A Day In The Life Of An End-Of-Life Doula

The UK is in the grips of a mental health crisis. Even before COVID-19 shattered our support systems, and overwhelmed an already struggling NHS, things were bad. What we’re less aware of though, is who exactly has been bearing the brunt of this crisis. Beyond the statistics, and the petitions, and the Parliamentary debates, who are the people moving the needle each day, helping to turn the tide one person, one phone call, one conversation at a time? We wanted to find out. To mark Mental Health Month 2021, we asked four people from different mental health care professions to walk us through a typical day on the job. Here, an end-of-life doula lays out a recent working day, and shares how she looks after herself while also looking after others.

No one likes thinking about death, let alone talking about it. But, thank goodness for Anna Lyons. Together with progressive funeral director Louise Winter, Lyons set up and runs Life. Death. Whatever, an initiative that aims to reimagine our (very difficult) relationship with death and dying. What started as a ground-breaking festival in partnership with the National Trust has evolved into TED talks, countless podcast appearances, talks across the country, consultancy, and most recently a book, We All Know How This Ends. However, the bulk of Lyons’ work is as an end-of-life doula, supporting people who are living with serious illness, their family and friends, and people living with grief.

“It is a fairly new profession,” she explains, “so it is completely unregulated.” Dignity in death and quality of life are two guiding principles in Lyons’ work. “I believe proper and supportive end-of-life care should be completely inclusive, and available to everyone,” she adds.

As it currently stands, that isn’t the case. So, Lyons does what she can – which is a lot. Here, she runs us through a recent day in her life: caring for clients, looking after her daughters (she’s a single mother of three), running Life. Death. Whatever, and promoting her new book.

April 20

6:45 a.m. My alarm goes off first, but Peebs – our one-eyed Shichon – is the first to rustle. Mornings are loud and a bit chaotic, so we have a checklist to make sure no one forgets anything. I sneak into the bathroom first, before heading downstairs to start on breakfast and packed lunches. Slowly, the girls join me in the kitchen. We play ‘riddle of the day’ on Alexa during breakfast, while Peebs sits under the table hoping to catch dropped crumbs, even though she's always the first to be fed.

7:45 a.m. My middle daughter sets off, and my youngest and I follow shortly after. (My eldest is currently studying at London College of Fashion, so isn’t around as much.)

8 a.m. Hand-in-hand, my 10-year-old and I wander over slowly to school. Each wearing an airpod, we listen to music together as we walk. “Party in the USA” and “Sunny Afternoon” by The Kinks are regulars, but today we’re listening to Adele and Mary Beth Maziarz’s version of “Daydream Believer.”

It’s moments like this that remind me of my friend – palliative care nurse Kimberley St John, who died recently – and what she called morbid gratitude. It’s the little moments in life – like holding my daughter’s hand as we walk to school, or walking around the park with Peebs – that really nourish me.

8:30 a.m. School run done, Peebs and I are off to the park. Often, I’ll meet a friend, too. Many of my friends got lockdown puppies, which means Peebs now has lots of friends to play with. My friend Ella and I have even bought our dogs matching velvet collars.

Spending quality time like this with my friends is my take on self-care. I don't know how people manage to fit in three hours of yoga and meditation, and all of those things; I have three girls, and clients to care for, I’m on my own, there's just no way that I could fit that kind of thing in. Instead, I treat our daily walks as my kind of meditation.

Spending quality time like this with my friends is my take on self-care

9:30 a.m. Back home, and the work begins. Pre-pandemic I would have been travelling around the city, getting from one appointment to another, but I do most of my work remotely now. It’s ironic, because I’m not a fan of being on the phone, and yet, here we are.

Today, I have to call three different hospitals for three different clients; talking about potential admissions, what is happening with certain tests or results; just getting some clarity for them. I thought this would take an hour or two, max, but it ended up taking much longer. I had to call one place about 10 times before I got through to someone who could help. I didn’t have the name of the doctor I needed for another call, and that delayed things also.

Information gathered, I ring my three clients to pass on the updates, discuss what they want to do next, and make notes necessary to start on those tomorrow.

1:30 p.m. I've had a few potential new clients get in touch. Mostly, people get referred through an internet search or Instagram, but I also get people who found me through the book, which still blows me away. Over the years, I've learned that I'm not always the best person to help, and I’ve learned how to say no. That is another form of self-care: saying ‘I can't take this on right now’ when I’m at capacity. It is a constant consideration in my work, and in my weekly supervision sessions. Instead, I refer these potential clients to others who can help.

2 p.m. Finally breaking for a quick lunch. Bagels – toasted sesame with cream cheese, especially from the B Bagel Bakery Bar in Soho – are my fave.

2:30 p.m. Pre-pandemic I had a childminder, which meant I could work longer hours in the day, but that’s now changed. At least homeschooling is over, because that made for very interesting – and not particularly productive – times. I run out to collect my youngest, and we return around the same time as my middle daughter gets back.

We often head to Telegraph Hill park after school, and I do circuits with Peebs while the girls play with their friends. I’m so looking forward to being able to have their friends over at home after school again. It’s been such a strange time for them, and it’s important to have some sense of normality back.

4 p.m. Back at home, the girls start working on their homework, while I think about mine. Louise and I are preparing a talk we are doing for BrumYODO, a Birmingham-based community group, about the book. We don’t like these talks to feel like we’re lecturing, so we’re thinking of ways to navigate that. I know I’ll need to return to it later.

5:30 p.m. Dinner time. Once a week we have a food challenge night, where someone picks out a type of cuisine as a theme, and then we make four different dishes from scratch that we rate out of 10. We had a really good time trying to make our own sushi recently, and our Greek food challenge was a runaway success, especially the pitta breads we kneaded together.

Sometimes, my middle daughter will read us a story while we cook. She’s reading the Noughts & Crosses series at the moment, but Holes is her absolute favourite. She has different voices for all the characters.

We always eat dinner together around the table, checking in about each others days, and how we are all doing. I can usually be persuaded to go and get a gelato from Oddono’s in East Dulwich, but today I need to get some writing done.

7 p.m. Evenings are varied, but I’ve spent a lot of time writing while the girls choreograph dances or watch some TV. They’re just finishing Dawson's Creek, and though they are desperate to watch Wild Child, so far I’ve not given in. They might watch an episode of Adventure Time – our dog is named after one of the main characters, Princess Bubblegum.

While they watch TV, I work on an article I’m doing for a Sunday newspaper about grief. Tomorrow, I have a podcast to record for the U.S. book launch, and I consider whether – given as it will be bedtime by the time I do it – if I can record it in my pyjamas…

10 p.m. I try to get to bed early, but invariably I end up chatting to my BFF for a little longer than my bedtime. Locking the door before bed is a little ritual of mine; the last thing I do before going to bed, which I love. It’s like I’m shutting the world out at the end of the day, and keeping the girls safe.