During our interview I told Tiffany Johnson that a neighbor of mine said, “That’s depressing” when I told her I was going to interview a death doula for the Review.
Tiffany laughed and replied, “Do I look depressed?!”
Indeed, throughout the hour-long conversation she was upbeat and excited about her work.
The International End-of-Life Doula Association defines an end-of-life doula “as a nonmedical companion who provides personalized and compassionate support to individuals, families, and their circles of care as they encounter and navigate death, loss, and mortality. An end-of-life doula advocates self-determination and imparts psychosocial, emotional, spiritual, and practical care to empower dignity throughout the dying process.”
“I’m so deeply honored to be invited and trusted,” Tiffany explained, “during a time when people are most vulnerable. I get to be present to such profound moments.”
She pointed out that people in our culture often talk about living well, but avoid learning how to die well — or getting help doing so. That is the vocation of a death doula. The term “doula” comes from the Greek word for servant. Doulas don’t fix things like mechanics or surgeons do. They don’t primarily teach techniques or exercises like physical therapists did to me in the hospital after surgery to repair my fractured femur.
What she does is begin her relationship with a new client by what she calls “reading the room,” i.e. sensing where those who are actively dying are on their journeys as well as their loved ones who accompany them.
“I don’t impose my journey on my clients,” she said. “It’s not my journey. I’m here to bear witness. It’s not my job to change anybody’s experience other than to show love and have dignity and autonomy. I want to show up and help do whatever they want and make sure they don’t do it alone.”
Although Tiffany does not impose her belief system on her clients, she does like the holistic approach of The Tibetan Book of Living and Dying by Sogyal Rinpoche, the major themes of which are:
Death: Framing it not as a final crisis, but as a natural stage of existence and an opportunity for spiritual awakening.
The Four Bardos: Exploring the continuous realities of life, the process of dying, the after-death state, and rebirth.
Practical Tools: Teaches meditation, compassion practices like tonglen, and ways to support loved ones through dying and grief. “Whatever you believe regarding the after, there’s the truth that this body has an expiration. People die the way they live. What happens after this body is individual. I don’t tell anyone what is for them, and I get to pick it for myself. I’m here to keep them safe and loved during that experience.”
Her role as an educator includes providing options. For example, in Illinois medically assisted dying is legal under the End-of-Life Options for Terminally Ill Patients Act (Senate Bill 1950), also known as “Deb’s Law,” which officially went into effect on Sept. 12, 2026. Illinois is the first Midwestern state and the 13th U.S. jurisdiction to authorize medical aid in dying.
Another option is water cremation, which many people have never heard of.
Tiffany also weaves willow caskets.
She urges people to begin the planning process well before they begin “actively dying” because you don’t want to make big decisions when you are in trauma.”
When clients visit Tiffany well in advance, she provides them a checklist, including everything from legal matters to where you would like memorials to go.
Vocation
Growing up in the woods along Lake Superior was a big influence, both on her vocation and her perspectives on life and dying.
“It started in childhood in the forest very closely related to the environment around me and always having animals coming and going — a natural part of living and dying in the woods. We had a lot of pets that we rescued — birth, life and death built into the framework, attachment and grief. It wasn’t hidden. Today we separate a lot of that.
“I grew up with reservation friendships, with Ojibwe people as friends of mine who had a deep reverence for land and life. I talked to the trees. I’m in communion with everything around me. I was definitely raised with a different perspective.”
One of her heroes is Robin Wall Kimmerer, a scientist who is also a registered member of the Potawatomi Tribe. Kimmerer wrote Braiding Sweetgrass: Indigenous Wisdom, Scientific Knowledge, and the Teachings of Plants. Some of her core themes are reciprocity: Nature gives us gifts, like food and clean water, so humans must give back by caring for the Earth. Ecological Consciousness: Healing the planet starts with listening to the natural world and recognizing our connection to all living things.
Tiffany sees plants as teachers.
“I grew up in Ashland, a town with a population around 8,000 and just one major nursing home. On weekends, instead of going to church, we would go to the nursing home and find residents who didn’t have family members around. A lot of people put their elders in nursing homes and walk away, leaving people who are lonely.
“We sat and listened and talked and listened. When I was 12 my dad had a massive stroke resulting in permanent damage. During my teenage years, my dad was on the brink of dying and then recovered. I got to witness what hospital care looks like.
Tiffany is opening a nonmedical, nonprofit hospice house. She will create a “cocoon” in each room and each person will come in with their own hospice team.
“I went to a trade school in Chicago and became a massage therapist, which informs the work I do now. For example, one daughter was afraid to touch her father because of his physical pain. She thought touching him would hurt him. I gave her permission to touch him and hold his hand. She didn’t know what to say to him but he didn’t need that.”
Check out Tom’s ongoing substack posts about the fiction life of Pastor Walter Mitty at https://tomholmes10.substack.com.