Death Doula Glossary

As if death weren’t already complicated, the legal and technical language we use to describe it often creates confusion. Here’s a breakdown of some of the common terms related to death, grief, and wrapping up affairs.

Active Dying: The hours prior to death.

Advance Directive: Tool to lay out the type of care you would like to receive in the event of a serious illness or terminal diagnosis. It also outlines who should make decisions for you in the event that you can no longer make decisions for yourself.

Anticipatory Grief: The grief before a death occurs. Caregivers often experience anticipatory grief, grieving the future loss of a person and also the loss of dreams, physical and mental abilities, etc.

Aquamation: Also known as alkaline hydrolysis and water cremation. This method of body disposition uses about 5-10% of the energy that traditional cremations use. The body is placed in a stainless steel tube with potassium hydroxide and water for about four hours. The muscles, skin, tissue, and fat dissolve in the solution and all that remains is a skeleton. The softened bones can be ground up and given back to loved ones if desired.

Bereavement: The period of grief after a death.

Death Doula: Someone who provides non-medical deathcare: They provide dying people and their loved ones with practical, emotional, and spiritual support. They also work with healthy people to create end-of-life plans.

End-of-life Plan: A comprehensive document that includes healthcare decisions, financial information, body disposition plans, legal documentation, emotional, spiritual, and practical considerations. A thorough plan will help provide clarity about end-of-life wishes.

Embalming: A process whereby the body is relieved of its natural fluids and injected with preservation chemicals in an effort to slow the decomposition of the body. Embalming is not required by law.

Euology: A speech during a funeral or celebration of life that honors the deceased. Often highlights characteristics of the deceased person, cherished memories, and accomplishments.

Green Burial: Green burials do as little as possible to interfere with the natural decomposition of the body. Bodies are buried either naked, shrouded in natural material, or in soft wood boxes or cardboard boxes. Bodies cannot be embalmed before burial or buried with anything that is not biodegradable. Graves may not have markers, in which case loved ones are given GPS coordinates if they would live to visit the site.

HIPAA: Health Information Portability and Accountability Act. Death doulas are ethically bound to comply with HIPAA to keep clients’ medical information safe.

Home Funeral: A way to honor a dead loved one in someone’s home. They can allow time for loved ones to care for a body and say goodbye as well as incorporate cultural practices. They can be big parties with food and music or simple gatherings. They can be a much more affordable alternative to traditional funerals.

Hospice: A theory of care that moves from curative (attempting to cure) to comfort-based. Hospice care can be received at home, at a care facility, or an otherwise specified location. The goal of hospice is to provide comfort. To qualify for hospice (covered by Medicare), a person must receive a referral from a medical team that notes a life expectancy of six months or less. You can graduate from hospice after six months and re-enter with referral.

Imminent Dying: Hours or minutes prior to death.

Legacy: We all leave something behind when we die, whether it’s the story of our lives, our work, our children, or our material possessions or finances. Most of us desire to be remembered in a specific way. Legacy work can help contextualize or celebrate your life long after you’re gone.

Last Will and Testament: A document that lists property distribution after death.

Life Review: An interview, conducted a variety of ways, to help a dying person process a range of their memories. These can also be captured on film so loved ones can rewatch.

Life Support: The intervention of machines or medications to keep someone alive when one or more vital organs has stopped working.

Living Trust: A legal entity that is used to convey property while someone is still living. Many people set up a Trust to avoid the pain and expense of going through the Probate process. The Trust creator places assets in the Trust which can be used as needed.

Living Will: Outlines wishes for medical treatment that the Medical Power of Attorney should follow. The second aspect of an Advance Directive.

MAID: Medical Aid in Dying, also known as Physician-Assisted Death or Death with Dignity. Describes an assisted death through the use of medications from a physician. The process differs by state. MAID is not legal in the state of Missouri.

Medical Power of Attorney: Also called “Health Care Agent” or “Durable Power of Attorney” depending on the state. The first aspect of an Advance Directive that names someone to act on another’s behalf when they are not able.

Natural Organic Reduction: Also known as human composting. Uses about 1/8 of the amount of energy of traditional burials and cremation. Decomposition takes place inside a modular, reusable vessel. Bodies are covered with wood chips and straw and aerated over a period of roughly 30 days. This process results in about one cubic yard of soil that can be used to grow new life.

Palliative Care: An umbrella term for care that treats symptoms, pain, and the stress of a disease. The goal of palliative care is to improve quality of life. You can receive palliative care while on hospice.

POLST Forms: Physician Orders for Life-Sustaining Treatment. Doctor-ordered instructions filled out by a doctor and patient to ensure that the patient’s preferred medical treatment is received.

Probate: The legal process by which a decedent’s will is processed in court.

Respite Care: Available when the primary caregiver needs relief. The patient is transferred out of their home to an inpatient facility with a medical team.

Rigor Mortis: A natural bodily process that includes the stiffening of muscles after death. Rigor mortis generally sets in 3-6 hours after a death. If you need to work with a body that has stiffened, you can massage it until it becomes flexible again.

Ritual: A practice that marks and honors the end of life. Rituals can include existing religious traditions, creating new symbolic practices, using elements and objects, and reflection. The point is to create a shared experience that you can come back to to remember and honor someone’s life.

Small Estate Affidavit: If your estate is valued at less than a certain amount, it is possible to skip the Probate process by using a Small Estate Affidavit. The threshold in the state of Missouri is estates valued at less than $40,000.

Vigil: The time we spend watching over a person who is actively or imminently dying. Often called the 11th hour. It is important to note that some people don’t want to be alone while dying and others will wait until they are alone to die.

VSED: Voluntary Stopping of Eating and Drinking. VSED is legal in the United States and includes voluntarily stopping consumption of all food and liquids. People with terminal diseases may choose VSED so dying will not be prolonged.