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As death discussions become less taboo, end-of-life doulas become more popular

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NAMPA, Idaho — It’s hard to talk about death, especially when it’s your own. It’s especially hard to do it in a room of people you’ve never met.

But Karen Midlo, Tara Marie, and Joe Morcomb are doing it, along with a dozen others, in a conference room in Nampa, Idaho. No one in the room is actually dying. They’ve been asked to act as if they have three months to live while the person across from them tries to help.

They are three hours into three days of training to become end-of-life doulas.

"These are times of transition, and that's what doulas are all about," said Kris Kington-Barker. She leads trainings for the International End-of-Life Doula Association, or INELDA. They train 1,200 people a year to guide patients and their families through a scary, often unknown process.

“We have a lot of gaps in our health care. We have things like hospice, hospitals and home health, but they all have spaces in between where people fall into gaps,” Kington-Barker said.

In one survey, nearly half of Americans said patients have too little control over end-of-life medical decisions. In another survey, more than a third said they’d given a great deal of thought to their end-of-life care. That was up 9% from a generation before. Nearly half said they’d experienced death up close, through the terminal illness of a close friend or relative.

It’s those experiences and others that Midlo, Marie, and Morcomb share upon meeting.

“Families seem to think that they don’t have to come up with a plan for when someone dies," Midlo said, "or that they’re not going to die.”

“It’s like the big elephant in the room, and we want to deny that it’s actually happening rather than honoring it the way we would honor the birth of a child,” Marie added.

But perhaps the conversation is becoming more open. And just as there are birth doulas, now there are death doulas. There is no government or industry standard for certification. But programs like INELDA’s offer rigorous training on how to engage, facilitate, and, above all, listen.

“Dying is a time for people to reflect on their truth. My truth doesn’t matter,” Kington-Barker said, “A lot of us are people who want to make people feel better. We want to make their lives better. And you can’t fix dying. You just can’t.”

It’s all part of being unafraid to look in the eye on a subject too often pushed to the side.

“They don’t show up because they’re afraid of coming too close to this topic," said Kington-Barker. "They show up here because they’re ready."