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She's a doula on the other end of life

Woman lends expertise to those facing hospice care

Allison Ronning gets some confused looks when she tells people she’s an end-of-life doula.

“People are like, ‘oh, you help birth babies,’ and I explain that I’m on the opposite end of that,” she said.

By definition, an end-of-life doula assists in the dying process, in the same way a midwife or doula does with the birthing process. Both a birth or end-of-life doula can serve somebody in their home or in a hospital.

“I know death is not an easy topic. Life is messy. Death is messy,” Ronning said. “But it’s something that we’re all going to go through. Whether it’s watching people we love pass away or when it is our own time.”

Ronning offers a range of services, from helping someone determine and write advance health care directives, to counseling people who have just been given a terminal diagnosis, to assisting families and people in hospice with everything from questions about care to what she calls legacy projects that one leaves behind for the next generation. She can act as a bridge between patient and family and medical professionals, asking questions, using her own experience to find solutions that might not require medication.

The care or guidance she provides is tailored to the situation, so it changes with each new person or family.

“If I can serve people in their own homes — where they’re most comfortable surrounded by their family and friends and their stuff and their pets — that can be really powerful,” she said in an interview earlier this month.

Getting here

Becoming an end-of-life doula was not a job Allison Ronning planned for. It was the result of trauma: she lost both her mom and dad within a year of each other.

While Ronning has nothing but praise for the hospice program and its nurses, there were gaps, questions, things she didn’t know because she’d never gone through an experience like that.

“I thought with hospice we were going to have somebody come in every day, we were going to have constant, consistent contact,” she said. “And I learned throughout my schooling that hospice nurses, God bless them, have specific duties.

They’ve got a number of patients they have to see a day in a week. And so rather than seeing my mom or my dad every day, they were able to see them maybe once or twice a week.

“So I didn’t have that kind of confidant, that person to kind of cheer me on, tell me ‘this is tough but we can do this, though.’ There was never a time where I could have someone help me breathe through it and do the planning and do the supportive stuff. That would have been really amazing.”

As an end-of-life doula, she can be a bridge, a cheerleader, and the wise auntie who’s seen this before, who knows just how to move someone to make them more comfortable, or start that uncomfortable conversation that needs to happen.

“I realized I can’t change my experience with my parents, but I can certainly take my experiences and look forward and support families and patients moving on,” said Ronning.

Within a year of her father’s death, Ronning left a 16-year job as a counselor at the Minnesota Sex Offender Program to become a care consultant and end-of-life doula. Her experience as a counselor also informs her doula care: she can help someone work through getting a diagnosis, learning their parent is dying, or resolving conflict so they can really say goodbye.

Ronning’s fellow therapist, Cyndi Richardson, knew Ronning well and said she wasn’t surprised to see her friend chart a new path.

“When she lost her parents, I really saw her leaning into that reality that our time here on Earth is so short,” she said. “She wanted to really honor that in the work she did. Being there for someone to help them, and their loved ones, is the perfect role for her.”

Richardson said she couldn’t think of anyone she would want more than Allison when her time comes because she brings such warmth, calm and grace to every situation, a feeling of safety.

She also pointed out that while the end-of-life doula feels like something new, people have been filling similar roles for a very long time.

“The profession is not new, people have just forgotten,” Richardson said. “I love that she is able to remind people that this is what it’s supposed to be like.”

No referral needed

All a person or family has to do to hire Ronning is call or email. She begins the process with a free consultation, to find out a person’s story and what they might need. However, her services aren’t free and, at this point, they aren’t covered by insurance. She’s hoping that will change.

“It is all private pay because right now it is not governed by state or federal regulation,” Ronning said. “I’m really happy that hospice is covered by insurance. That’s just such a necessity. But I also like to believe that end-of-life doula work is a necessity and can be extremely beneficial.”

She charges $40 an hour for end-of-life doula services, and $100 for the advanced health care planning services she offers. That is usually a much shorter contract.

“That’s generally the timeframe where we get the paperwork together, we make sure that you’ve talked with your family that you’re on board with what your wishes are, what your desires are,” Ronning said. “When you do a health care directive, you get to decide. … it takes such a burden off of the family because they don’t have to decide to stop the medications, or take someone off a machine.”

Doula care and support can last a few days into months, depending when she gets the call and what kind of end-of-life process the person is experiencing. She can work with people from the moment they receive a terminal diagnosis through the end; she can work with families, she can be with those who have no one to sit with them.

After death

Ronning’s services don’t have to end with a person’s passing. She can help care for a body after death, using dry ice to preserve it, undressing and bathing the person, wrapping them in whatever clothing or shroud they have chosen. Or she will just sit with a family and let them have that space.

“I really am there to support people and say, there is no rush,” she said. “There is no emergency. There are no more doctor’s appointments. This is your moment to spend with your person. That is sacred time that you don’t get back after the hustle and bustle of asking outside people to come in.”

She also offers bereavement care afterwards, checking up on loved ones, making sure they have the resources they need.

Ronning is spiritual, but doesn’t advocate for a particular faith tradition, she said.

“It’s really about honoring them at the very root of themselves and not being so concerned with what faction they belong to, because death knows no bounds,” she said. “Death happens to us all, so why not serve everyone?”

Want to know more? Call Ronning at 218-393-4734 or search for Soulfeggio on Facebook.

How end-of-life doulas serve:

-Provide the opportunity to speak openly and frankly about dying;

-Talk about creating an advance care directive;

-Explore the meaning of the dying person’s life and legacy;

-Discuss and support end-of-life care planning;

-Develop a plan for how the space looks, feels and sounds;

-Incorporate traditions or create new rituals to mark special moments;

-Encourage appropriate ways of touching the dying person;

-Bring a focused and intuitive presence to the bedside;

-Assist with physical and practical care to ease the burden on caregivers;

-Provide respite for exhausted caregivers;

-Explain the signs and symptoms of the dying process;

-Process the emotions and experiences with loved ones;

-Support the spiritual practices of all involved;

-Guide people through the early stages of grieving.

~Courtesy International End-of-Life Doula Association

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