The 11th hour
As 63-year-old Bernadette “Bernie” Nord Christiansen vacillated in and out of consciousness at home, her family watched and knew that their beloved family member, who had fought a long battle with pancreatic cancer, was actively dying.
Preparations for this moment began when Christiansen sought out death doula Nina Guertin shortly after her diagnosis in 2019. During those final moments of her life in November 2021, Christiansen had comfort and ease about dying and was ready because of the spiritual guidance Guertin used to support her journey to death.
Guertin normalized dying.
“She just made the whole death experience so beautiful and calm,” Christiansen’s sister Mary Nord said. “Part of the reason was that I saw my sister that way [calm]. She [Bernie] wasn’t afraid.”
Nina Guertin at her Northeast studio, 4 Angels Creations.
The birth of a death doula
Nina Guertin, owner of 4 Angels Creations, 2653 Stinson Blvd., never set out to be a death doula. She worked in a corporate setting for many years before she realized she needed and wanted to do something different. At first, she reconciled with her love for clay, becoming a full-time artist.
But she also had another career nudge – to become a spiritual director. And soon after, another nudge – to work in hospice with terminally diagnosed patients. After she began working in hospice care, her interest in becoming a death doula immediately sparked after learning more on a local public radio show.
Right there, Guertin knew death doula work was part of her calling. She completed training and requested any client from her employer who was actively dying. From the beginning, Guertin made it clear she would work with any person who was dying, regardless of diagnosis or criminal history, and learn from each unique experience.
“[Whether] it’s a bereaved client, a dying client, or if it’s a hospice client where I’m working, every single one of them is my teacher,” Guertin said.
Guertin’s own brushes with grief have contributed to her personal journey. She has grappled with grief surrounding her parents’ deaths, her brother’s death from AIDS and her own experience having three stillborn babies. Many of those reflections help scope how she helps her current clients.
“Being with my mom during that [dying] period, I would watch her and there were times when she wouldn’t talk at all,” Guertin reflected. “I thought, how do I get in?”
With all those experiences in mind, Guertin eventually opened 4 Angels Creations, a studio meant to create space for clients to experience grief through artwork with clay, spiritual direction through imagery rituals and legacy work as clients move closer to their deaths. The space also helps families become involved and actively participate in the process, allowing them to prepare for their loved ones to die.
“You have an opportunity to do something together [that is] meaningful and not sit there and say, ‘I’m so sad and you’re going to die,’” Nord said.
The process of dying
As a death doula, Guertin spends time with each client from the first contact to the day they die.
Guertin uses her certifications as a spiritual director and grief support specialist, experiences and work as an artist, education as a death doula and her work as a chaplain in hospice to craft plans that make each client’s death experience unique to them.
She offers clients and their families a visual imagery meditation that walks each person through the process of dying using four elements: earth, water, fire and air. Once certain characteristics of an element leave the body, the body moves toward the next phase, eventually ending with the absence of air, or rather, death.
“I was in tears at the end,” Nord said about the imagery. “Nina explains where you’re at and what’s going to happen by laying it out in a physical, emotional, and spiritual way.”
“The more that we can educate, the less fear there is, and the family can lean in more,” Guertin said. “It gives their person, I believe, a beautiful death in that their family can be there, they’re not stressed out, and they are really there [for them].”
Death doula services also include time to work with clay; something Guertin believes helps the grief process. Clients can make angels and legacy pots that include a client’s thumbprint, given to family members as a personalized remembrance. All the firing and glazing is done right inside the studio.
“Clay is like us in that it can be hard, soft, cold, or hot,” Guertin explains. “It can be resistance, and it can surrender.”
“Grief that sits in this visceral region of the abdomen gets moved up and out and through their hands into the clay, and then it’s released,” Guertin said. “If they release it, they can move forward, so it’s a beautiful process.”
Some of the legacy pinch pots, which contain loved one’s thumbprints.
Voluntary stopping eating and drinking
When Christiansen became paralyzed from the waist down after the tumors from her cancer had grown against her spinal cord, she made the decision to die without waiting for her cancer to overtake her body. She was ready.
“It’s not a pretty process to watch,” Nord reflected. “The body is shutting down; it wants to fight and she didn’t want to do that.”
Voluntarily stopping eating and drinking (VSED), a method to reduce suffering and end terminal diseases earlier, is the only option Minnesota currently has that can lead to a planned death. Only 11 states nationwide support the Dignity to Die Act, which allows anyone over the age of 18 who is diagnosed with a terminal illness the ability to obtain medications from a physician that will end their life.
Guertin explains VSED options as she works with her clients. If chosen, she advises family on the process and what this looks like during the final days and hours. The process isn’t easy or immediate, but it allows those who are actively dying to have control over how they die.
It took eight days for Bernie Christiansen to die by VSED, but the decision on timing and the finality of her death was in her control.
“For the person who is at the end of their life to be relaxed and accepting of it, and for me as a family member, who watched her be that way, made me more accepting,” Nord said.
Guertin helps families by facilitating a ceremonial washing of their loved one before the body is released to the funeral home.
“People grieve and understand that the spirit and soul are gone,” Guertin explains. “This is just the shell of what’s left. It’s to help people to touch the shell and to keep remembering, ‘This isn’t my mom. This is her body.’ What I invite them to do when we do a body washing ritual is to thank that body.”
Death is inevitable.
For Bernie’s sister Mary Nord, Guertin’s spiritual guidance changed her vision on the fear and anxiety about dying. She encourages others to consider death doulas because as humans, we are all on the same trajectory.
“As a culture, we don’t talk about death,” Nord says. “We don’t talk about getting old and dying, and yet, we’re all going to do it.”
“I’ve developed a lot of different rituals that are part of how people take care of unfinished business,” Guertin said. “You are inviting them into the most peaceful and dignified death.”
Guertin provides services to both humans and animals who have terminal diagnoses. For more information on Guertin’s wide variety of services, visit: https://4angelscreations.com