• Death doulas assist individuals and families navigate the various challenges in dying
• Many point to an end-of-life care crisis in Michigan, as the state’s population ages
• Many older residents in the state have done little to prepare for long-term health care, according to the University of Michigan

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YPSILANTI — Kimberly Wamba realized what she wanted to do with her life in watching members of her family die.

She always had a desire to help people, a desire that started in childhood watching her grandmother work as an aide.

“My grandma used to go to different clients’ homes and take care of them,” Wamba told Bridge Michigan. “I really admired what she did.”

Wamba would earn a doctorate in information technology. But she took on a new role when her father got sick, returning to Michigan to help ease him through his “threshold of death” as he succumbed to illness.

“The very day of his death, I was able to be at his bedside, and I was able to hold him and look directly into his eyes,” Wamba said. “While I didn’t know anything about being a doula at that time, that experience stuck with me.”

Her father’s death led Wamba toward her work as a death doula — a wide-ranging, usually non-medical role that assists individuals and their families navigate dying — joining a small, but growing number of people in Michigan and nationally who have pursued roles in providing “death care.” The goal, Wamba said, is to fix a “broken” system of services for people at the end of their life.

“For me, being a death doula is basically like somebody who walks with someone during that process of moving through transition, whether that be at the time when they’re closest to death, or even quite a bit before than,” Wamba explained.

Now the president and founder of the Metro Detroit-based non-profit Sacred Life Care Initiative, Wamba is able to work with those at a critical juncture between life and death.

Wamba, who lives in Canton, generally focuses on clients in hospice who are closer to the end of their lives, acting as a “companion” for those who want to talk about their last moments. 

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That work came full circle when she became her grandmother’s death doula. 

In the last months of her life, the two shared meals and spent nights together. Other times, when other relatives were “dog tired” from providing the day-to-day care, Wamba said she was present for deep introspection and conversation.

“I was also able to listen to her wishes, things that she wanted us to be aware of before she transitioned,” Wamba said. “She could talk through those things with me, and there would be a level of acceptance to be able to hold that space in a specific way that it might have been harder for sometimes her children to hold space for.” 

A ‘gigantic spectrum’ of deathcare

Death doulas operate as a “spiritual, emotional support” role, according to Hanna Hasselschwert of Acacia End of Life Services in Ypsilanti.

“We don’t have control of our death, typically, but we do have a lot of things that we can control — what happens to our bodies and decisions that are made when we’re gone,” said Hasselschwert.

Death doulas, also referred to as death midwives or end-of-life doulas, exist on a “gigantic spectrum,” Hasselschwert said. Sometimes the work is administrative, assisting families in finding the proper resources for estate planning or funeral arrangements. Other times, the work is focused on providing comfort for clients undergoing end-of-life palliative care.

Hasselschwert focuses on advanced planning, helping her clients navigate medical directives and estate logistics and how those details get communicated to families. She also helped launch the Michigan Deathcare Collaborative, a directory for “alternative, holistic deathcare” in Michigan, where she estimates about 50 death doulas operate.

As part of her work, Hasselschwert hosts a twice-monthly “Death Cafe” meet-up at coffee shops to normalize conversations about confronting death and grief.

“Death is gonna happen. Talking about it doesn’t make it more likely,” said Melissa Chapman, a frequent Death Cafe participant and aspiring doula. “If somebody’s pregnant … they learn about kids and about what pregnancy is like and how it works. It’s a very similar thing.”

Many at the cafe spend their time recounting their personal experience with family members and friends who have died, or “pre-grieving” those battling terminal disease and the difficulty they find engaging others about mortality.

Tommy Cook discovered the Ypsilanti Death Cafe after a friend died by suicide.

“Growing up, a lot of father figures were taken out of my life. Both my grandparents and then my dad as a senior in high school,” Cook said. “Grief, for me, always continues where it left off.”

Being present for difficult conversations about loss keeps Cook returning to the Death Cafe. “What we’ve all been through is really brutal,” he said. “I feel like it’d be good if we all got training on how to be a death doula and how to be able to hold space for people grieving.”

Hasselschwert, who works part-time at a fitness studio, said it’s difficult for death doulas to make a full-time job of their positions, given the individual capacity for providing services and emotional tax the work has.

“We do this out of just our passion, our care. So most doulas work off a sliding scale,” she said.

There’s no formal license to become a death doula, but programs around the country provide assistance. In 2024, the National End-of-Life Doula Alliance reported its membership had grown to over 1,600 up from about 250 in 2019. 

Both Hasselschwert and Wamba trained through the organization Going with Grace, which educates death doulas across the country through webinars and group studies. Alua Arthur, Going with Grace’s founder, explained her role as a death doula in a 2023 Ted Talk.

“My goal is to help them answer the question: ‘What must I do to be at peace with myself so that I may live presently and die gracefully, holding both at the same time?’”

An aging ‘crisis’

In Michigan, death is outpacing life.

The state’s death rate has increased over the decades from 8.6 deaths per 1,000 residents in 1970 to 10.3 in 2023 when 103,359 state residents died.

By comparison, Michigan registered 99,179 live births that year, marking a 60% decline in birth rates over the course of a century.

The state’s flattening population growth has been described as an “unfolding crisis” by a task force appointed by Gov. Gretchen Whitmer. Funding to address the problems identified by the panel failed to materialize in the state’s latest budget.

An ongoing Bridge investigation of aging in Michigan found that the state ranks 36th out 48 in Medicaid spending on long-term care.

A recent survey conducted by the University of Michigan reports that while one-third of the state’s population is over 50, few have taken proper preparations for their future long-term care needs. 

Only 25% of residents over 50 have designated a durable power of attorney for medical care and 58% incorrectly believe Medicare will pay for nursing home care, according to the U-M poll. 46% of state residents 50 to 64 and 39% of those over 65 say they have not discussed future health care plans with anyone.

Wamba said her organization is trying to address Michigan’s lack of end-of-life services, aiming to provide her services free-of-charge using alternative funding and donations. 

“We’ve got so many more people that are moving into that space and needing the care,” she said. “We also have this huge gap, though, of people who can’t afford to have someone come in for $30 an hour to give 24-hour care to their loved ones.”

Confronting death is something Chapman had already done before attending the Ypsilanti Death Cafe sessions — she had a “gut-wrenching” experience taking care of her father as he died.

But his death has given her perspective about what to expect at the end.

“Life is not all about longevity. It’s all about quality,” Chapman said. “We’re all not going to get out of here alive.”