Sacred Transitions: The Transformative Work of End of Life Soul Doulas
What exactly is an end-of-life doula? Similar to how birth doulas support mothers through labor, end-of-life doulas guide individuals and families through the death process, providing emotional, spiritual, and practical support. Mary's unique approach incorporates plant medicine, energy work, and spiritual insights that help both the dying and their loved ones navigate this threshold with greater peace and understanding. In a society that often relegates death to sterile hospital rooms and uncomfortable silences, Mary's work brings back the sacred elements of this universal human experience, reminding us that how we approach death ultimately teaches us how to live more fully.
The Journey to Becoming a Death Doula
Mary's path to becoming an end-of-life doula began, as it often does for those in this field, through personal experience with death. While supporting her grandfather during his transition, she found herself instinctively providing the same type of care she had previously offered to people in plant medicine ceremonies. This natural alignment between plant medicine work and end-of-life support created a moment of clarity—Mary wasn't experiencing grief in the expected way, but instead felt drawn to facilitate this sacred passage.
The confirmation of her calling came unexpectedly when, a week and a half after her grandfather's passing, one of her medicine teachers casually asked if she had ever considered becoming a death doula. Those two words—"death" and "doula"—resonated deeply within her, awakening what felt like ancient knowledge. Despite having an established career in finance and insurance in the motorcycle industry, Mary put in her three-month notice that very day, diving headfirst into certification and developing her practice as an end-of-life doula.
What began as a personal calling has since evolved into both a private practice and an educational platform. Mary now not only serves clients directly but also trains other end-of-life doulas through her three-month program, which includes modules, coaching, and in-person mentorship in partnership with Golden Gate Hospice. She describes her training program as a "mystery school" because each doula emerges with their own unique approach—some choosing to work exclusively with children, others with pets, and still others with people facing death alone. This diversity reflects Mary's belief that everyone inherently knows how to die; the doula's role is simply to help access and honor that innate wisdom.
Plant Medicine and End of Life Care
One of the most distinctive aspects of Mary's approach is her incorporation of plant medicine into end-of-life care. She views psychedelic experiences as inherently connected to death—even for those not facing terminal diagnoses. The plant medicine journey often involves the death of limiting beliefs, outdated patterns, or ways of relating to oneself and others. For those at the end of life, these experiences can be particularly empowering, especially after having endured the loss of autonomy that often accompanies serious illness.
Mary shares the story of a jovial businessman from Tennessee who ran a nut-roasting company. During his liver cancer journey, she facilitated a low-dose 5-MeO-DMT session for him. His response—"This is better than morphine"—speaks volumes about the potential of these medicines to offer not just physical relief but a transcendent perspective during life's final chapter. In another powerful example, she worked with a woman whose greatest fear was that separating from her physical body would be painful. During a guided 5-MeO-DMT ceremony, this woman experienced herself floating above her body through clouds, later reporting with wonder: "It didn't hurt." This profound realization transformed her relationship with death, allowing her to spend her remaining time engaging more fully with her family rather than being consumed by fear.
When integrating plant medicine into end-of-life care, Mary emphasizes the importance of thorough intake processes, medical coordination, and appropriate dosing. She works closely with families, care teams, and when possible, doctors and pharmacists to ensure safety and eligibility for various medicines. For terminal patients, she often uses lower doses than would be typical in other contexts, recognizing that the physical body may not have the energy for prolonged journeys. This careful, personalized approach creates just enough space in what neuroscientists call the "default mode network" to allow barriers to drop and helpful insights to emerge.
Legacy Projects and Memory Preservation
Beyond the moment of transition itself, Mary places significant emphasis on legacy projects—unique creations that capture the essence of a person's life and the impact they've had on others. She describes these projects as fingerprints, magnifiers, or holograms that preserve someone's life story and influence in tangible ways that survivors can revisit and draw comfort from long after their loved one has passed.
Legacy projects take countless forms, as unique as the individuals they commemorate. Some examples Mary shares include:
Cookbooks containing family recipes
Video recordings of stories or messages
Personal diaries or written reflections
QR codes placed on gravestones that, when scanned, might reveal the deceased's favorite recipe or a video of them dancing
Audio recordings of significant memories or wisdom
The beauty of these projects lies in their ability to transform grief into creativity while keeping the essence of the person accessible to those who remain. Mary recalls how her work with one family led to the creation of a cookbook that allows younger generations to continue making "grandma's cookies," thus preserving not just recipes but the love and connection they represent. These tangible touchpoints help survivors process grief while honoring the continuing influence of their loved ones.
Reframing Our Relationship with Death
At the heart of Mary's work is an invitation to fundamentally reconsider how we think about death. Rather than viewing it as an end or something to be feared, she encourages us to see death as a graduation from the physical body—a celebration of the soul moving into something much larger. This perspective shift doesn't deny the natural grief that comes with loss, but it does place that grief within a broader context of spiritual understanding and continuity.
Mary challenges the common notion that working with death and dying is inherently draining or depressing. Contrary to what many assume, she finds her work deeply energizing and nourishing. She explains that after "slaying the dragon of fearing death," she received the gift of being able to step into a different plane of existence during her work—becoming a conduit or "battery" for energy rather than depleting her own resources. This allows her to be fully present with clients while still maintaining boundaries that enable her to step back into her everyday roles when needed.
This reframing extends to how we approach preparation for death, both our own and others'. Mary advocates for everyone to complete an advanced directive document like her "Final Chapters," which includes not only practical end-of-life decisions but also legacy and vigil questions. She views this planning not as morbid but as a spiritual practice—a way of "forward-facing" death that ultimately enriches life. By considering how we want to be remembered and what environment we want during our final days, we exercise agency and intentionality that can bring peace both to ourselves and to those who will eventually care for us.
Death as a Teacher for the Living
Mary's parting wisdom offers a powerful reframing: "Death is for the living." This seemingly paradoxical statement contains profound truth—our encounters with mortality, whether through personal losses or contemplation of our own finite nature, create space within us for a greater capacity to live fully. There is always more on the other side of grief and loss, Mary assures us, but we must be willing to "stay in the ashes long enough to find our own diamond."
This perspective invites each of us to consider how we might approach death differently—both in supporting loved ones through their transitions and in preparing for our own inevitable passage. Rather than postponing this contemplation, Mary encourages us to begin today, recognizing that there is no guarantee of tomorrow. By facing mortality directly, we gain the urgency and clarity needed to live according to our deepest values rather than postponing our most meaningful contributions.
If you feel called to explore this sacred work further, consider taking these next steps:
Create your own advanced directive document, including not just medical decisions but also your wishes for the environment, comfort measures, and meaningful rituals during your final days.
Begin a conversation with loved ones about death and legacy, breaking the taboo that often surrounds these topics.
Consider what legacy project might meaningfully represent your life journey, and perhaps begin creating it now rather than leaving it to others.
Explore local resources for end-of-life planning, including doulas, hospice services, and spiritual support aligned with your beliefs.
Practice presence with natural cycles of death and rebirth in your environment as a way of becoming more comfortable with life's transitions.
Remember that, as Mary so beautifully states, "Everybody's here on purpose," and the end of life offers a powerful opportunity to reflect on that purpose with the benefit of seeing our "full body of work." By approaching death with intention, awareness, and openness, we transform not only our final chapter but every page that precedes it.
To learn more about Mary Telliano's work as an end-of-life doula or to explore her training program, visit www.connectanamcara.com or follow her on Instagram @mary_telliano.
Visit mooncollectivesanctuary.com or follow @mooncollectivesanctuary for more resources.
