When Love Masks Need

palmquistdeathdoul
May 6
4 min read

Funny thing about your phone ringing in 2026—most of the time, you already know who it is.

Caller ID. Saved contacts. A quick glance, and there’s no mystery left.

Almost no surprise.

Until today.

An unrecognizable number. Mid-morning. An interruption.

I answered anyway.I always do.

I’m a death doula—and death rarely announces itself politely. It arrives more like an unknown caller: uninvited, unavoidable, and often, urgent.

“Carey?” she asked. Her voice was steady, but carried an edge.

“This is Carey.”

“My friend is dying.”

No easing into it. No buffer.

“She was diagnosed with pancreatic cancer not long ago. It’s moving fast. We’re… overwhelmed.”

“I’m so sorry,” I said. “How can I help?”

What followed was a conversation woven from urgency and care—questions, observations, fears. She was thoughtful, informed, prepared in the way people get when they love someone deeply and know time is short.

She had done her homework. On cancer. On pancreatic cancer. On timelines. On what to expect.

And still—she was searching for something more.

“Here’s my problem,” she said. “Her husband is in denial. But she’s been clear—she wants a death doula. She wants help walking through this.”

We talked through what that could look like. Support. Comfort. Presence. Planning not just for death, but for the days leading up to it—the living that still happens at the end.

When we hung up, she was crying. Not just from grief, but from relief. She had done what her friend asked of her.

I was to wait for the husband’s call.

I waited two days.

With pancreatic cancer, two days is not just two days.

So I called her back.

“I haven’t heard from him,” I said. “How is your friend?”

Her answer landed heavy.

The husband had decided a doula would be an intrusion. A stranger in an intimate space. Something unnecessary.

He would handle it himself.

He didn’t just decline support—he closed the door. To me. To her friends. To the circle of women she had asked to be there with her.

Women who were ready to sit vigil. To witness. To care.

To love her through the end of her life.

As doulas, we center the autonomy of the dying.Their wishes. Their voice. Their version of what a “good death” looks like.

And while I have no doubt this husband loved his wife, love alone doesn’t always protect someone’s final wishes.

In this case, it overrode them.

Her carefully considered decisions—about how she wanted to leave this world—were quietly set aside.

And we will never fully know what that cost her.

This is the part that stays with me.The part that aches.

Because planning for the end of life isn’t something to wait for when things fall apart. It’s something to claim while you still have the clarity, strength, and voice to do so.

Bringing in a death doula early—while you’re healthy, while you’re planning—isn’t morbid.

It’s wise.

It’s no different than a 401(k). A plan. A safeguard.

An investment in a death that reflects you.

I spoke to her friend again after it was over. She was angry. She was heartbroken.

Because she never got to say goodbye.

As we ended the call, she said something I won’t forget:

“My failure to keep my promise will haunt me for the rest of my life.”

What A Death Doula Does

A death doula provides non-medical support to people who are dying and their families. Their role includes:

Offering emotional and spiritual comfort
Helping with practical tasks like planning and organizing
Facilitating conversations about wishes and fears
Supporting family members through grief and decision-making

Unlike medical professionals, death doulas focus on the holistic needs of the person and their loved ones, ensuring dignity and respect throughout the dying process.

The Emotional Toll of Not Having a Death Doula

Without a death doula, families often face overwhelming emotional challenges alone. The absence of this support can lead to:

Increased anxiety and fear for the dying person and their family
Feelings of isolation and helplessness
Unresolved conflicts or unspoken wishes
Difficulty processing grief during and after the death

For example, a family may struggle to communicate openly about end-of-life preferences, leading to confusion or regret later. A death doula helps create a safe space for these conversations, reducing emotional burdens.

Practical Challenges Families Face

End-of-life care involves many practical decisions and tasks. Without a death doula, families might encounter:

Difficulty coordinating care and managing appointments
Overwhelm from legal and administrative paperwork
Lack of guidance on comfort measures and rituals
Missed opportunities to create meaningful memories

One family shared how they felt lost managing medication schedules and coordinating hospice care without extra support. A death doula could have eased these pressures by providing clear guidance and hands-on help.

How a Death Doula Enhances Quality of Life

Hiring a death doula can transform the dying experience by:

Promoting peace and acceptance for the person who is dying
Helping families focus on connection rather than logistics
Encouraging meaningful rituals and legacy projects
Supporting spiritual or cultural needs that medical staff may not address

For instance, a death doula might help a person create a memory box or facilitate a final conversation with loved ones, enriching the time left.

The Cost of Missing This Support

Choosing not to involve a death doula can have lasting effects beyond the moment of death. Families may face:

Prolonged grief and complicated bereavement
Regret over missed opportunities for closure
Increased stress and burnout among caregivers
A sense that the end-of-life experience was rushed or impersonal

These consequences highlight the value of comprehensive support that addresses more than just physical care.

How to Decide If You Need a Death Doula

Not every family will choose to hire a death doula, but considering these questions can help:

Do you feel overwhelmed by the emotional or practical aspects of end-of-life care?
Are there unresolved conversations or wishes that need attention?
Would you benefit from someone who can guide you through rituals or legacy work?
Do you want to ensure the dying person’s comfort beyond medical needs?

If the answer is yes to any of these, a death doula can provide essential support.