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As an end-of-life worker, I often support individuals and families navigating difficult choices in the final stage of life. One option that has gained attention is <a data-mce-href="https://www.amazon.com/VSED-Handbook-Practical-Voluntarily-Stopping-ebook/dp/B09VFS7QT6/ref=tmm_kin_swatch_0" href="https://www.amazon.com/VSED-Handbook-Practical-Voluntarily-Stopping-ebook/dp/B09VFS7QT6/ref=tmm_kin_swatch_0" target="_blank" rel="noopener">VSED</a> (Voluntarily Stopping Eating and Drinking), a legal and intentional decision to hasten death when faced with terminal illness or unbearable suffering. While VSED is deeply personal, it’s also complex—both medically and ethically.A recent study published in the Journal of Pain and Symptom Management (Suri et al., 2023) sheds light on the realities of <a data-mce-href="https://www.amazon.com/VSED-Handbook-Practical-Voluntarily-Stopping-ebook/dp/B09VFS7QT6/ref=tmm_kin_swatch_0" href="https://www.amazon.com/VSED-Handbook-Practical-Voluntarily-Stopping-ebook/dp/B09VFS7QT6/ref=tmm_kin_swatch_0" target="_blank" rel="noopener">VSED</a>, offering valuable perspectives for those considering this path. The research explores the motivations behind VSED, the role of caregivers, and the physical, emotional, and ethical dimensions of the process.Key Findings from the Study One of the most important takeaways from this research is that individuals who choose <a data-mce-href="https://www.amazon.com/VSED-Handbook-Practical-Voluntarily-Stopping-ebook/dp/B09VFS7QT6/ref=tmm_kin_swatch_0" href="https://www.amazon.com/VSED-Handbook-Practical-Voluntarily-Stopping-ebook/dp/B09VFS7QT6/ref=tmm_kin_swatch_0" target="_blank" rel="noopener">VSED</a> are often driven by a strong desire for autonomy. They want control over their dying process, often to avoid prolonged suffering, loss of dignity, or the advanced stages of degenerative illnesses like Alzheimer’s. The study confirms what I’ve witnessed in my own work—patients and families approach this decision thoughtfully, weighing their values and quality of life above all else.Another crucial aspect highlighted is the role of caregivers. <a data-mce-href="https://www.amazon.com/VSED-Handbook-Practical-Voluntarily-Stopping-ebook/dp/B09VFS7QT6/ref=tmm_kin_swatch_0" href="https://www.amazon.com/VSED-Handbook-Practical-Voluntarily-Stopping-ebook/dp/B09VFS7QT6/ref=tmm_kin_swatch_0" target="_blank" rel="noopener">VSED</a> is not something that happens in isolation; it requires emotional and logistical support from family, hospice teams, or <a data-mce-href="https://journeyingon.com/about" href="https://journeyingon.com/about" target="_blank" rel="noopener">end-of-life workers</a> like myself. The study emphasizes that caregivers experience significant emotional strain, particularly as they witness changes in their loved one’s physical condition. This underscores the importance of <a data-mce-href="https://journeyingon.com/services" href="https://journeyingon.com/services" target="_blank" rel="noopener">guidance, preparation, and clear communication throughout the process</a>.Ethical and Medical Considerations One of the ongoing discussions around VSED is how to balance medical ethics with patient autonomy. The article highlights concerns among healthcare providers about withholding food and water, even when it is a patient’s voluntary choice. It also notes that while VSED is legal, not all medical professionals are comfortable supporting it. This makes advanced planning critical—ensuring that a compassionate, informed care team is in place.Another key finding is that <a data-mce-href="https://www.amazon.com/VSED-Handbook-Practical-Voluntarily-Stopping-ebook/dp/B09VFS7QT6/ref=tmm_kin_swatch_0" href="https://www.amazon.com/VSED-Handbook-Practical-Voluntarily-Stopping-ebook/dp/B09VFS7QT6/ref=tmm_kin_swatch_0" target="_blank" rel="noopener">VSED</a> is not always as straightforward as people assume. While many individuals become unconscious within a week, the process can take longer depending on a person’s condition and hydration levels before stopping intake. Symptom management—such as addressing dry mouth, restlessness, or discomfort—is essential, and having an experienced support network makes a significant difference in maintaining comfort.Final Reflections Reading this study affirmed much of what I’ve seen firsthand: <a data-mce-href="https://www.amazon.com/VSED-Handbook-Practical-Voluntarily-Stopping-ebook/dp/B09VFS7QT6/ref=tmm_kin_swatch_0" href="https://www.amazon.com/VSED-Handbook-Practical-Voluntarily-Stopping-ebook/dp/B09VFS7QT6/ref=tmm_kin_swatch_0" target="_blank" rel="noopener">VSED</a> is a deeply personal choice, but it requires preparation, <a data-mce-href="https://journeyingon.com/about" href="https://journeyingon.com/about" target="_blank" rel="noopener" data-mce-selected="inline-boundary">support</a>, and <a data-mce-href="https://journeyingon.com/services" href="https://journeyingon.com/services" target="_blank" rel="noopener">compassionate care</a>. Whether you are considering this option for yourself or supporting a loved one, having the right information and guidance is essential.If you’d like to talk about VSED and how I can support you or your family in this journey, I offer a <a data-mce-href="https://calendly.com/journeyingon/15min?month=2025-02" href="https://calendly.com/journeyingon/15min?month=2025-02" target="_blank" rel="noopener">free 15-minute consultation</a> to discuss your needs. Let’s navigate this path with care, dignity, and the support you deserve.(Reference: Suri, S., et al. (2023). "<a data-mce-href="https://www.jpsmjournal.com/article/S0885-3924(23)00565-1/pdf" href="https://www.jpsmjournal.com/article/S0885-3924(23)00565-1/pdf" target="_blank" rel="noopener">Voluntarily Stopping Eating and Drinking (VSED): A Qualitative Study of Family Caregiver and Clinician Perspectives."</a> Journal of Pain and Symptom Management.)

Understanding VSED: Insights from Recent Research

Japanese pampas grass/silver grass and cosmos bouquet. autumn. monochrome

I have a section on my website’s <a data-mce-href="https://journeyingon.com/faq" href="https://journeyingon.com/faq" target="_blank" rel="noopener">FAQ</a> page that outlines the meaningful services an End-of-Life Worker (Death Doula) can offer. However, not everyone reads this page. &nbsp;So, I wanted to take the time to expand on this in a blog post, providing a deeper understanding of the ways I can support individuals and families during this transition. While every journey is unique, and I always tailor my services to meet each person’s specific needs, this post highlights some of the many ways I can help.Emotional and Spiritual Support <ul><li>Provide a calming presence and compassionate listening. </li><li>Support clients and their families emotionally through all stages of end-of-life.</li><li>Guide clients through reflective practices to find peace, closure, and acceptance.</li><li>Facilitate conversations around legacy, life review, and values.</li></ul>Practical Assistance and Planning<ul><li>Help with organizing paperwork and making end-of-life wishes known. </li><li>Assist in creating advance directives and other essential documents. </li><li>Coordinate with hospice, palliative care providers, and other services as needed. </li><li>Provide a planning framework for vigils, memorials, or celebrations of life. </li><li>Manage care schedules and offer logistical support for families and caregivers.</li></ul>Legacy and Memory Creation<ul><li>Facilitate memory-making activities, such as journaling or recording stories. </li><li>Organize keepsakes, letters, or audio recordings for loved ones. </li><li>Offer guidance on creating a legacy project, like a scrapbook, video, or art. Physical Comfort and Non-Medical Care </li><li>Use techniques like guided meditation, gentle touch, and music to promote relaxation. </li><li>Provide comfort measures, such as repositioning, light massage, or creating a soothing environment. </li><li>Assist with daily non-medical tasks, enhancing comfort and dignity in final days.</li></ul>Family and Caregiver Support<ul><li>Offer respite and emotional support to caregivers. </li><li>Educate family members about the dying process, including physical changes. </li><li>Mediate and facilitate discussions to resolve potential family conflicts. </li><li>Help family members understand grief and support them through the grieving process.</li></ul> After-Death Support<ul><li>Assist with immediate post-death arrangements and rituals as desired by the family. </li><li>Help organize memorial or celebration of life ceremonies. </li><li>Provide bereavement support and resources for grieving family members. </li><li>Each of these services can help create a more supported, meaningful end-of-life experience for both clients and their families. </li></ul>Check out my <a data-mce-href="https://journeyingon.com/services" href="https://journeyingon.com/services" target="_blank" rel="noopener">SERVICES</a> page for more details about packages and rates I currentlyt offer. <a data-mce-href="https://calendly.com/journeyingon/15min" href="https://calendly.com/journeyingon/15min" target="_blank" rel="noopener">CONTACT ME</a> to schedule a complimentary 15-minute consultation to explore how I can best support you and your loved ones during this important time. There’s no obligation—just an opportunity to connect and learn more.Love Sundara Heart

Meaningful services an End of Life Worker (Death Doula) can offer:

<figure id="figure-7gxv2rwf2dm6oifrxq" class=""><iframe id="7gxv2rwf2dm6oifrxq" src="https://www.youtube.com/embed/lcp__Vek4gQ" class="w-full bg-gray-100 " style="aspect-ratio: 16/9;" allowfullscreen="" data-url="https://www.youtube.com/watch?v=lcp__Vek4gQ#ddg-play" data-corners="default" data-fullwidth="false" data-mce-src="https://www.youtube.com/embed/lcp__Vek4gQ" data-mce-style="aspect-ratio: 16/9;"></iframe></figure>I watched this film today, and it deserves several awards—along with our attention. Whether you're living or dying, this film resonates because, eventually, we all arrive at that moment. The artistic choices and direction are spectacular, as expected from Pedro Almodóvar. Julianne Moore and Tilda Swinton deliver incredible performances, bringing depth and sincerity to a story that is both heart-wrenching and profoundly important. Not only does the film take a serious look at the challenges of the end of life, but it also highlights the stigma surrounding death and terminal illness—particularly the struggle to face mortality with grace and dignity. There is still much work to be done in freeing people from this burden, fostering greater education, and cultivating compassion around these conversations. Go see it. This is a film that matters.&nbsp;Now Playing at Violet Crown in Santa Fe ﻿<a data-mce-href="https://santafe.violetcrown.com/movie/VC002185" href="https://santafe.violetcrown.com/movie/VC002185" target="_blank" rel="noopener">https://santafe.violetcrown.com/movie/VC002185</a>

The Room Next Door - OUT NOW

selective focus photography of green succulent plant

As an End of Life Worker, I know how important it is to find moments of peace, especially in times of transition. Whether you’re navigating your own end-of-life journey or offering care and support to a loved one, emotional grounding can bring comfort when everything feels uncertain. That’s why I’m sharing a 30-Minute Meditation for Deep Relaxation and Emotional Support, this meditation I recorded a few years ago now and I am now offering it here free on my website and on Youtube.<figure id="figure-6zn4j43v1em6fr35ly"><iframe id="6zn4j43v1em6fr35ly" src="https://www.youtube.com/embed/NjUyXAqB2nY" class="w-full bg-gray-100 " style="aspect-ratio: 16/9;" allowfullscreen="" data-url="https://youtu.be/NjUyXAqB2nY" data-corners="default" data-fullwidth="false" data-mce-src="https://www.youtube.com/embed/NjUyXAqB2nY" data-mce-style="aspect-ratio: 16/9;"></iframe></figure>Yoga Nidra, often called “yogic sleep,” or Non-Sleep Deep Rest for those who are put of by the term Yoga Nidra, is a powerful meditation practice that guides you into a deep state of relaxation, helping to calm the mind and soothe the body. In this 30-minute session, you’ll be gently guided to release tension, connect with your inner stillness, and create space for peace to settle in. It’s a space where you can find comfort, even in the most challenging moments.I’m currently recording several more meditations that will address relaxation, grief, sleep, love, forgiveness, and pain management, I even have delicious sleep stories to share. These will be available for a small fee to listen too and download from my website unless you are a patient and their family members, then they will be accessible whenever needed to download or stream here.In these meditations, I aim to offer more than just a moment of respite. I want to provide you with tools to navigate the complex emotions of loss, healing, and acceptance. They are meant to support you in whatever stage you’re in—whether that’s processing grief, finding peace and acceptance in the present, or moving through pain at end-of-life.You can play the meditation above or save to your playlists on <a data-mce-href="Non-Sleep%20Deep%20Rest" href="Non-Sleep%20Deep%20Rest" target="_blank" rel="noopener">Youtube</a> . I believe in the power of self-care, mediataion and non-sleep deep rest &nbsp; especially in the face of life's toughest transitions.Thank you for being here, and I hope these meditations bring you the comfort and support you deserve.Warmly, Sundara Heart

30-Minute Meditation for Deep Relaxation and Emotional Support

This month, I’m starting a new series of blog posts aimed at other End of Life Doulas, hospice workers, care workers, and nurses. Each month, I’ll feature a book I’m reading (or have read) that offers insights and practical guidance for working with the dying. These posts are designed to inspire and support those of us who are dedicated to walking this journey with others.For the families and individuals navigating the end-of-life process, I’ve created a <a data-mce-href="https://journeyingon.com/resources" href="https://journeyingon.com/resources" target="_blank" rel="noopener">Resources</a> section on this blog. This area includes books, videos, and podcasts that I’ve found valuable. It’s a space where the dying and their loved ones can find tools and information to help them through this tender time.To kick off this series, I’m excited to share <a data-mce-href="https://www.amazon.com/Dreaming-Beyond-Death-Pre-Death-Visions/dp/0807077151" href="https://www.amazon.com/Dreaming-Beyond-Death-Pre-Death-Visions/dp/0807077151" target="_blank" rel="noopener">Dreaming Beyond Death: A Guide to Pre-Death Dreams and Visions by Kelly Bulkeley and Patricia Bulkley.</a>This book sheds light on the profound and often mysterious dreams and visions experienced by those nearing the end of life. Drawing on real-life case studies, the authors highlight recurring themes such as reunions with loved ones, symbolic journeys, and moments of healing or forgiveness. These dreams often provide emotional resolution and peace, not only for the dying but also for their families.As professionals, understanding the significance of these dreams can deepen our work. They remind us that the dying process is not only physical but also emotional and spiritual. By recognizing and respecting these dreams, we can create space for the dying to find meaning and closure.My Personal Connection to Dream InterpretationDreams have always played a powerful role in my life, shaping my understanding of connection and transition. When I was a child, I had a dream that one of my grandmothers would die. In the dream, it was my other grandmother, but two days later, the unexpected happened, and my nana passed. That night she visited me and told me everything would be OK. &nbsp;She was right. &nbsp;I remember vividly feeling her presence after her death—a deeply comforting experience that has repeated itself with other family members over the years who passed and with my nana to this day.This personal profound connection led me to explore dream interpretation more deeply. I have developed ways of analyzing and documenting my dreams. &nbsp;Many of my paintings come from dreams or visions. &nbsp;In 2023- 2024 I belonged to a weekly dream group in Santa Fe, learning how to uncover the layers of meaning within dreams. We were a small but powerful group of women and one male, the group was rewarding and insightful. &nbsp;Over time, I’ve supported others in interpreting their dreams, helping them find clarity and comfort. As a End Of LIfe Doula, I offer this as a service to help the dying understand their pre-death dreams and the messages they might hold.Why Dreaming Beyond Death Matters The stories in this book highlight the transformative power of dreams at the end of life. For example, the authors share a case about an elderly woman who dreamed of a vibrant garden where she reunited with her mother and sister. This dream gave her a profound sense of peace and readiness to transition. Another story involves a man who dreamed of boarding a ship to join friends from his youth, which helped him articulate his acceptance of death to his family.Practical Applications For end-of-life workers like Doulas, hospice staff, and nurses, Dreaming Beyond Death serves as a resource to:<ul><li>Recognize the transformative power of pre-death dreams.</li><li>Foster deeper connections with patients by inviting them to share these experiences.</li><li>Offer reassurance to families by explaining the healing potential of these visions.</li></ul>These dreams are more than just visions—they are pathways to emotional and spiritual resolution. As professionals, we can honor these experiences by encouraging those in our care to share their dreams and by helping families understand their significance.Final Thoughts Dreaming Beyond Death is an invaluable resource for those of us working in end-of-life care. It reminds us that dreams are not just personal—they can be communal and deeply healing. By bringing attention to these dreams, we can help the dying and their loved ones find meaning, connection, and peace.If you’re a end of life doula, hospice worker, or caregiver, I highly recommend this book. And if you or someone you’re caring for is experiencing vivid dreams near the end of life,<a data-mce-href="https://journeyingon.com/services" href="https://journeyingon.com/services" target="_blank" rel="noopener"> I’d be honored to help explore their meaning.&nbsp;</a>Warmly, Sundara Heart

Dreaming Beyond Death: A Guide to Pre-Death Dreams and Visions

I recently became aware of a patient in the late stages of Alzheimer’s whose family explored Medical Aid in Dying (MAiD) as an option here in New Mexico. Unfortunately, due to the patient's condition, MAiD was not available to him. The family considered Voluntary Stopping of Eating and Drinking (VSED) but ultimately decided against it. Their journey and thoughtful deliberation inspired me to write this post to offer information about VSED as an end-of-life option for those seeking alternatives.In places like New Mexico, where Medical Aid in Dying (MAiD) may not be accessible to all individuals, those seeking control over their end-of-life journey sometimes turn to voluntary cessation of eating and drinking (VSED). While this decision is deeply personal, it is important to approach the subject with compassion, understanding, and informed guidance.What Is VSED? Voluntary cessation of eating and drinking is a legal, nonviolent way for individuals to hasten death by choosing to stop consuming food and fluids. This choice is often made by individuals with terminal illnesses or those experiencing unbearable suffering, particularly when other forms of end-of-life care, such as MAiD, are unavailable or inaccessible.Why Consider VSED? For some, the desire to avoid prolonged suffering, loss of autonomy, or burdensome medical interventions leads them to consider VSED. Unlike suicide, which can be impulsive or traumatic, VSED is a deliberate, mindful choice that allows individuals to prepare for death on their terms. It can also be an act of acceptance—letting go of the body's physical needs as part of the natural process of dying.The Process of VSED The journey of VSED requires careful planning and support. It is not merely about "starvation" but rather a conscious decision to stop consuming both food and liquids. Without hydration, the body typically transitions into the dying process within 7–14 days.Physical Effects: Initially, individuals may experience hunger and thirst, but these sensations often diminish after the first few days. With proper palliative care, discomfort can be managed effectively. Mental and Emotional Effects: Preparing mentally and emotionally is crucial. Meditation, counseling, and spiritual support can provide comfort and clarity during the process. The Role of a Death Doula As an End-of-Life Worker, I’ve seen how vital compassionate care and informed support are during the dying process. A death doula or end-of-life guide can help facilitate a meaningful, peaceful experience for both the individual and their loved ones.Here’s how an end-of-life-doula can help during VSED:Emotional Support: Providing a nonjudgmental space to explore fears, hopes, and unresolved emotions. Palliative Guidance: Working alongside healthcare providers to manage discomfort and ensure dignity. Legacy Work: Helping individuals create meaningful memories or share their story with loved ones. Ethical and Practical Considerations Choosing VSED is not an easy decision. It is essential to:Communicate with Loved Ones: Open discussions help family members understand and respect the choice. Engage Healthcare Professionals: A hospice team or palliative care specialist can provide medical guidance. Prepare Legally: Document wishes clearly in advance directives or living wills. Respecting Personal AutonomyAt its core, VSED is about autonomy—giving individuals the right to make decisions about their bodies and their deaths. While it may not be the right choice for everyone, for some, it offers peace of mind and control in a situation where options may feel limited.Individuals who chose to stop eating and drinking and document their final weeks on VSEDMeet Dr Micheal MillerThe story of Dr Michael Miller, retired surgeon and hospice patient with end-stage cancer who chose to stop eating and drinking to hasten and ease his death at <a data-mce-href="http://www.dyingwishmedia.com" href="http://www.dyingwishmedia.com" target="_blank" rel="noopener">www.dyingwishmedia.com</a><figure id="figure-yftghq5nrm5vessxy"><iframe id="yftghq5nrm5vessxy" src="https://www.youtube.com/embed/VNGXbi84U5o" class="w-full bg-gray-100 " style="aspect-ratio: 16/9;" allowfullscreen="" data-url="https://www.youtube.com/watch?v=VNGXbi84U5o" data-corners="default" data-fullwidth="false" data-mce-src="https://www.youtube.com/embed/VNGXbi84U5o" data-mce-style="aspect-ratio: 16/9;"></iframe></figure>Meet Rosemary Bowen (viewer discretion advised)At age 94, Rosemary Bowen hastened her death by voluntarily stopping eating and drinking (VSED) in 2018. For twenty years, Rosemary Bowen had told her family that she would hasten her death when she was no longer able to live independently. Several months after suffering a back injury, she decided that she was ready to die. Rosemary asked her daughter to make this video to show others that VSED could be a sensible end-of-life option.<figure id="figure-3mraqq6t9um5vdmuyb" class=""><iframe id="3mraqq6t9um5vdmuyb" src="https://www.youtube.com/embed/FpEwH6AKeVA" class="w-full bg-gray-100 " style="aspect-ratio: 16/9;" allowfullscreen="" data-url="https://www.youtube.com/watch?v=FpEwH6AKeVA&amp;rco=1" data-corners="default" data-fullwidth="false" data-mce-src="https://www.youtube.com/embed/FpEwH6AKeVA" data-mce-style="aspect-ratio: 16/9;"></iframe></figure>Conclusion The end of life is as unique as the life lived. For those in New Mexico or elsewhere without access to MAiD, VSED may provide a path to a dignified death, guided by choice and surrounded by support.Compassion and Choices an organization dedicated to improving care, expanding options and empowering everyone to chart their end-of-life journey has a wealth of information on VSED. &nbsp;You can view their website <a data-mce-href="https://compassionandchoices.org/resource/facts-about-voluntarily-stopping-eating-and-drinking-vsed/" href="https://compassionandchoices.org/resource/facts-about-voluntarily-stopping-eating-and-drinking-vsed/" target="_blank" rel="noopener">HERE</a>If you or a loved one are considering this option, <a data-mce-href="https://journeyingon.com/contact" href="https://journeyingon.com/contact">reach out </a>for compassionate guidance. Together, we can create a plan that honors your wishes and provides peace in life’s final chapter.In Support - Sundara

Journeying On

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Understanding VSED: Insights from Recent Research

Meaningful services an End of Life Worker (Death Doula) c...

The Room Next Door - OUT NOW

30-Minute Meditation for Deep Relaxation and Emotional Su...

Dreaming Beyond Death: A Guide to Pre-Death Dreams and Vi...

Starvation as a Voluntary End-of-Life Choice: A Compassio...