While hospice and palliative care provide physical end-of-life care for patients and their loved ones, a death doula — or end-of-life doula — can enhance traditional care by offering an additional layer of support. Death doulas provide non-medical emotional, spiritual, and physical support to individuals who are transitioning to death, and their loved ones.
As hospice and palliative care focus on pain and symptom management for patients and their loved ones, death doulas can often help those facing the end of life achieve a better death by allowing them to live the time they have left with purpose and companionship.
The word “doula” originates from a Greek word meaning “a woman of service,” and was later adopted by those guiding women through their birth process in a term used widely today: birth doula. The titles “death doula” or “end-of-life doula” are the most common terms for the type of practitioner described here, but you may also hear a death doula referred to as a death midwife or an end-of-life coach.
Central to the doula’s role is non-judgmental, holistic support that empowers patients and their loved ones to make the choices they want for their death experiences and to do so surrounded by the support they need. Doulas work to create and hold space for the needs and wishes of the dying while at the same time using their expertise to bring perspective, greater meaning, and comfort to the dying process.
Who can benefit from a death doula?
Anyone nearing the end of life can benefit from a death doula, and death doulas can begin working with patients and/or their families at any point in the death process. Some will choose to engage with an end-of-life doula as soon as they learn of a terminal diagnosis or receive a prognosis with limited time, though doulas are not bound to the six-month-or-less prognosis that hospices must abide by. Others will choose to integrate a death doula when they are closer to death, using their services for emotional and spiritual peace during a more difficult phase. Others still may engage a doula after the death of a loved one for support through the grieving process.
Doula services can be provided alone or in conjunction with traditional healthcare services—like hospice care and palliative care—to enhance the patient and family’s experience. While hospice care does provide interdisciplinary, holistic support, the death doula can offer expertise in areas that most hospice do not cover.
What services might a death doula offer?
The services that each doula offers depend on their skill set and training. Below are some of the core services an end-of-life doula may provide, though this list is not exhaustive. If you’re looking for a death doula that is right for you or your loved one, be sure to ask which services they furnish to ensure they can meet your unique needs.
- An explanation of common signs and symptoms of the dying process, as well as their meanings
- Help exploring the meaning of the dying person’s life and legacy
- An open ear to receive the frank thoughts of the dying, and provide counsel if requested
- Companionship during the death process – many doulas sit vigil so those in the death process are not alone
- Appropriate, comforting touch and massage
- Caregiver assistance and respite as well as emotional support
- Referrals for patients and family members to additional community resources or care providers, as needed
- Practical support through errands, household help, transportation, etc.
- Grief support for the bereaved
How can I find the right death doula for me?
While there is no single death doula certification or program that serves as the industry standard, it is important to ensure that the doula you entrust with you or your loved one’s care is professionally trained. Several certifications and training programs exist throughout the United States, each with a slightly different focus or set of core beliefs. The list below is not exhaustive but does outline a few death doula certifications and training programs that you can look for when choosing your end-of-life doula:
- The University of Vermont Robert Larner, M.D. College of Medicine End-of-Life Doula Professional Certificate
- Sacred Passage: End Of Life Doula Certificate, Conscious Dying Institute
- International End-of-Life Doula Association’s (INELDA) End-of-Life Doula Training
- Peaceful Presence End of Life Doula – Professional Presence End of Life Doula Training
It may also be helpful to get started on your search with these reputable doula directories:
- National End-of-Life Doula Alliance (NEDA) Directory
- International End-of-Life Doula Association’s (INELDA) Directory
Review the types of care that are available and see if a death doula can help you meet your needs.
