palliative care doula        

                end-of-life doula

                              deb turnow


                  “we shall find peace. we shall hear angels.

                  we shall see the sky sparking with diamonds.”

                           ~anton chekhov  



                spiritual guidance

     roxanne o’reilly & deb turnow

              “there is a voice that doesn’t use words. listen.”





          what can a palliative care doula offer?

First of all – what is a doula? In the ancient Greek, a doula is “one who serves”.  A doula provides emotional, spiritual and informational support to their clients, in addition to being an advocate.

In this role I help patients navigate the medical system following a serious diagnosis. I assist them in communicating with health providers to obtain the information needed to make informed and intentional decisions.

after receiving a serious diagnosis, many people have these types of questions:

  • What does my diagnosis mean?
  • What questions should I be asking my doctor?
  • What are my treatment options?
  • How would I go about getting a second opinion?
  • How will I know when it’s time to move from aggressive treatment to comfort care?


what I do as a palliative care doula:

  • Help walk you through the initial diagnosis
  • Gather additional information on your condition and/or illness
  • Attend specialist appointments with you, take notes and help you ask questions, so you have all the information you need to make appropriate decisions
  • Help you understand what was discussed in the appointment
  • Accompany you to medical tests
  • Accompany you as you get your test results and help you understand them
  • Help you navigate treatment options
  • Ensure that your needs and wishes are communicated
  • Help coordinate treatment with the different treatment providers
  • Communicate with doctors, nurses, and other providers
  • Assess the need for a second opinion
  • Identify areas where there is more care needed
  • Assist with completing advanced directives

“embrace uncertainty. some the most beautiful chapters in our lives won’t have a title until much later.”

bob goff


what an end-of-life doula can offer…

The first thing to acknowledge is that we all will die – it’s not if we will die but when. It will be a universal experience for all of us. Recognizing that death is a natural part of the human experience can help us when it becomes a reality in our own life or in the life of someone we love. Having a trained doula walk with you on this journey can be a great comfort and makes the transition from life to death a sacred time.

An end-of-life doula or midwife can help with many aspects of the dying process. I provide a supportive, compassionate, intentional, non-judgmental, and nurturing environment that encompasses the physical, emotional, and spiritual needs of both the person who is dying and their loved ones. 

client services  

holistic support – emotional, physical, and spiritual

  • What are you feeling and thinking? Are you angry, fearful, concerned for your loved ones? Together we can explore and process these feelings and thoughts. This can be a time of deep, emotional healing.
  • What unfinished business do you have? Are there relationships you want to attend to?  Forgiveness you wish to seek or offer? Confessions you wish to make?
  • What might you wish to do with the time you have left? What might be some ways to bring comfort to your body? What might you expect to happen as the time draws near?
  • What do you think happens after you die? What have you been taught?  What do you believe?  What does it look like to integrate what you truly believe with where you find yourself at this moment? What does it look like to draw on your faith or spirituality as you enter into this final part of your journey on earth.

legacy work

  • What do you want to leave as a legacy? What does it look like to create something that reflects the meaning of your life?  This could be written, painted, photographed, quilted, etc.


  • I spend time with you – talking, reading, or just being present.                                  

creating ritual

  • I help you create meaningful and intentional rituals that can be done prior to, while you are in your last hours and even after your death. If a ritual is desired, they are unique to each individual.

creating a peaceful environment

  • What do you wish to be surrounded with as you enter into the last days? Soft fabrics, special music, candles, nature? I will help you create an environment that is peaceful, serene and calm, and uniquely suited to what you want.


sitting vigil

  • Vigil is the act of sitting with you during the last hours. It includes maintaining the environment you desire, sitting by your bedside, offering non-medical comforts, helping your loved ones understand the dying process and being present to you, physically, emotionally and spiritually as you transition.

support for loved ones

education on the dying process

  • What are the signs one sees in the process of dying? Because we are so disconnected from the natural process of dying, we are unfamiliar with and frightened by what the body goes through as it begins to shut down.


  • I provide respite for family members sitting vigil, giving them time to refresh and renew.

bereavement support

  • I offer support to your loved ones, both as you move through the process of dying (anticipatory grief) and after you have passed.


I will work with you to choose the elements that help you create the experience you want/need.


how does what I do differ from hospice?

This is a common question. I often work with patients who have Hospice services. Having both Hospice and an end-of-life doula are complimentary. While Hospice provides the medical support that doulas cannot, their services are regulated by Medicare which limits the time they can spend with each patient.  End-of-life doulas are not bound by these limits, allowing them to spend as much time with the patient as is needed to provide social, emotional and spiritual support..

“death is not extinguishing the light. it is putting out the lamp because the dawn has come.”

rabindranath tagore


I offer a sliding scale if there is a need.  I feel that everyone should be able to receive these services regardless of their ability to pay. 


*initial consultation – no charge

This time will be spent assessing what services may be needed and how I can best meet those needs.

Following the initial consultation, the sessions are personalized for each client based on where the person is in their process, and the amount of support the family/caregivers need during this time.

Here is my pricing structure per session or session package.  Sessions are 1 hour long.

1 session     – $100

3 sessions   – $240

5 sessions   – $400

10 sessions – $800

Sessions can be used as needed, including a pause if there is a improvement in symptoms, and then resuming when there is a need.

vigil supportive care 

Vigil is the bedside presence that is held when a person has entered the active dying phase. It can be helpful to have a doula present for some of that time to help explain to the caregiver(s) what to expect. Caregivers may also feel the need for a break, or they may want the doula there as a supportive presence.

Daily supportive care visits can occur at one time or broken into shifts to offer the best support depending on your individual situation during the active stage of dying and through death.

bedside supportive care includes –

  • Includes 24 hour on-call support.
  • Guided imagery and meditation for the dying, as well as their care givers, if needed.
  • Support and guidance to ensure the vigil plan is carried out as intended.
  • Anticipatory grief work with family and/or care givers.
  • 3-6 weeks after the death, the doula will meet with the loved ones to reprocess the experience and provide beginning grief support and resources.


There are three tiers for this services based on the needs of the caregiver(s).

supportive care – tier 1

Best for individuals with a large support system that may need minimal guidance

Up to 5 days of vigil support – 2 hours per day

 5 days @ 2 hours per day – $800

supportive care – tier 2

Best for individuals with a dedicated support system that may need more guidance with doula presence at the bedside, and some caregiver respite.

Up to 5 days of vigil support – 4 hours per day

5 days @ 4 hours per day – $1600

supportive care – tier 3

Best for individuals looking for extensive guidance, doula presence at the bedside and caregiver respite.

Up to 5 days of vigil support –  8 hours per day

5 days @ 8 hours per day – $3,200

For more information, call or text me at 717-487-2443 or email me at deb@earth-sky.com


Spiritual Guidance

sacred alchemy

with roxanne & deb

Our work together can be described as a balanced complementary contrast – yin and yang. Together we’ll listen deeply to the Spirit on your behalf, share what arises, and process that with you. Together we hope that in your session with us you see a larger picture and are moved to whatever action Spirit is inviting.

Maybe the journey isn’t so much about becoming anything. Maybe it’s about unbecoming everything that really isn’t you so you can be who you were meant to be in the first place.

Paulo Coelho

sacred alchemy

with deb + roxanne


In the work that we do together, we both bring our unique giftings and expressions of them. While individually what we offer is of value, in our working together a window opens into a much larger landscape where you are offered a view that can be eye and heart-opening, healing, and inspirational. In our session with you, we listen deeply to the Spirit on your behalf, share that with you, and then process with you what arises from our time together. Together we hope that in your session with us you see a larger picture and are moved to whatever action you are invited in to. 

Is this for you?

If you are looking for clarity, purpose, and a sense of direction, this session is for you. Through our work together you have the opportunity to become aware of things that have been under the surface.  This session brings the best of what we each offer together in one place. The benefit of both perspectives – Earth and Sky.

 What does the process look like?

You may either bring a question or topic to the session or come open, waiting to see what is brought forward. We begin with silence to settle in and see what arises giving us the space and time to listen on your behalf. At the conclusion of that time, we will share with you what we heard or sensed. You will then move into a time of processing with us to notice what resonates with you and why. Clients leave the time with increased awareness and clarity.


Wondering if sacred alchemy is for you or want to book a session?

Email us if you would like to book a discovery call to see if this is the best next step for you!



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We value connection and it's important to us to work with those who feel in alignment with what we offer. Schedule a free call to see if this is the next step of your journey.



What Our Clients Are Saying

"I felt gently cared for and deliciously at rest"

I felt gently cared for and deliciously at rest as Deb and Roxanne listened to Love on my behalf. Their no-hype, humble offering of what they saw, sensed and heard strengthened my curiosity and courage to enter more deeply into living loved. What a gift to sit with listeners committed to Love and the flourishing of others and to receive attention and guidance. I'm especially grateful that they sent a summary after our time together because my focus word for the year emerged as I continued to sit with all that was received.

"I felt validated"

First, let me say the session was beautiful. I honestly wasn't quite sure what to expect but I loved it. I guess the words that come to mind for me are "validated" and "community". All these years, I knew that I was different. I felt much more deeply than those around me. I always know exactly how every single person in a room is feeling. I also have known/felt when something is going to happen. These are just gut feelings. Anywho... I have spent a lot of energy hiding these gifts. After meeting with you both, I realized that what I have, are definitely gifts and it is okay to be who I am. They are not evil and there is nothing wrong with me. I now know, that there is real-life community that I can be a part of that that I don't have to hide anything and won't be judged.

"Stuck places became unstuck"

The deep listening session was a significant place of definition in my spiritual journey. The atmosphere was comfortable, inviting, supportive, yet very spacious.  I’d expected the process to be effortful on my part, but it felt more like a release, an opening of the flood gates.  That was somewhat surprising. As I was reflecting on the experience and hadn’t noticed that you termed it “deep listening”, deep was the descriptor that arose for both my telling and your listening. Your presence evoked telling from a new place.  It was as if your presence lifted my story.  I felt more power for clarity and articulation as the floodgates opened.   Stuck places became unstuck and there was an energetic flow that I don’t experience on my own. What you shared opened a different dimension by which to view my unfolding journey.  The images were fresh and wonderful guides toward new perspectives/possibilities/potential. Some of it was present awareness and some was hopeful into the future…as the journey is often dark.


There are still things that were said in my session that pop up in my head. Almost like whispers of encouragement.

I think one of the big things for me is that the time with the two of you felt intentional and generous. Sitting in silence together, not needing to bring anything other than openness, and then having the two of you listen on my behalf - it was restorative.