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Death doulas are changing how the world and India approach dying: Why this end-of-life care is gaining attention

Death is a subject that most of us avoid talking about and want to brush under the carpet most of the time. But we often forget that all of us, our parents, dearest siblings, partners, friends, and every other being, are finite. In the vast ocean of death literacy, ‘death doulas’ are gradually bringing compassion, presence, and dignity to people’s lives. Recently, Hollywood actor Nicole Kidman revealed that she is learning and training to become a death doula after losing her mother, Janelle Ann Kidman, in September 2024 at the age of 84. During a HISTORYTalks event in Philadelphia, she shared, “It’s helping people in the end stage of life. It’s helping the families. It’s being present, impartial. I think it’s fascinating. It’s, it’s really fascinating, it’s very beautiful, and you have to be a certain personality to be able to do it, but I found out that I’m actually that personality.”

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.

She mentioned that people often suffer in the last few days of their lives. “There is always suffering in life, right? But if there are people there who can help with that and make those final stages less painful, you can feel the connection and the love, and that is a lovely thing to be able to do. So that’s what I’m exploring.”

She went on to share how death doulas are a “huge necessity” in modern life, considering longer life expectancies, loneliness, and the way in which “people are treated in (that) stage of life”.

Nicole Kidman lost her mom in October 2024 (Photo: Nicole Kidman/Instagram)

She is not the only one. Director Chloe Zhao admitted to training to be a death doula to help her overcome fears around death.

In most Indian urban households today, death has moved from the home to the hospital. Families dealing with a terminal diagnosis are managing medical decisions, financial strain, and their own grief all at once, often with no one guiding them through what is actually happening emotionally. “The dying person, meanwhile, is frequently sedated, surrounded by machines, and spoken about rather than spoken to. Death doulas are the ones who support the idea that how a person dies matters as much as the quality of care they received while living,” described Dr Chandni Tugnait, MD (A.M), psychotherapist, life alchemist, coach, and healer, founder and director, Gateway of Healing.

All the death doulas

Families are overwhelmed, doctors are focused on the clinical, and the person at the centre of it all is frequently left without anyone whose sole purpose is simply to be there with them, without an agenda, without paperwork, and without the need to fix anything. “This is the gap that death doulas step into,” mentioned Dr Tugnait.

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A death doula, sometimes called an end-of-life doula or death midwife, is a trained non-medical companion who supports a dying person and their family through the process of death. “Their work includes helping someone articulate what kind of death they want, facilitating difficult conversations between family members, holding space during the final hours, and guiding families through the immediate period after death. “They are not there to manage symptoms or administer medication. They are there to ensure that the experience of dying is humane, considered, and as closely aligned to the wishes of the person dying as possible,” said Dr Tugnait.

Udaipur-based Bhawna Jain was working as a nurse in oncology and used to see deaths from close quarters. After she left nursing, she started homeschooling her children, and it was then that she started reading more about death. “I started reading and started helping relatives and people on my own. We have midwives to support a mother and child, and we feel safe when someone is holding that space. Just like delivering a baby, the dying person also has a labour. So, I facilitate that space as a death doula, as a channel, from 2022 for active dying, which includes even understanding signs, like not force-feeding people when someone’s health is deteriorating,” Jain, 49, said.

What it actually means to die with dignity

Dying with dignity does not simply mean dying without pain, though that matters enormously. It means having your preferences heard and respected. It means not being alone unless you want to be. It means being able to say what needs to be said, and being treated as a full human being rather than a patient at the end of a clinical process. “Death doulas are trained to hold all of this, practically and emotionally, in ways that exhausted family members and time-pressured medical staff simply cannot,” described Dr Tugnait.

Jain mentioned, “This is not a negative space. It is something that is steeped in the science of care. I try to make the people and their families try and accept the eventuality,” said Bhawna, who doesn’t charge for the same.

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Kacie Gikonyo, a 42-year-old based in Cleveland, Ohio in the United States, is a registered nurse, death doula, and death educator. While she has been working as a death doula since 2022, she has been in “end-of-life care since 2011 through my work as a nurse”.

A death doula provides non-medical support to individuals who are dying, as well as their loved ones, as they navigate terminal illness, the dying process, and grief. “My work typically begins months before death, often six months to a year in advance, and focuses on helping people prepare emotionally, practically, and psychologically for what’s ahead,” she described.

Abhijit Dam (Photo: Abhijit Dam)

Kacie supports her clients in “creating end-of-life plans, understanding what to expect as the body changes, and making informed decisions about their care”. “A large part of my role is helping people maintain a sense of autonomy and control during a time that often feels uncertain. I also help them focus on living fully in the time they have left, not just preparing to die,” she mentioned.

So, her support includes “emotional, spiritual, educational, practical, and logistical care”. “This can look like facilitating legacy projects, helping coordinate additional caregiving services, guiding families through the healthcare system, and providing clear, honest education about the dying process. I work alongside hospice and medical teams, complementing the care they provide by focusing on the human experience of dying,” she told indianexpress.com.

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No two days in this work look the same. “Some days I am sitting with an individual having meaningful conversations or working on a legacy project. Other days, I am at the bedside, holding space and supporting both the individual and their family as death approaches. At times, that means simply being present and ensuring no one feels alone,” she expressed.

death Families dealing with a terminal diagnosis are managing medical decisions, and financial strain (Photo: Freepik)

Kacie is also the founder of Death Doula School, an international training programme that has educated death doulas around the world. “Through this work, I provide education, mentorship, and guidance to those entering the field. In addition, I teach and speak at hospitals, healthcare systems, and universities to help bridge the gap between healthcare and deathcare and to improve how we approach end-of-life care as a whole,” she asserted.

At its core, her work is about changing the way people understand and experience death. According to Kacie, who is also the author of Laboring Out of Life: A Death Doula’s Approach to Intentional End-of-Life Care which is expected to be published in September this year (and available for pre-oder), when people are supported, informed, and “given space to approach death intentionally, it can become less chaotic and more meaningful, not just for the person who is dying, but for everyone who loves them”.

Notably, her book expands on her work as a nurse and death doula, offering both practical guidance and a new perspective on how to approach death, dying, and the final chapter of life.

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Dr Abhijit Dam, a palliative care specialist who did his MD from AIIMS in 1995, and founder of Kosish-The Hospice in Jharkhand (2004), has been doing a similar work in India’s rural and tribal populations.

“Since my early days, I was fascinated by technology and intensive care. I shifted to Bokaro, and started working with Steel Authority of India, and went there to start their ICU. I was working in the ICU. That was my passion at that time to try to save lives. Over the years, by 2003-04, I suddenly started realising that instead of actually saving lives, what I was actually doing was causing deaths that were painful, lonely, and undignified. People would die in the ICU beds hooked onto ventilators and life-sustaining equipment, devoid of their dignity in vain, with a financial drain on their whole family. That got me thinking that this wasn’t the way that one should die. And that prompted me to embrace palliative care, and I went to Poland to begin my training in the same,” he recalled.

Kacie Gikonyo (Photo: Kacie Gikonyo)

Despite being a strong atheist at that time, he shared that he “read the Vedas, Upanishads, and did advanced courses”, along with studying compassionate end-of-life care. “I am a very scientific person, so I decided to understand the principles of Quantum physics. That too believes that consciousness never dies. The last few days of our lives are very important. In this modern society, people die with neglect and out of loneliness. So, who looks after them? So, I created my own hospice in Jharkhand and started training the village women who were otherwise neglected,” he mentioned.

In 6-month batches, they are taught how to look after and care for bedridden patients so that they don’t die alone and feel supported. “Now, we have the 10th batch enrolled. They were being taught, trained, the passouts were called Farishteys,” he said.

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It led him to found the International Death Doula Foundation in 2023, which offers a “culturally appropriate” death doula course in India with its emphasis on the teachings of Quantum Physics, palliative medicine, and spirituality. “So that people from all phases of life..not necessarily healthcare professionals…are taught these things,” said Dr Dam, who also founded the National Association for Palliative Care for Ayush and integrated medicine.

Indian culture has never been afraid of death in the abstract. “Rituals, prayers, and ceremonies around dying are woven deeply into almost every tradition here, and yet, in the very personal, very human experience of sitting with someone who is actively dying, there is often a profound absence,” expressed Dr Tugnait.

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“The concept of death doulas is still new in India, concentrated mostly in metros like Mumbai, Bengaluru, and Delhi, and largely accessed by urban, educated families. But the conversations are beginning, and a generation that has watched parents and grandparents die in hospital corridors is starting to ask whether there is a better way,” reiterated Dr Tugnait.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.

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Soha Ali Khan discusses latest blood report, says a gene makes her predisposed to heart disease: ‘I have to keep my cholesterol even lower’

Soha Ali Khan, 47, recently opened up about her latest blood work, sharing that she has a gene that makes her “predisposed to heart disease”. “I am so obsessed with being healthy. I have been told that the Mediterranean diet is the healthiest. I just did my blood test. My LDL, which is the bad cholesterol, is good; it is low, and HDL, which is the good cholesterol, is high, which is good, but I have a gene that is genetically predisposed to heart disease. I have to keep my cholesterol even lower than normal. But I have always been into eating healthy, and I thought this diet….which is about fresh food, lean protein, and the fats, oils we use. At some point, we all had vegetable oils, and Kunal (Kemmu; husband) said, out with them and…seed oils are what you should be cooking with,” she told chefs Ranveer Brar and Garima Arora on her YouTube podcast.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.

What does her report actually mean?

Dr Parin Sangoi, consultant interventional cardiologist, Wockhardt Hospitals, Mumbai Central, noted that predisposition means the body may have a higher natural tendency to develop heart issues, even if routine reports look fine. “In these cases, factors like cholesterol should be kept under tighter control. A person may have normal or good levels but may still need to lower them to reduce long-term risk.”

He mentioned that a growing number of people are realising that even with “good” reports, genetics can still affect heart health. This often leads to stricter lifestyle choices and more thoughtful eating.

diet plan Here’s what you should consider (Photo: Freepik)

If LDL is low and HDL is high, is there still a concern?

While those are positive signs, genetics can change the target range. “For someone with a family or genetic risk, doctors often recommend even lower LDL levels. It is not about panic but about being proactive and preventing future complications,” said Dr Sangoi.

Does following a ‘healthy diet’ like the Mediterranean pattern help?

Yes, a diet focused on fresh foods, lean protein, nuts, seeds, and healthy fats supports heart health. It helps control cholesterol, reduce inflammation, and maintain overall balance. Consistency matters more than occasional healthy choices.

Also Read | Shoaib Ibrahim reveals battle with ‘health anxiety’ after wife Dipika Kakar’s cyst recurrence: ‘Ghabraahat si hone lagi hai bahut zyaada’

Are seed oils better?

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The focus should be on using oils in moderation and choosing those with better fat profiles. “Instead of heavily processed or repeatedly heated oils, it is better to use fresh oils and rotate options like olive oil, mustard oil, or other balanced choices. The way oil is used often matters as much as the type,” said Dr Sangoi.

Even with a strong focus on health, regular check-ups and small adjustments can make a big difference. “When genetics is involved, staying informed and consistent becomes the real advantage,” said Dr Sangoi.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.

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Coffee, Diet Coke, and comfort: Inside Gen Z’s world of ’emotional support’ drinks

Joshua Thakur’s days are usually very hectic and planned. His mornings start at 5 am with a pour-over. “That’s non-negotiable. Life genuinely feels incomplete if I miss my morning coffee,” he tells indianexpress.com. The advertising executive from Hyderabad treats beverages like “emotional support”, something that helps him stay on track. “They’re like little indicators or rewards I earn after I finish a task,” he says. And when the afternoon slump hits, he needs at least two beverages to pull him out of it. “A pour over and a Coke Zero. One to take the edge off, one to bring it back,” he shares.

With the US-Iran War causing a Diet Coke shortage in India, Gen Z has been struggling without access to their “emotional support drink”. From memes to reels, social media is flooded with their withdrawal symptoms online. And here’s a quick video explaining why:

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Popularly labelled ‘fridge cigarette’ a few months ago, soft drinks have long been considered one of Gen Z’s go-to choices of coping mechanism. But with Diet Coke out of the picture for now, what is the youth of India turning to?

Like Thakur, Shivasree Venkateswaran also cannot start her mornings without a shot of caffeine. Her emotional support beverage is a freshly brewed filter kaapi. “I come from a Brahmin family where filter coffee is a daily ritual, so I grew up drinking it. Over time, it just became something I cannot do without,” she says, elaborating how, over the course of time, coffee became a constant in her life.

“When I started working, it slowly turned into my emotional support in a way. Whenever I feel tense or need to focus and get something done quickly, I grab a cup of coffee, sit with it, sip slowly and get into work mode,” adds the senior account executive at Milestone Pune.

What exactly is an ’emotional support’ drink?

From a psychological perspective, clinical psychologist Dr Rimpa Sarkar explains that the idea of an “emotional support drink” is less about the drink itself and more about what it represents emotionally.

“At a basic level, humans are wired to seek comfort, predictability, and small rituals when they feel stressed or overwhelmed. An “emotional support drink” becomes a symbolic coping tool, something familiar, easily accessible, and immediately soothing,” she told indianexpress.com.

Whether it is coffee, matcha, boba, or even a soft drink, it creates a sense of control in moments where emotions may feel unpredictable.

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Aaditya Sharma swears by Appy Fizz, which has a flavour profile distinct from the usual rotation and lacks caffeine. For him, it’s less about the drink and more about having one reliable thing when everything else feels uncertain. “You can always go back to that one thing and it will always be the same and bring you the same taste and comfort. Doesn’t have to be deep, it just has to be yours,” the PR professional shares.

“I made a conscious call to stay away from alcohol when I’m stressed. Do it once and the association forms; suddenly you’re reaching for it every time things get heavy, and that’s a habit I don’t want to build,” Sharma further elaborates.

Is Gen Z really not relying on alcohol?

Sharma’s statements go in line with a truth most baby boomers and millennials find it hard to digest. Despite being tagged as partyholics who cannot function without turning everything into a “fun scene” — whether that’s bhajan clubbing or a coffee rave, Gen Z has embraced the sober-curious movement with open arms. Unlike Millennials, who normalised partying and social drinking, Gen Z chooses personal well-being, effectively dismantling the “drinking = fun” myth.

Don’t believe us? The numbers speak for themselves. A 2024 UK study found that consumers aged 20 to 24 are nearly half as likely to prioritise spending on alcoholic beverages compared to previous generations. The Conversation has called Gen Z “the soberest generation.” And in 2023, only 18-20 per cent of Americans under 28 said they regularly drank alcohol, according to Statista.

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So, an emotional support (non-alcoholic) drink is just a clean option to turn to whenever life beats you down. And in certain cases, it can also be a convenient excuse to blow your money on pretty-looking cups and saucers. Bhumija Rishi loves her coffee, but more than her caffeine fix, she is a sucker for aesthetic crockery. “I love my gold and white cup. It has an old-world charm,” admits the consultant at Network18 Media and Investments Ltd.

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Going deeper

Dr Sarkar decoded a few reasons behind this trend:

Micro coping in a high stress environment: Many people today are dealing with constant low level stress. Instead of large coping mechanisms, they rely on small, repeatable habits. A drink becomes a quick emotional reset during the day.

Ritual and predictability: Having the same drink at a certain time creates structure. This predictability can calm the nervous system and reduce anxiety because it signals familiarity and routine.

Sensory regulation: The act of holding a warm cup, sipping something sweet or flavourful, and slowing down engages the senses. This can have a grounding effect and bring attention back to the present moment.

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Identity and self soothing: For many, it becomes part of their identity. Saying “this is my emotional support coffee” is also a way of acknowledging stress while normalising self soothing behaviour in a socially acceptable way.

ALSO READ | Rare drinks in India you may not know about

Social and cultural reinforcement: Social media has amplified this trend by turning everyday coping habits into relatable content. It creates a shared language around stress and comfort.

Coping mechanism — repackaged and made fun

Dr Sarkar reiterated that it is important to understand that while such habits can be helpful, they are surface level coping mechanisms. “They provide temporary relief but do not address deeper emotional concerns. And at the end of the day, the trend reflects something very real where people are looking for accessible, non overwhelming ways to regulate their emotions in daily life,” she concluded.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to.

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Vicky Kaushal’s father Sham Kaushal, 70, crushes weights in the gym

Vicky Kaushal’s father and action director Sham Kaushal, 70, recently shared a glimpse of himself working out in the gym. He could be seen doing resistance exercises like suspension training and bench press in a video shared on his Instagram Stories. He captioned the post, “By God’s grace, small efforts to continue…”

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.

Taking a cue from his inspiring glimpses, we asked an expert how essential is it for those in their 70s to strength train.

Consultant dietitian and fitness expert Garima Goyal said that this glimpse is not only about physical strength, but also about long-term discipline and consistency. “It isn’t just a motivational moment, it is a strong reminder that fitness truly has no age limit,” she said.

From a clinical nutrition perspective, what stands out here is the concept of active ageing. “As we grow older, muscle mass naturally declines, a process known as sarcopenia. However, regular strength training can significantly slow down this loss, improve bone density, and enhance metabolic health. It also supports better insulin sensitivity, which is crucial for preventing age-related metabolic disorders like type 2 diabetes,” described Goyal.

Sham Kaushal weight trains in the gym (Photo: Sham Kaushal/Instagram Stories)

Another important takeaway is the role of protein intake and recovery. “At this stage of life, maintaining muscle is not just about exercise but also about adequate nutrition. Sufficient protein, along with micronutrients like vitamin D, calcium, and B12, becomes essential to support muscle repair and strength. Hydration and proper rest further amplify these benefits.”

What’s also inspiring is the mindset behind his caption, “small efforts to continue.” “This highlights that fitness is not about extremes or quick transformations, but about showing up every day, even in small ways. Consistency, not intensity alone, is what builds long-term health,” shared Goyal.

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In today’s lifestyle, where many people associate ageing with slowing down, this is a powerful shift in perspective. “Strength training in your 50s, 60s, or beyond is not just safe when done correctly, it is necessary for maintaining independence, mobility, and quality of life,” said Goyal.

The takeaway is simple but powerful. “You don’t stop working out because you age. You age faster when you stop working out,” Goyal shared.

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‘There would be a gaddha here’: Lessons from Mini Mathur’s Botox disclosure

Actor and host Mini Mathur recently opened up about her experience with Botox and why it didn’t work for her. Recalling an incident from years ago, she shared, “15 years ago, I was going to do a show deep in the jungles, and there was a lot of shooting in the daylight, and I would constantly do this (frown), and there would be a gaddha here (in between eyebrows). The team told me that this line really looks like a black line, so aap isko kara lo. I said theek hai, I went and said ye gaddhe ki line hai, ye camera pe dikh rahi hai, the doctor said ya I can freeze it. I couldn’t emote, I died…I said I am feeling sad, but it’s not looking sad, I am emoting, I was acting at that point in time…I was like this is horrible, thankfully it lasted for 3 months.”

To understand what really happens, Dr GS Arora, MBBS, MD (Dermatology, Venereology & Leprosy), breaks it down.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine

Can Botox make you ‘lose expression’?

“A ‘frozen’ or less expressive look can happen, but it is not universal,” says Dr Arora. “This usually occurs when excessive doses are used or when injections are not precisely placed.”

He emphasises that such outcomes are avoidable. “When performed by an experienced practitioner, Botox is designed to soften lines—not eliminate movement entirely.”

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Smooth skin vs natural movement

One of the biggest challenges in aesthetic dermatology is achieving visible results without compromising expression. “Every face has unique muscle dynamics, so treatment must be highly individualised,” explains Dr Arora.

He points to newer techniques like micro-dosing, often called “Baby Botox.” “Smaller, strategically placed doses help relax overactive muscles while preserving natural expressions like smiling or frowning. The goal is refinement, not rigidity.”

ALSO READ | Three lifestyle hacks to reverse insulin resistance and protect your liver

Why botox doesn’t last forever

Mini Mathur mentioned that her results lasted about three months, which is fairly typical. “Botox generally lasts between three to four months, though this can vary,” says Dr Arora.

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Factors like metabolism, muscle strength, and lifestyle all play a role. “People with more active facial muscles or faster metabolisms may see quicker fading, while others may experience longer-lasting effects.”

Interestingly, repeated treatments may slightly extend longevity over time. “With regular sessions, muscles can become conditioned, sometimes leading to longer intervals between treatments,” he adds.

What are the alternatives

For those hesitant after hearing experiences like Mathur’s, dermatologists say Botox isn’t the only option. “There are several alternatives that offer subtle, natural-looking results without affecting muscle movement,” says Dr Arora.

These include:

Dermal fillers to restore volume
Microneedling and chemical peels for skin texture
Laser treatments for fine lines
Skin boosters for hydration and glow

He also highlights the importance of basics. “A consistent skincare routine with sunscreen, retinoids, and antioxidants can significantly delay visible ageing.”

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DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine

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‘Why do I pee so much after swimming?’

The urge to pee is stronger when swimming in colder water, as compared to warmer ones (Images: Unsplash)

Ever noticed how you suddenly need to pee right after getting out of a pool or the sea? You’re not alone. The question recently came up on Reddit, with a distressed internet user asking ‘Why do I pee so much after swimming?

Turns out, there’s a clear medical explanation behind it. Dr Tarun Singh, Senior Consultant, Urology, ShardaCare-Healthcity, says this happens because of how your body reacts to being in water.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.

Your body thinks there’s “too much fluid”

“When you get into the water, your body gets a bit confused,” says Dr Singh. “The water pressure pushes blood from your arms and legs towards your chest and the middle of your body.”

Your heart senses this shift and “tells your kidneys that there is too much fluid, so they should get rid of some.” As a result, the kidneys make urine. This process is known as immersion diuresis, wherein “you need to pee” because you are in the water.

Since your brain thinks that there is excess fluid in the body, it tells your kidneys to get rid of it.” This is why it can happen just a few minutes after you get into the water.”

swimming Athletes who swim for a long time are more likely to feel the need to pee frequenly (Images: Unsplash)

Also Read | ‘What are the potential risks of taking high-dose vitamin D supplements for an extended period of time?’

Why cold water makes it more intense

If you swim often you might have noticed how the urge to pee intensify when you are in cold waters. This isn’t merely a coincidence. “Cold water makes the blood vessels near your skin get smaller which pushes blood towards the important parts of your body. This makes the immersion diuresis effect much stronger,” explains Dr Singh.

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That’s why in cold water, like the sea, ocean or an outdoor pool outside, the “diuretic effect” is stronger, and you feel the urge to pee more urgently, compared to warm water.

“Saltwater also makes your skin a little dehydrated, which can confuse your body signals about fluid,” Dr Singh further notes.

So if you feel the urge more after swimming in the ocean than in a pool, temperature is likely the reason.

Why some people feel it more

Dr Singh confirms that some people are more “prone” to this than other. As per the urologist, people with bladder problem, those who “drink a lot of water before they swim, and older people, whose bladder control may be weaker.

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“People who take medications for blood pressure will also feel the effect more,” and “athletes who swim for a time are more likely to need to pee because they are in the water for so long.” However, if it hurts to pee or if you see blood in your urine you should talk to a doctor.

To put it straight, that post-swim urge isn’t unusual; it’s your body responding to water pressure and temperature. However, keeping an eye for accompanying symptoms will help you avoid any health complications.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.