Colorado now has more options available for care at end of life than ever before. The vast array of options allow for more personal choice during the final days of life, as well as for funeral and body disposition. Every option available may not be right for you personally, but knowing and understanding your options will help you make the best choices for you and your loved ones.

The need for end-of-life doulas

Many people are familiar with hospice care for the terminally ill. Although hospice services are immensely helpful, there is a gap between what hospice can provide and what the dying person needs to successfully navigate the end of life. This is where end-of-life doulas, or death doulas, come in.

End-of-life doulas are non-medical support for the dying. They are not a replacement for hospice, but are in addition to hospice to help fill the gap. One of the major gaps in hospice care today is the limited time hospice workers are allowed to spend with patients. End-of-life doulas are able to provide the time for additional care, such as offering emotional and spiritual support and companionship, serving as a liaison for the care team, completing a life review, creating legacy projects, developing a vigil plan, providing respite care and sitting vigil, just to name a few. Some doulas also serve as home funeral guides to help families and communities who wish to care for their own deceased at home, as was both custom and tradition years ago.

Each end-of-life doula brings their own unique skills, experience, and talents to their work. Thus, no two doulas are alike. In searching for an end-of-life doula, it is recommended that one interviews several doulas to find the one that best fits.

Additional autonomy options at end of life

Choice in care is one way to exercise autonomy at end of life. Another is in making personal decisions about when and how one’s suffering will end. Colorado’s End of Life Options Act went into effect in early 2017, allowing the terminally ill access to medication to end their suffering peacefully and on their own terms. Since then, hundreds of terminally ill patients have been prescribed the aid-in-dying medication, even though barriers to access remain problematic for many people across Colorado. The need for education still exists around this option to help those who want access.

Another available option is called Voluntary Stopping Eating and Drinking, or VSED. This process falls under the terminally ill person’s legal right to refuse medical care, which includes nutrition and hydration.

For both the Medical Aid in Dying and VSED options, it is best if one has an experienced support system of hospice workers and/or end-of-life doulas to safely carry them out.

Choices for body disposition

Colorado is at the forefront in terms of options available for body disposition. No longer are embalming with interment or fire cremation the only two options. The desire for more environmentally friendly ways of final disposition have given way to more sustainable methods. Colorado now has alkaline hydrolysis (aka water cremation or aqua-cremation), natural organic reduction (aka human composting), and a dedicated green burial preserve.

The most important thing to realize is that you have choices available and knowing your options will help you make the decisions that honor your own personal wants, needs and desires at end of life, as well as knowing you can make your last act on earth a kind one.

Cindy J. Kaufman, MEd, EdS is president and co-founder of Colorado End-of-Life Collaborative. To learn more contact 720-989-1929, cindy@coeolcollaborative.org or visit coeolcollaborative.org.

This column is hosted by the Seniors’ Council of Douglas County. Please join us for our next virtual online presentation May 5 at 10 a.m. Cindy J. Kaufman will be our presenter and provide an overview on end-of-life care. For more information, please visit www.MyDougCoSeniorLife.com, email DCSeniorLife@douglas.co.us or call 303-663-7681.