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It Takes a Village
Rethinking Death Care as Community Care
Reprint from Substack
Oct 16, 2025
We say it takes a village to raise a child.
But it also takes a village to help someone die well.
And another to carry the living after loss.
Yet somewhere along the way, we stopped seeing death as a community responsibility.
We outsourced it.
We built systems and professionals to handle it for us.
We took something once shared and sacred and turned it into a service you call when something goes wrong.
It’s time to take it back.
Because death was never meant to belong to one profession.
It was meant to belong to all of us.
Photo by Tim Marshall on Unsplash
Death Education: Where the Village Begins
Most people were never taught what happens when someone dies.
Not what the body does.
Not what paperwork is needed.
Not who to call.
Instead, we learned to look away. To change the subject. To protect others from sadness. But avoidance doesn’t protect us; it isolates us. It leaves us unprepared when loss comes. And it will come.
Death education isn’t about morbidity. It’s about literacy.
When we talk about death early and often, we normalize it. We empower people to plan. We replace fear with understanding.
I’ve seen the difference.
In classrooms where students ask questions with curiosity, not horror.
In bars where “Death Over Drafts” events turn into honest, healing conversations.
In families who, after learning the basics, approach death as something they can meet with grace, not confusion.
Education is where community care starts.
Because when people understand death, they don’t run from it; they show up for each other.
When the Village Shows Up
When someone is dying, the best care happens when everyone works together.
Hospice nurses ease pain and offer comfort.
Funeral directors help plan the goodbye.
End-of-life doulas hold space for the emotional work of dying.
Clergy, therapists, neighbors, friends, all have a role to play.
Each brings a different kind of medicine.
But right now, these worlds are often separate.
Hospice ends where the funeral begins.
The funeral ends where grief support should start.
And families fall through the cracks between systems that were never meant to be separate.
We can do better.
We can build bridges instead of silos.
We can treat deathcare as a continuum, not a collection of disconnected services.
Imagine this instead:
A hospice nurse calls a trusted funeral partner before death occurs to prepare the family for what comes next.
A funeral director connects that family with a grief counselor in their own community.
An end-of-life doula collaborates with both, ensuring continuity of care.
Each one hands the family forward gently, never dropping them in the space between.
That’s holistic deathcare.
That’s what it means to have a village that shows up, not only for the dying, but for the living who remain.
After Loss: Carrying Each Other Forward
The funeral is not the end. It’s the beginning of a new kind of living.
After the service ends and the flowers fade, people are left with a quiet no one prepares them for.
The silence of a house that holds too many memories.
The pile of mail that keeps coming.
The tasks no one wants to do: sorting clothes, returning medical equipment, changing account names.
Grief lives in those ordinary moments.
Professionals can support those who grieve, but it’s the community that carries them through it.
A check-in text two weeks later matters.
A meal left on a porch matters.
An invitation to coffee months after everyone else has moved on matters.
We need more of that.
Grief companions and support groups are essential, yes, but so are coworkers who understand, neighbors who remember, and friends who don’t say “let me know if you need anything,” but instead say, “I’m coming by.”
Community care after loss doesn’t require training. It requires willingness.
To sit in discomfort. To show up imperfectly. To remember that grief isn’t a problem to solve, it’s a process to witness.
The Missing Piece: Connection
The future of deathcare isn’t about more technology or efficiency. It’s about connection.
Connection between professionals.
Connection between the living and the dying.
Connection between people and the land they’ll return to.
We need spaces where hospice, funeral, and grief professionals talk to each other. Where doulas, cemeterians, celebrants, and therapists share resources instead of competing. Where families know where to turn because every door leads to someone ready to help.
This is already happening, in small ways, in small towns, in community-led projects, in forests, in living rooms.
Every time someone chooses to learn about death before they need to, every time professionals collaborate, every time a community rallies around someone grieving, another piece of the village returns.
Building the Village Again
So how do we rebuild it?
We start by talking.
By educating.
By remembering that this work belongs to everyone.
We host community events where death isn’t taboo.
We teach the language of dying and grief to kids, so they grow up unafraid.
We create partnerships between hospice and funeral homes, doulas and cemeteries, grief groups and local businesses.
We make space in our neighborhoods for conversations about how we want to live, and how we want to die.
We make death a part of life again.
Because Here’s the Truth
No one should die alone.
No one should grieve alone.
And no one should carry the sacred work of care alone, either.
It takes a village to live well.
It takes a village to die well.
It takes a village to remember well.
And if we can remember that, maybe we’ll start to see death not as something to avoid, but as something we walk through, together.
Marc D Malamud
Transitioning Doula
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Help Us Keep the Light On at TransitioningDoula.com 💜
Hi friends,
I’m reaching out with a full heart and a humble ask.
Transitioning Doula, LLC started as a quiet dream—a space where people could find comfort, guidance, and gentle support during one of life’s most tender transitions. Today, it’s grown into a community of care, and I’m so grateful you’re here.
As a 501(c)(3) nonprofit, we rely on the kindness of donors to keep our services accessible to everyone who needs them. Whether it’s helping someone navigate grief, offering comfort to those nearing the end of life, or simply being a steady presence when things feel uncertain—we’re here, and we want to keep showing up.
What Your Support Makes Possible:
- Free grief counseling courses for families
- End-of-life comfort care for those without close loved ones
- Resources and education for caregivers and communities
- A growing online hub of compassion and connection
How You Can Help:
- Donate (even a few dollars makes a big difference!)
- Share our story with your circle
- Sponsor a care session in honor of someone you love
We’re Officially Registered!
Transitioning Doula, LLC is proud to be a 501(c)(3) nonprofit organization, which means your donations are tax-deductible as allowed by law.
You can view our IRS determination letter https://apps.irs.gov/pub/epostcard/dl/FinalLetter_93-4613115_TRANSITIONINGDOULAANJNONPROFITCORPORATION_03072024_00.pdf for full transparency.
Thank you for believing in this mission. Thank you for being part of it.
With warmth and gratitude,
💜 
Marc D Malamud
Founder, TransitioningDoula.com
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What this course IS
This class is a small, online, interactive gathering of adults working through a past or anticipated grief.
We will guide you through exercises to see your circumstances in a new light, honoring you and your experiences.
Register for day one and additional days are included.
Event Information
Event Date 10-08-2025 8:00 pm
Event End Date 10-08-2025 9:30 pm
Cut Off Date 10-08-2025 5:00 pm
Capacity 22
Registered 0
Available Place 22
Individual Price $500.00
Location https://zoom.us/meeting/register/9wI3wGoJS1uEnH2DQww-vw
https://www.transitioningdoula.com/index.php/death-cafe/event-list/grief/navigating-grief?tmpl=component&print=1
Warmly,
Marc D Malamud
Transitioning Doula
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When the Caregivers Need Care Too
Mental Illness Awareness Week and the Funeral Profession
In funeral service, we are known for being steady in the storm. Families see us as calm anchors, guiding them through the unimaginable. But what happens when the people who carry everyone else’s grief are also carrying anxiety, depression, PTSD, or other mental illnesses?
The truth is, mental illness doesn’t skip over funeral professionals. If anything, the demands of our work, long hours, exposure to trauma, isolation from peers, and constant emotional labor make us more vulnerable.
Silence in a Culture of Strength
In our profession, there is an unspoken rule: be strong for the family. Many of us extend that rule into our personal lives as well. We minimize our struggles, fearing stigma or judgment. We tell ourselves that burnout is “just part of the job” or that therapy is for someone else.
But mental illness is not weakness. It’s human. And silence is not strength.
Trauma-Related Grief and Hidden Wounds
Without acknowledgment, without access to treatment, mental illness can quietly erode the very professionals families rely on most.
Why Access and Support Matter
Employers and associations can lead by:
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Offering mental health coverage that includes trauma-informed therapy
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Normalizing the use of EAP programs, counseling stipends, and peer groups
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Building training and conversations that reduce stigma and increase awareness
Resources for Funeral Professionals
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NFDA’s Work/Life Resource Center
Offers confidential counseling, legal and financial advice, and wellness resources for funeral professionals. -
Funeral Professionals Peer Support (FPPS)
A peer-led community offering virtual and in-person support groups designed specifically for those in funeral service. -
The American Foundation for Suicide Prevention (AFSP)
Education, advocacy, and local chapters offering community support and training around suicide prevention. -
National Alliance on Mental Illness (NAMI)
Helpline, peer groups, and education for anyone navigating mental illness—for yourself or loved ones. -
Crisis Resources
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988 Suicide & Crisis Lifeline (U.S.) – Call or text 988 anytime.
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Crisis Text Line – Text HOME to 741741 for 24/7 support.
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Grief and Trauma-Specific Therapists
Search directories like Psychology Today and filter for trauma, grief, or first-responder experience.
These aren’t just “nice to have” resources. They are lifelines for those who quietly carry the grief of others while neglecting their own.
A Profession That Heals Its Own
When we make it safe to say “I’m not okay,” we don’t just protect funeral professionals. We protect the families we serve because every family deserves a caregiver who is whole, present, and supported.
Marc D Malamud
Transitioning Doula
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I Know You Love Me — Now Let Me Die
(Dr. Louis M. Profeta is an emergency physician, writer, and speaker. He is the author of book, The Patient in Room Nine Says He’s God. Used with permission of the author, this article first appeared on LinkedIn.)
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In the old days, she would be propped up on a comfy pillow, in freshly cleaned sheets under the corner window where she would in days gone past watch her children play. Soup would boil on the stove just in case she felt like a sip or two. Perhaps the radio softly played Al Jolson or Glenn Miller, flowers sat on the nightstand, and family quietly came and went.
These were her last days. Spent with familiar sounds, in a familiar room, with familiar smells that gave her a final chance to summon memories that will help carry her away. She might have offered a hint of a smile or a soft squeeze of the hand but it was all right if she didn’t. She lost her own words to tell us that it’s okay to just let her die, but she trusted us to be her voice, and we took that trust to heart.
You see, that’s how she used to die. We saw our elderly different then.
We could still look at her face and deep into her eyes and see the shadows of a soft, clean, vibrantly innocent child playing on a porch somewhere in the Midwest during the 1920s perhaps. A small rag doll dances and flays as she clutches it in her hand. She laughs with her barefoot brother, who is clad in overalls, as he chases her around the yard with a grasshopper on his finger. She screams and giggles. Her father watches from the porch in a wooden rocker, laughing while Mom gently scolds her brother.
We could see her taking a ride for the first time in a small pickup with wooden panels driven by a young man with wavy curls. He smiles gently at her while she sits staring at the road ahead; a fleeting wisp of a smile gives her away. Her hands are folded in her lap, clutching a small, beaded purse.
We could see her standing in a small church. She is dressed in white cotton, holding hands with the young man, and saying, “I do.” Her mom watches with tearful eyes. Her dad has since passed. Her new husband lifts her across the threshold, holding her tight. He promises to love and care for her forever. Her life is enriched and happy.
We could see her cradling her infant, cooking breakfast, hanging sheets, loving her family, sending her husband off to war, and her child off to school.
We could see her welcoming her husband back from battle with a hug that lasts the rest of his life. She buries him on a Saturday under an elm, next to her father. She marries off her child and spends her later years volunteering at church functions before her mind starts to fade and the years take their toll and God says:
“It’s time to come home.”
This is how we used to see her before we became blinded by the endless tones of monitors and whirrs of machines, buzzers, buttons, and tubes that can add five years to a shell of a body. It was a body entrusted to us and should have been allowed to pass quietly, propped up in a corner room, under a window, with scents of homemade soup in case she wanted a sip.
You see, now we can breathe for her, eat for her, and even pee for her. Once you have those three things covered, she can, instead of being gently cradled under that corner window, be placed in a nursing home and penned-in cage of bed rails and soft restraints meant to “keep her safe.”
She can be fed a steady diet of Ensure through a tube directly into her stomach, and she can be kept alive until her limbs contract, and her skin thins so much that a simple bump into that bed rail can literally open her up until her exposed tendons are staring into the eyes of an eager medical student looking for a chance to sew.
She can be kept alive until her bladder is chronically infected, until antibiotic-resistant diarrhea flows and pools in her diaper so much that it erodes her buttocks. The fat padding around her tailbone and hips are consumed, and ulcers open up exposing the underlying bone, which now becomes ripe for infection.
We now are in a time of medicine where we will take that small child running through the yard, being chased by her brother with a grasshopper on his finger, and imprison her in a shell that does not come close to radiating the life of what she once had.
We stopped seeing her – not intentionally, perhaps, but we stopped.
This is not meant as a condemnation of the family of these patients or to question their love or motives. But it is meant to indict a system that now herds these families down dead-end roads and prods them into believing that this is the new norm – that somehow the old ways were wrong, and this is how we show our love.
A day does not go by where my partners don’t look at each other and say, “How do we stop this madness? How do we get people to let their loved ones die?”
I’ve been practicing emergency medicine for close to a quarter of a century, and I’ve cared for countless thousands of elderly patients. I, like many of my colleagues, have come to realize that while we are developing more and more ways to extend life, we have also provided water and nutrients to a forest of unrealistic expectations that have real-time consequences for those frail bodies entrusted to us.
This transition to doing more and more did not just happen on a specific day in some month of some year. Our end-of-life psyche has slowly devolved and shifted, and a few generations have passed since the onset of the Industrial Revolution of medicine.
Now we are trapped. We have accumulated so many options, drugs, stents, tubes, FDA-approved snake oils, and procedures that there is no way we can throw a blanket over all our elderly and come to a consensus as to what constitutes inappropriate and excessive care. We cannot separate out those things meant to simply prolong life from those meant to prolong quality life.
Nearly 50 percent of the elderly US population now dies in nursing homes or hospitals. When they do finally pass, they are often surrounded by teams of us doctors and nurses, medical students, respiratory therapists, and countless other healthcare providers pounding on their chests, breaking their ribs, burrowing large IV lines into burned-out veins, and plunging tubes into swollen and bleeding airways. We never say much as we frantically try to save the life we know we can’t save – or perhaps silently hope we don’t save.
When it’s finally over and the last heartbeat blips across the screen, and we survey the clutter of bloody gloves, wrappers, masks, and needles that now litter the room, you may catch a glimpse bowing our heads in shame, fearful perhaps that someday we may have to stand before God as he looks down upon us and says, “What in the hell were you thinking?”
When it comes time for us to be called home, those of us in the know will pray that when we gaze down upon our last breath, we will be grateful that our own doctors and families chose to do what they should – instead of what they could – and with that, we will close our eyes to familiar sounds in a familiar room, a fleeting smile, and a final soft squeeze of a familiar hand.
Reprinted from https://www.thegooddeathsocietyblog.net/2025/10/05/i-know-you-love-me-now-let-me-die/
Marc D Malamud
Transitioning Doula
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