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Everyone wants to be an end of life doula! The recent uptick in calls and emails from people who want to be death doulas or end of life educators or grief coaches says to me that people truly feeling called to do the work. Mostly because they have experienced a deep loss. Grief changes us. They are finding their way into and through and around grief.  They are still healing so they want to find a way to legitimately hang out in the end of life realm.  They have a lot to offer. I encourage them to become a hospice volunteer and sit bedside; to check out some of the end of life doula certificate programs; to immerse themselves in the many excellent books and films and podcasts on the topic. My friend and colleague, Gabby Jimenez, wrote this lovely quote about being a loving witness for someone who is dying or in grief. I hope it touches your heart as it does mine.

Thoughts on MLK Day, January 20, 2025 “My head is like a bad neighborhood, I would rather not go there." I have been meditating for 51 years and I still feel this way about my head, pithily captured so accurately by Jack Kornfield. Such a noisy mind I have!  So many awful and totally strange thoughts enter when I venture to sit quietly. Sometimes, lovely ones or clarity comes across the screen of my mind. Buddhists say this is the nature of the mind, and advise becoming curious and relaxing into the noise. Push nothing away. Welcome it all. Aspire for right word, thought and deed but let yourself be. Jewish ethics says its expected to have a less than stellar mind. It is okay to have impure, negative and bad thoughts, just don't act on it in word or action.  I would just like to sit quietly with a quiet mind today. It is an auspicious day. I am determined to stay clear and strong and not give into negative thoughts and future fears. I attended a zoom yesterday with Jon Kabat Zinn and Roshi Joan Halifax, two of my favorite spiritual teachers. Roshi read this quote in honor of Jon’s late father in law and my/our personal hero Howard Zinn:  "To be hopeful in bad times is not just foolishly romantic. It is based on the fact that human history is a history not only of cruelty but also of compassion, sacrifice, courage, kindness. What we choose to emphasize in this complex history will determine our lives. If we see only the worst, it destroys our capacity to do something. If we remember those times and places—and there are so many—where people have behaved magnificently, this gives us the energy to act, and at least the possibility of sending this spinning top of a world in a different direction. And if we do act, in however small a way, we don’t have to wait for some grand utopian future. The future is an infinite succession of presents, and to live now as we think human beings should live, in defiance of all that is bad around us, is itself a marvelous victory."

I am doulaing. As someone with a propensity for making nouns into action verbs, I am doulaing. That means that an extremely articulate and homeless woman with a chronic disease for 33 years has asked for help to find her resources for a dignified way to leave the world of the living. That means a man dying of cancer 3,000 miles away got my number from a mutual friend and called me to say he doesn't understand why he isn't well since he sees the light everywhere and feels jubilant. That means a woman who I know from my weekly, virtual Death Cafes for five years but have never met in person, joined me for dinner last week on her first tour of the west coast. That means that I am trying to find a cheap restaurant that will allow 25 local doulas to gather and dream together of that which we are building. That means that I am trying to find a way to offer my courses again through the Elisabeth Kubler Ross Foundation, knowing some of the administrative challenges we have while feeling the pull to teach. That means coaching a 75 year-old woman who took my class "End of Life Intentions for Dummies, Pragmatists and Seekers" and realized she needed to reboot for her 'third act' in life after healing from hip replacement, the loss of her wife and of her dog.  That means that I am filled with gratitude for my healthy 87 year-old client who wants to confess all his regrets and mistakes so that he can die in peace. End of life doulas do all sorts of things in all sorts of way to provide compassionate support, witnessing, guidance and education. The texture, the flow, the meaning-making, the rhythm of it moves all around. We move into it and through it and with it. We are doulaing.

Why do so many senior citizens think age 65 +- date?  We want love and intimacy! 36% of adults aged 65 and older report being single, compared to 29% of people aged 50 to 64, and 21% of adults aged 30 to 49. Dating is a huge business for people 65 years of age and up. They might find themselves single after a long term relationship due to divorce or death. They might have finally found their someone after many years happily single. Or they just may like dating. What is the unanticipated consequence of more seniors dating?  In the United States, the number of STIs among people aged 65 and older more than doubled between 2000 and 2022.  Furthermore, the rate of infection increased 23.8% for people aged 65 and older from 2020 to 2023.  According to Science of Health, here are some reasons for the rise in STIs amongst older adults: Older people may underestimate their risk and not take precautions such as condom use and STI testing before having sex with a new partner. Lack of concern about pregnancy also likely diminishes condom use. Erectile dysfunction drugs help more older men remain sexually active. Hormone therapy helps more older women remain sexually active. A larger number of older adults live together in assisted living facilities. Older people aren’t given STI education and it’s been many decades since they received any sexual health education. Older adults can have weakened immune systems. So, to all you 65+ out there, follow the late Dr Ruth's wonderful advice (she died in 2024 at 96 and had a glorious impact!), but be safe and smart! Get regular testing and protect yourself and others. #seniorcitizens   #healthyintimacy   #thirdactcoaching

Did you know that this holiday season there are more than 11 million widows and 3 million widowers?  Most are over 65 years of age.  Many are determining when is the right time to start dating again after the loss of their long time partners. They might worry about other people's judgments, especially their own kids. They always can count on their grief to accompany them through the rest of their days. The loss they have experienced, often after years of caretaking, maintains its size. But their own lives grow bigger around that loss.  Are they not entitled to their slice of happiness? Can we encourage them to live fully again? Can we be happy for new love?  As an end of life doula, I listen to many people's stories of losing their beloved partners, and their bravery in finding their way to a new life. They stay close to their deceased loved one. They relish so many past moments of exquisite tenderness. They allow themselves the sorrow. And they continue on. One step at a time. They go through the grief and the grief goes through them. This holiday season, here is to loving again after profound loss. Here is to life growing around the grief!

My confession about wanting people to just stop talking continues! I wrote a post two days ago, sheepishly expressing my sometimes-wish that people would stop talking. In other words, they would shut up. And the very next day, it happened again.  I had tea with a friend. Every time I started to speak to comment on a topic, my friend cut me off to rush in with his own experience. I didn't get to finish my sentence or make my point. I really felt like he was like a kid in a 4th grade classroom, waving wildly at the teacher, squirming restlessly in his seat, "Oh! Oh! Pick me! Pick me!" Except he didn't wait to be called on.  After a while, I noticed I was feeling overwhelmed and tired. He is a nice guy who is working to increase his self awareness. He doesn't get defensive and cops to his faults. I respect that.  Still, I didn't love the feeling of being emotionally hijacked. So I pulled up my big girl pants and asked him if we could take a pause. I told him I noticed he was interrupting me. "Was I boring you?", I asked.  "No", he replied. "I was excited to share how I related."  "Okay, great, but what would it be like to pause and let me finish my sentence?" "Oh, no problem, I can do that. Its just that we are in agreement on so many things." After he interrupted me three more times, I decided to try again. "Okay, but what would it be like to pause and just listen? Are you afraid you won't get a chance to share your experience if you wait a few seconds?"  "No, I just felt excited and I admit, kind of anxious. Let me try again."  "I would like to hear about the anxiety," I said. "I feel anxious about listening. Its hard to do." he admitted. "I love listening and suspending my own stories. What is hard about it? " I asked. "Well, then I have to really be there for someone else. Its not about me. I might mess up." "Oh. So you are afraid of not doing it right?" "Yes, mostly. But you love to listen and that is why you are good at being a death doula," he opined. Bless him!

I have to confess something. I am not proud of it: Sometimes I wish people would just stop talking already.  One of my favorite things in life is a great conversation with someone, where we are on the same wavelength, feel mentally stimulated, and are excited about the learning and growing we are exchanging. The conversation is just flowing and we feel alive and tingly. One of my least favorite things are conversations where that fails to happen. I am not talking about those times when we are in crisis and need to vent. Talking is therapeutic, a release, a discharge, and helps us find clarity. I definitely care about the people I talk with. They are lovely, possess outstanding character traits, and do their part to make the world a better place. But still. We are so media literate and know all about sound bites and fast-paced editing. The word 'montage' is in the common vernacular for decades now.  Maybe the problem is all mine. I was an editor for many years, after all.  Yet how many people consciously edit themselves?  Sometimes I feel guilty because I feel impatient with the amount of excruciating and extraneous detail I am hearing. There are alot of weeds and not much attention paid to editing the content to get to the 'point'. I even wonder if my presence is necessary to the other person. Sometimes I get frustrated when I bring something up to explore and before I know it, that topic has been 'hijacked', as my friend Ray calls it, and they are off on another self-referenced story about themselves. Sometimes I wonder if people are invested in what they are saying or are they just on automatic pilot to 'respond'? Of course, we relate each other's experiences to our own. That is natural. But are we obligated to report it? What if it is really not that relevant? What if it deflates the conversation? Can we acknowledge it to our own selves and sit on it for a moment?  Sometimes I get the feeling that they have stopped listening and are waiting for me to take a breath so they can jump in?  Here is an idea: What about pausing?  Seriously.  What if we just wait a beat? In that pause, in that space that was created by consciously waiting, perhaps we ask a question. Or maybe we entertain a new thought. Truthfully, sometimes I am the one I wish would stop talking. Sometimes I am horribly guilty of circumlocution. Here are the questions I try to remember to ask myself before I respond: Is it important to me to share my experience? Is my experience even remotely interesting to others? How can I best respond to what I have heard to further the connection?  This photo is a simple pneumonic that helps me.

Stand up if you are a Caregiver! Let me, let all of us, applaud you!  Family caregivers, those unpaid folks who are on 24/7 caring for their loved ones, are my heroes.  The husbands, the wives, the daughters, the sons, the partners, the sisters, the brothers, the granddaughters, the dear friends, we bow down to you! Caregiving is not only exhausting, overwhelming and isolating, but it can also lead to depression, extreme anxiety, illness, and brings risk for end of life. Our healthcare system does not, except in rare cases, support the caregiver. This is a tragedy. It is also an honor to care for our loved ones. Sometimes there is tremendous spiritual growth and acceptance and peace can flourish, amidst all the challenges of the job. As an end of life doula and a human being, I want to thank every caregiver from the bottom of my heart.  This holiday season, I hope you can get a massage, soak in a bubble bath, drink a glass of wine with a friend and laugh, have someone cook you your favorite food, and take a walk full of trees with changing leaves, birds singing and sunny, crisp temperatures.  I salute you! Gratitude!

My sister died with regrets. I don't want to. So I work hard on letting go of mine. I had regrets about my divorce and after 25 years my x husband and I spent a year, via email, unraveling what drove us apart and going through a sincere process of forgiveness.  I was motivated by the desire to not carry these regrets one day to my deathbed. I feel so free from those regrets now and I have forgiven and been forgiven. My regrets list is getting shorter and that feels good. Here are common regrets that people expressed on their deathbeds: “I wish I’d had the courage to live a life true to myself, not the life others expected of me.” “I wish I hadn’t worked so hard.” “I wish I’d had the courage to express my feelings.” “I wish I had stayed in touch with my friends.” “I wish that I had let myself be happier.” Do you relate to any of these regrets? What regrets do you have? Write them down now and give yourself some time to work through them and let go of them while time is on your side. You will be glad to lose them. I promise! Let me know how it goes!

Can you be 80 years old and planning for your next chapter of life? You bet!!! As a Third Act Retirement Coach and End of Life Doula, I am in the amazing position of receiving inspiration from people who choose to work with me. Like my 80+ year old client, who took my class, 'End of Life Intentions for Dummies, Pragmatists and Seekers', and decided she had planned plenty for her death. Now she wanted to plan for her life! She is healthy, widowed, childless and strong! She loves walking and music and naps. She is involved with different social and service groups. She studies and reads and pursues the life of the mind. Sounds good, right? She wants to become more intentional about her days. She wants to reach out to a few new people in her life and become more focused on what brings her joy. She wants to create more ease around navigating the pain in the butt grind of daily life.  She inspires me to no end. She shows up for life in such a full, sweet, charged way! What a model for the rest of us!  The whole point of planning for our death is that it truly does point us to the path of living fully. I feel so much gratitude to her. You go, girl!

53,000 Americans are expected to die from colon or rectal cancer this year . I usually write here on topics of death and dying. I don't usually write on diseases that can lead to death. But we know so much about inflammation leading to diseases, and in particular the relationship between dysregulation of the gut and disease. I just can't not write about this today. We can take the leap that an inflamed microbiome will result in problems downstream in the colon, or large intestine. Are you with me? Colonoscopies are widely used, but there is another option available: fecal tests. A colonoscopy is where a doctor inserts a colonoscope — a flexible tube with a video camera at the end — into the rectum and colon and looks for polyps and cancers to remove. The doctor may also take samples for study in a lab. If no polyps or cancers are found, the average patient can wait 10 years before having another colonoscopy. Fecal tests can be done at home. Patients collect a stool sample and mail it to or drop it off at a testing lab. The fecal immunochemical test, or FIT, should be repeated annually. A lab analyzes the sample for traces of blood, which can indicate a polyp or cancer. If blood is detected, the patient must have a colonoscopy. One study found that after 30 years, people who had fecal tests had a 33 percent lower death rate from colon cancer than people who were not screened. A 10-year European study of colonoscopy found a 30 percent reduction in the risk of getting colon cancer.  If one test is highly invasive with certain risks that are associated with inserting instruments into the body, and the other is simple and easy done in one's home, and both have about the same rate of success in identifying colon cancer, why isn't the fecal test considered best practice?  The answer, of course, has to do with profits. “Colonoscopy is a massive revenue generator for hospital systems,” said Dr. Adewole Adamson, of the University of Texas in Austin, who studies cancer screening. I have never had to drink that awful colon-clearing liquid on the day before a colonoscopy. I have never had a colonoscopy. I have never been wiped out for a day or two after a colonoscopy. Need I say more? I have had annual fecal tests for ten years. Ask your doctor about fecal tests.  Stop the madness!

People are writing their own obituaries before they die. There are a handful of common questions obituary writing guides often ask. But my favorite one is 'who will miss you the most'. I think of who I miss the most and by far it is my mom, with her unconditional, unwavering love. I try to give that to my kids and think they will miss having my love the way I miss having my mom's love. I miss her in a sweet, loving way. And that seems right, fair, in alignment with life's natural laws.  But I also miss Shauna, my college friend who was brutally raped and murdered by the Marin County Trail Killer way back in 1981. I miss her in a painful, gut wrenching way because she didn't get to live out her life because someone's sick and perverse will overpowered her beautiful and kind spirit.  Who else will miss me? I have a small group of people who I love very much and it is a toss up as to who will die before me. My partner and I talk sometimes about me dying before he does and I love his ideas for caring for me at the end. I am all for that.  But its the random moments of connections with people that I don't know well or even at all that I will miss the most; the person on the train who was reading about Nietsche, the student in my class, the auto mechanic, the cook at my favorite taqueria, the person in line next to me at Sprouts who also loves chai, the end of life client, my new doula friend. Its that chance to share kindness, love, or a closeness designed to remind us that indeed, we are all just walking each other home. I would love to hear, who will miss you the most?