne B. O’Brien, RN, shares what she learned while caring for more than 1,000 patients at the end of life. As a former hospice nurse, Suzanne often had about one hour in a patient’s home. During that visit, she had to assess the patient, review medications, manage symptoms, teach the family, answer questions, calm fears, and explain what might happen next. Then she had to leave. The family stayed—and they were often frightened, overwhelmed, and unprepared for the care they were expected to provide. This is not a criticism of the caring nurses, aides, social workers, chaplains, and other professionals working in hospice. They are doing important and sacred work. This is about a healthcare model that families often do not understand until they are already in a crisis. In This Episode, You Will Learn: What the word care leads families to expect Why consulting may be a clearer description of home hospice What hospice provides—and what it usually does not provide Why families often enter hospice without enough time to prepare What Suzanne experienced during her years as a hospice nurse Why family caregivers need education before a crisis How learning the three phases of end of life can reduce fear Why caregiving should never fall on one exhausted person How we can return end-of-life care to families and communities What Families Need to Know A person can qualify for Medicare hospice when a doctor believes they may have six months or less to live if the illness follows its normal path. Yet the median hospice stay was only 19 days in 2024. This means half of hospice patients received hospice services for 19 days or fewer. In 2024, hospice patients received an average of 3.9 in-person visits per week. Those visits totaled about 3½ hours of hospice staff time each week. There are 168 hours in a week. Who is present during the remaining hours? Usually, it is the family caregiver. Hospice is a vital part of the care team—but hospice alone is not a complete caregiving plan. We Used to Know How to Do This One hundred years ago, caring for someone at the end of life was a skill passed down from grandmother to grandchild. Families understood how the body changed. They knew how to provide comfort, gather support, sit with someone who was dying, and create meaningful rituals. Death was not carried by one person. It was held by the family and the community. We have not lost our ability to care. We have lost the education and community support that once showed us how. There Is a Better Way Doulagivers Institute was created to fill this education gap. The free Level 1 Family Caregiver Training teaches the three phases of end of life in clear, simple language. It helps families understand: What changes they may see Why those changes are happening What they can do to provide comfort When they should call for help How they can create a peaceful and sacred space This education can reduce fear, build confidence, support healthier grief, and help families understand that the natural dying process is not a medical failure. The training is free and available in 15 languages because every family deserves access to this knowledge. Do not wait until someone you love is actively dying.