End-of-life care plans. Naming a power of attorney. DNR and DNI status. The legal paperwork, the financial paperwork, the cremation-or-burial question nobody wants to ask out loud. These are decisions every single one of us will face. Most families put them off until the very last moment — or never have them at all.
And when that happens, we don’t just leave chaos for the people who are left behind. We strip the dying person of the one thing they should have been able to keep: a say in how their own life ends.
That’s just the tangible stuff. What about the rest of it? The legacy they wanted to leave. The grief plan nobody made. The conversation that never happened because there was no one left to have it with.
Here’s the thing: there’s a name for this work now. A whole profession built around walking families through the end of life with intention instead of chaos. And this week, two of them are on the show.
Hot take this week:
Everybody dies, but almost nobody wants to talk about it.
This Saturday, september 19th, on Aging Together // Unfiltered
Talking About Death Won’t Kill You: What Is a Death Doula & Other End-of-Life Care Needs with Lindsay Lenhart RN & Kim Ladd, RN, certified death doulas and co-founders of Walking Home Doulas.
Lindsay and Kim met as neonatal intensive care nurses in Chicago more than twenty years ago, holding space for families through both the beginning and the abrupt end of life. Since 2022 they’ve served as hospice volunteers and trained as end-of-life doulas through Going with Grace. They came to this work the way most people do — through their own losses, and through everything the system didn’t give them when it mattered.
This is a conversation four scheduling attempts in the making, and it covers ground the show has never touched before. We recorded it two days before Illinois became the first Midwestern state where medical aid in dying became a legal option. So naturally, I had to roll it out sooner than planned!
What is a death doula, and how is that different from hospice?
Most families have heard of hospice. Fewer have heard of palliative care. Almost none have heard of a death doula — and the ones who have often assume it’s the same thing with a different name.
It isn’t. Lindsay and Kim are explicit that their work is non-medical. They don’t administer medications. They don’t replace the hospice nurse. They fill a different segment entirely — the one hospice, for all its value, structurally cannot cover.
"As the body dies, the body knows how to die. But for the people surrounding them, it's scary, and they don't know what to expect."
If you’ve sat with a dying parent at 2 a.m. wondering whether what you’re watching is normal, you already understand the gap they’re describing. Lindsay and Kim name exactly what a doula does in that gap and what they deliberately don’t do.
Why do families wait until a crisis? And what does that cost them?
We ask when the right time is to bring someone in. The answer is something nobody wants to hear.
"It always seems too early until it's too late."
There’s a version of this conversation that happens quietly, in whispers, inside friend groups — is your mom not as sharp as she used to be either? — and never makes it to the family dinner table. Lindsay and Kim have watched what happens when it stays a whisper, and they’re direct about the cost: siblings with competing certainties about what Mom would have wanted, nothing in writing, and a decision that has to be made in the next four hours.
They also have a strong opinion about hospice timing itself — that families reach for it far too late, treating a six-month benefit like a final week of life. Why that costs families more than they realize is one of the more uncomfortable stretches of the episode.
What does end-of-life planning actually include beyond an advance directive?
The advance directive is the floor, not the ceiling.
Lindsay and Kim walk through what’s underneath it: body disposition options most people don’t know exist, passwords, legacy, grief plans, and the questions that never appear on any form. Who do you want in the room? Who do you not want in the room? Do you want to be touched?
"She's still alive until you're dead."
Planning for the end isn’t a rehearsal for dying. It’s what clears enough space to keep living on purpose while you still can.
How does anticipatory grief show up for caregivers, and does planning help?
Caregiving grief doesn’t start at the funeral.
Family caregivers carry at least three losses at once: the person they’re slowly losing, the life they had before caregiving started, and the identity they’ll have to rebuild after it ends. That third one almost never gets named, and it’s what ambushes people six weeks after the service.
We get into what actually helps here, and, honestly, into what doesn’t. Because “go take a walk” and “go do some yoga” have become the default American answer to caregiver burnout, and both Lindsay and Kim have watched that answer fail in real time. What they offer instead is smaller, stranger, and considerably more useful. It involves sticky notes.
And then an Illinois law was signed into effect
Two days after we recorded this conversation, the law in my state changed.
On September 12th, Illinois became the first state in the Midwest — and the thirteenth U.S. jurisdiction — where medical aid in dying became a legal end-of-life option. The law is SB 1950, the End-of-Life Options for Terminally Ill Patients Act, better known as Deb’s Law, named for Deb Robertson, a Lombard resident and former social worker who spent the last years of her life advocating for it.
It applies to a narrow group: Illinois adults with a terminal diagnosis and a prognosis of six months or less, confirmed by a second physician, with the mental capacity to make their own healthcare decisions, who are able to self-administer the medication.
Read that eligibility line again, because it should look familiar. Six months or less is the same threshold that qualifies someone for hospice.
So we now have a state where the moment a person becomes eligible for this option is the exact moment they become eligible for hospice. As Lindsay and Kim describe, most families don’t reach for hospice until there are days left. Will it be the same for this?
The law is genuinely contested. The Catholic Conference of Illinois opposed it and urged a veto, arguing for expanded palliative care instead. Some disability rights organizations fought it in federal court through this month. And “effective” isn’t the same as available: hospital systems across the state are still deciding whether they’ll participate at all, which means a legally available option may be a practically unavailable one depending on where you live and who treats you.
I asked Lindsay and Kim where they stand on medical aid in dying near the end of our conversation. I knew roughly what they’d say. I didn’t expect the reason, and it had less to do with dying than with what fear does to people who are still living.
One timing note for listeners:
We recorded two days before the law took effect, so you’ll hear me refer to medical aid in dying as not yet legal here. As of September 12th, it is.
The caregiver takeaway: What you Can Do Right Now
You don’t need to book anyone this week. You need one conversation, and it doesn’t have to start with death.
Start with the smallest possible question: “What’s your understanding of what’s going on right now?” Lindsay and Kim use it as an opening move, and it works because it isn’t a request for decisions. It’s a request for their read on their own situation, which tells you, immediately, whether you’re talking to someone in denial, someone anxious, or someone who’s been waiting for anyone in the family to bring it up.
Ask it in the car. Ask it while the dishes are going. You are not planning a death. You’re finding out where the person actually is.
The full conversation with Lindsay & Kim drops tomorrow morning. Follow aging together // unfiltered wherever you listen or watch so it lands straight in your feed.
Want more conversations like this one? Tune in to the Aging Together Unfiltered podcast, and follow along on Instagram and LinkedIn. If this resonated, share it with another caregiver who needs to read it.
At Aging Together, we’re dedicated to helping you navigate aging together — whether you’re an older adult planning ahead, a caregiver seeking support, or simply someone who wants to understand the aging process. I hope you’ll join us on this journey.