Judith Arasi
Patient and Family Service
Compassus Hospice, North Andover, MA
Recipient of the National Hospice Volunteer Award
Judith Arasi always felt like she was a natural caregiver with the desire to develop meaningful relationships with those around her. After retiring early from a 25-year career in dental office management, she was searching to fulfill her life’s purpose. Judi’s mother- in- law had passed away a year prior with the support of Compassus Hospice. She was so impressed with their amazing support that she decided to begin volunteering her time with them as a Patient Companion. It was there that she quickly realized this was the path that her life was meant to take.
In the five years that Judi has been volunteering, she has learned that the most important gift you can give a patient is your time. She is passionate about being “in the moment” with her patients, learning about their lives, and understanding everyone is a unique individual with different needs. She considers her patients to be her friends, and looks forward to spending time with them. Whether it’s reading a book, sharing a favorite snack, listening to music, recreating an activity from the past that brought them joy, or simply holding hands with them, she has learned that the smallest gestures can make the biggest impact. She feels that it is an honor to be invited into one of the most sacred times in someone’s life, and is fortunate to be able to accompany them on their journey.
The 2023 Volunteers are the Foundation of Hospice Awards were sponsored by the Furst Group and NuBrick Partners
An end-of-life doula can provide support for both patient and family
Judi Arasi walked Winnekenni Park with her dog, Chesney, to find peace in nature. She started a new career two years ago as an end-of-life doula after volunteering for hospice for five years. She will host a presentation at Haverhill Public Library on March 9 at 6:30 pm. You can register for the event at the library’s website, haverhillpl.org. Haverhill Life photo by Alison Colby-Campbell
Making connections with and showing compassion for older adults has always come easy for Judi Arasi. Her compassion was evident when, as an 11-year-old child, she would sit with a neighbor’s infirm grandparent, when a patient would forget to pay their bill at the dental practice she managed for 18 years, and when she’s with Chesney, the rescue dog she adopted from Nevins Farm 12 years ago.
Identifying a career that was an ideal fit for this virtue took decades, but when Arasi became a hospice volunteer at Compassus Hospice Care in North Andover, her direction became clear. Eventually she learned of a relatively new field: the end-oflife doula.
Compassus Hospice Care serves all of Essex and Middlesex counties. In her five years with the service, Arasi has served more than 50 patients and made hundreds of visits. “Judi has a special gift,’ said Compassus volunteer coordinator Kim Iannacci. “She can sense what people need at the most vulnerable time of their lives. She sees beauty in everything, even in what others find hard to bear and talk about. She comes without a personal agenda and listens and observes intently to find ways to individualize the care and comfort patients need but might not be able to articulate. I don’t know how else to say it but that Judi has a gift from God. She is so in tune with her patients that we actually have her training new volunteers to share her knowledge and provide them with a realistic view of what life as a hospice volunteer is about.”
Iannacci believes that being a doula is a good fit for Arasi. “Judi brings her whole heart and soul to people at the end of their life,” Iannacci said. “She listens to and addresses their needs either personally or by bringing in others, whatever it takes to help them achieve their final goals and wishes. I think of her doula role as being a concierge.”
The term doula was coined in 1976. It derives from the ancient Greek word meaning woman servant. While most doulas in the United States help with childbirths, an emerging branch of the practice seeks to aid patients and their families as the patient is dying.
“In our area, there are all sorts of people who help bring new life into the world but not nearly as many to help normalize and support patients in a non-medical, non-clinical way at the opposite end of that spectrum,” said Arasi.
Arasi is a proud advocate of hospice, but, she says, doulas provide the “gift of time.” They are not covered by insurance, so they are not subject to time constraints. During the final days and hours, end-of-life doulas can be with a patient for as long as the patient or the family desires.
Becoming a doula is more of a calling than a vocation, said Arasi. There is no special certification or licensing required because end-of-life doulas do not perform medical procedures or administer medication. There are, however, organizations including the International End of Life Doula Association and the National End-of-Life Doula Alliance that offer training and resources. Arasi was certified through the Doula Givers Institute and the National End of Life Doula Alliance. She is certified in reiki, grief and bereavement counseling, dementia care, and medical aid in dying (which is not legal in Massachusetts). Doula Givers re- quires her to take regular courses to keep her certification current. As a hospice volunteer, Arasi is required to participate in regular dementia training.
Arasi believes the doula’s role is to be a guide, companion and educator about the physical and mental aspects of dying; to offer peace; and to assist in resolving issues that may have been part of the patient’s life. Doulas offer a supportive presence to the dying and their loved ones without judgment. They strive to honor the wishes of the patient, allowing them to maintain autonomy and control in whatever way they can. The main goal is to ensure a peaceful, comfortable and dignified end-of-life experience.
“Please remember that you only get one chance to assist your loved one at the end of life, and the goal is to help make it a peaceful and dignified journey for them,” said Arasi.
Recently, Arasi received a heartfelt note from a family she served. The family expressed their deep appreciation for the support their loved one and they received. “Kind gestures like that solidify that I have at last found my purpose in life,” said Arasi.
Arasi can be reached through her website, judiarasi.com. She will host a presentation about end-of-life doulas on March 9 from 6:30 to 8:00 p.m. at Haverhill Public Library. She accepts patients throughout the Merrimack Valley and abutting towns but limits the number of patients to provide the care each individual and family needs.
Because end-of-life doulas are part of an emerging field in New England, there are a limited number of practitioners in the area. To find one near you or your loved one, access one of the several doula directories including inelda.org, doulagivers.com, nedalliance.org.
UNDERSTANDING THE PROCESS OF DYING
Here are some things Judi Arasi would like people to understand about the end-of-life experience.
. People near death should be situated in a “sacred space” that can include soft music, soft lighting, and the loving touch of pets if desired.
. People will stop eating and drinking, which is natural. They are not starving to death; their bodies no longer have a use for food and beverages, and, in fact, having food or beverages foisted on them can lead to discomfort, choking and pneumonia.
. It’s not uncommon for people to think they are being visited by loved ones who have gone before them. If they ask whether you can see them too, the best advice is to be honest and say no while expressing happiness that the patient can.
. People on the cusp of death will start talking about wanting to go home. Most often that is not a physical space but an emotional one. It is okay to support them by packing a bag for them if it eases their agitation.
. Medication at this stage is for comfort; it will not hasten death.
. Sleep will increase to the point that a person is no longer conscious, but remember that sound and touch are the last senses to leave. Say the important things. Put a phone up to their ear so they can hear the voices of people who cannot be at their side. Share stories with dignity and discretion. Never say anything in front of the person that you would not say while they are awake. Personal care should be done in private.
. Breathing changes are not uncommon. There can be periods of long pauses or rapid breaths. Fluid may collect in the patient’s lungs and produce a rattle sound. These changes are natural and not uncomfortable for the patient. But simple acts such as elevating their head may help reduce the fluid collection in their throat.
. Give your loved one permission to go. Let them know you want them to be at peace. Not every patient is comfortable dying with loved ones around. Some will actually wait until everyone has left the room. If that is the case, and your loved one dies without you present, it was what they wanted and should not be a point of regret.
. When your loved one passes, take the time you need to begin processing your grief. Sit quietly, say your goodbyes, and let friends and family members know. There is no need to rush out of the hospital or nursing home. Take the time you need.
Judith Arasi - End of Life Doula 