End of Life Doulas Near Me

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FAQs:

What is a Death Doula?

A death doula also known as an end-of-life doula, end-of-life coach, death midwife, or death coach — assists a dying person and their loved ones before, during, and after death. An end-of-life doula provides emotional and physical support, education about the dying process, preparation for what’s to come, and guidance while you’re grieving. A doula wants to do as much as they possibly can to help facilitate what the person and their family need. Doulas make sure the threads are connected between the dying person and the important people in their lives, including their hospice team. End-of-life doulas aren’t licensed to provide any medical assistance, but they may advocate for the dying person’s wishes and needs while working together with healthcare providers. There is value in having an interdisciplinary team, with the idea that different fields have different things they bring to the table. The best way to give great care to someone is to involve different viewpoints, different levels of expertise, and different types of expertise. End-of-life doulas and religious leaders both fall into that framework.

What Does a Death Doula Do?

Each dying person’s needs are unique to their specific situation, but the services offered by an end-of-life doula could include a mix of the following:

- Providing the opportunity to talk openly and honestly about the dying process.

- Alleviating the anxiety, guilt, and shame often associated with death and dying.

- Developing a plan for how the person’s environment looks, feels, sounds, and smells.

- Coordinating with family and friends to evaluate visitation.

- Overseeing 24/7 care alongside healthcare providers like hospice and palliative care.

- Providing education and guidance related to other medical services like do-not-resuscitate orders and healthcare power of attorneys.

- Creating guided meditations and rituals specific to a person’s religious faith or spirituality.

- Sitting vigil with a person as they near their final moments.

- Assisting with obituaries and planning funeral services.

- Providing supplemental grief counseling and companionship after someone has died.

- Finding creative ways to honor the person after they’ve died, which can include the person who’s dying as a part of that process and exploring that person’s life and legacy.

The goal is to provide the kind of support people need so that families aren’t exhausted. We want families to have a chance to rest and we want to ensure that people who are dying are not unsafe at home.

Part of that process is making sure the person who’s dying is aware of what’s happening and, if they’re able or they desire it, to give them the space to confront their grief and be an active participant in their dying process.

Along the way, an end-of-life doula may help with what’s referred to as “legacy work,”. It is about exploring the most meaningful moments of someone’s life and finding ways to pass on their legacy. Sometimes, this looks like putting together a scrapbook of memories. Other times, it’s about making those phone calls and writing those letters to long-lost friends or siblings and finding closure in other ways.

Doulas can help facilitate those conversations to make sure they tie up those loose ends and they’re able to say what they want to say before it’s too late. And end-of-life doulas can extend their services to those loved ones who are grieving by providing education and resources along the way. Sometimes, that means a doula may have to call the funeral home to announce the death of the person who died and make an appointment for the funeral. Other times, a doula may just be on standby should the family need their support during the final hours of a person’s life and in the weeks or months after they’ve died.

What’s the Difference Between a Death Doula and Hospice?

End-of-life doulas are similar to hospice care in that both offer counseling, spiritual support, and other nonmedical services to help a dying person and their loved ones during their final days. The medical piece is what sets hospice care and end-of-life doulas apart because doulas are typically not licensed to provide any hands-on medical assistance. That said, doulas are fast becoming an integrated part of hospice care teams. If your hospice care team doesn’t have an in-house doula, if you decide to hire one, the hospice care team should work with them throughout the dying process.

An end-of-life doula’s approach to care is very consistent with hospice care and they’re very synergistic. Where end-of-life doulas excel seems to be advocating for people who are dying, planning and having some of those crucial conversations. The medical piece is just a small part of somebody’s end-of-life experience and we have to acknowledge, as healthcare providers, that sometimes the medical pieces aren’t the most important. Sometimes, it’s connecting, from one human to another.

Who Hires Death Doulas?

Death doulas are hired by patients or family members when a terminal diagnosis is given and stay with that person and their family through their death and beyond. When people are nearing the end of their lives, a doula will visit and often sit vigil with them as they are dying. They also help patients with their will and other advanced directives.

Should You Hire a Death Doula?

The decision to hire an end-of-life doula is very personal, one that should be discussed with you and your family in the same manner of understanding and respect that any other end-of-life decision should be discussed. It’s not easy being cared for. When you see your doctors, you’re expected to sort of be able to clarify and explain exactly what’s going on physically, emotionally, and spiritually. At the same time, you’re not feeling well. So, that’s a really hard thing to do. Having somebody like a death doula who has experience taking care of people at the end of their lives and who has the time to sit and be with that person and help them figure out what’s going on can be really valuable.

How Much Do Death Doulas Charge? 

The cost of hiring an end-of-life doula will depend on the patient’s specific needs and the doula’s pricing. Generally, death doulas are independent contractors, so some may charge an hourly rate, ranging from $25 to $100+ an hour, while others prefer to set a flat fee. As of right now, insurance, including Medicare and Medicaid, does not cover death doula costs. With that said, because the transition to death is such a delicate matter and each case is unique, some doulas are willing to provide rates on a sliding scale or even offer their services for free. When searching for the ideal doula, be sure to inquire about pricing before making your final decision.

How Can I Decide if a Death Doula is a Good Option for Me or My Loved One?

A good way to determine if an end-of-life doula is a good option for you or your loved one is to have a conversation with one or more. Ask them to explain what they do and see if it feels like a good match. Every family, every dying person, and every end-of-life doula is different. And each doula brings a unique set of experiences and expertise. Some might be more versed in providing emotional and spiritual support while others might be more gifted in offering physical and respite care. Find the combination that best meets your needs.  

How Much Time Does a Death Doula Spend with the Person Who is Dying? with the Family?

The amount of time spent with the dying person and their family varies greatly. It depends on when the doula begins the companioning and how much the dying person and their family want the doula to be present. Some families want the doula to empower them to make the journey themselves. Others want the doula beside them every step of the way.  There is no right or wrong way - just what works for each individual and their family.

What is the Difference Between a Death Midwife and a Death Doula?

Defining the roles, responsibilities, and titles of end-of-life support professionals is an ongoing process. Terms for the role may include end-of-life guide, death doula, soul midwife, transition guide, and death midwife.

A Death Doula is most often recognized as someone who guides and supports individuals and their families in the dying journey. This role may or may not include after-death care depending on the training of the doula.

A Death Midwife supports the family through the dying journey; after-death care of the body, the 3-day vigil, home funeral, burial, or cremation.

When Should You Hire an End-of-Life Doula?

Death doulas help people at every stage of the end-of-life process. Anyone older than 18 can contact an end-of-life planner. People of all ages can create advanced directives and organize their physical and online assets, easing the task for loved ones later. They can also choose a health proxy, the individual who will make medical decisions when the injured or sick lose their decision-making ability. This is especially important for those isolated from family. For those diagnosed with a terminal illness, an end-of-life doula can help transform a traumatic situation into a meaningful one for everyone involved. Doulas walk with the dying and their loved ones through their journey for as long as they need.

Are Death Doulas Certified?

It’s important to note that a death doula is not a medical professional and doesn’t have a medical role in a patient’s care. For example, they can’t prescribe pain medication or take vitals. Instead, a death doula provides emotional and spiritual support. There’s currently no credentialing body for death doulas. However, all death doulas should have appropriate training. Training courses are offered by accredited organizations such as the International End of Life Doula Association (INELDA), the Lifespan Doula Association, and the University of Vermont. When you search for a doula, make sure they have the required training. Also, note that death doulas aren’t typically affiliated with any particular religion. Doula services are often designed to be universal. Whether your patient adheres to a specific religious tradition or not, a death doula can still be appropriate.

The Rise of Death Doulas

Humans have looked for ways to ease the transition from life to death for thousands of years. Death doulas are hardly a new concept, though they’re certainly growing in popularity across the nation. For those who have heard the calling themselves, this is a movement that’s here to stay. Death doulas can help people answer some of life’s most pressing questions. Namely, what must be done to create the peace needed to die with grace? Death is far from one-size-fits-all. Death doulas are here to curate the holistic, practical, and spiritual side of mortality. Mortality is precious and limited. It’s what we do with the time we have that matters. As end-of-life doulas know, nothing will bring you as close to understanding the true value and meaning of existence as confronting your death.

Six Guiding Principles of the Doula Model of Care

- Non-medical support ~ Doulas refrain from performing any clinical or medicalized tasks. 

- Non-judgmental support ~ The doula does not impose her/his values on the client such as acting on biases in favor of one method.

- Family-centered approach ~ The individual and their family form the unit of care.  Doulas do not take the place of partners, family members, or other care providers. 

- Holistic care ~ Doulas recognize the biopsychosocial and spiritual aspects of the whole person and provide services in the context of this understanding.

- Empowerment ~ Doulas promote informed decision-making and foster maximum self-determination for the individual and family.

- Team members ~  Doulas are team players with special roles.

Role of a Death Doula During the Dying Three Phases

Death Doulas offer a number of different services and specialties, which are often dependent on several criteria: 1) the person(s) they are serving (the dying/ their loved ones/ the dying AND their loved ones) and 2) the individual stage of the dying process that the person(s) is in. Generally, the event of dying can be categorized into three phases. Care needs for the person(s) involved are different based upon each of these stages: pre-death, active dying, and post-death.

Below are just SOME of the roles that a death doula can offer during each of these phases:

Pre-death: 

- an advocate for the dying and educating on advance directives and other end-of-life documents

- a facilitator to assist with funeral planning

- a translator to help the family understand difficult medical language

- assisting the dying with legacy projects to help their loved ones cope after they have died

- act as additional eyes & ears to communicate with the Hospice team for the care needs of the dying and their loved ones

- a companion for hospital visits and general listening

- a resource guide to offer assistance to families to locate help with meals, housekeeping, or assistance in creating a care-taking schedule for family members

- a calm & unbiased mediator to assist loved ones with any hard conversations that still need to be shared with the dying person before entering the active dying phase. 

- a community educator, to teach at churches, community centers, senior centers, etc... in the role of a death cafe coordinator, education on what death doulas can offer, how advanced directives can make death a much easier process, etc... 

 Active dying: 

- an advocate for the dying and their wishes (sometimes loved ones do not want the same wishes as the dying, there must be an advocate for the dying person individually)

- companion & active listener

- sitting vigil (offering respite to allow loved ones to rest during the transition period of active dying)

- compassionate & calming presence (a death doula understands what's coming, and knows the physical signs of active dying, and they can reassure family members what's happening is normal and part of the dying process) 

- a guide to help loved ones say goodbye to the dying

- a helper to provide practical support and non-medical comfort care such as assistance with repositioning, changing bedsheets, and other comfort care measures, etc. 

- provide solace, spiritual support, gentle/compassionate touch, Reiki, meditation, aromatherapy, etc.. to the dying and their loved ones

 Post-death: 

- A coordinator/communicator between the funeral home and loved ones for services desired

- A resource person to help guide loved ones to community resources, and care of the body (dependent on state/country laws)

- Assistant with after-death paperwork, meal train, and be a voice for the loved ones and their families/friends as they plan arrangements

- Offer bereavement/grief/spiritual support as loved ones continue working through the journey of mourning and grief

Holistic Support Death Doulas Provide

Death Doulas care for the whole person, taking into account patients’ emotional, mental, spiritual, and physical factors. They provide invaluable assistance in three notable areas of holistic support:

Legacy: We are all born and we all die; it’s what we do in the middle that creates our legacy. What we leave behind is far more than simply wealth and possessions. We can share our stories or give wisdom, advice, love, and support even after we have passed. And in doing so, give the future a glimpse of your essence – who you were, how you saw the world, and what gave your life. Death Doulas can help patients with the powerful, uplifting process of developing a legacy plan.

Presence: The last phase of our life can stir fear and anxiety as we each face our end-of-life. This is simply because we have not walked this path before. Having someone present with the experience and training in such a time can bring a sense of comfort and familiarity to the otherwise unfamiliar. Death Doulas provide holistic support as they accompany individuals and their families before, during, and after death.

Dignity: Everyone wants to have a positive passing where they maintain dignity and honor as they exit life. We all have our values, traditions, and belief systems that will influence our vision and expectation of what that would look like. Creating an environment that represents that vision is important. This along with developing a legacy and present work is what an End-of-Life Doula brings to you and your family.

Reasons to Hire a Death Doula

There are many reasons death doulas should be hired, all of which typically amount to creating a compassionate and caring experience for both the individual who is dying and the family experiencing the loss. It's important to remember that a death doula is generally experienced in handling death and the connected events that take place after someone passes away. Even if you feel like you can handle every single logistical item on the checklist, having additional support during such a difficult time is going to be helpful. Here are some reasons why you may want to consider hiring a death doula:

- They can help you, your family, and the patient navigates the dying process.

- Death doulas help clarify the patient's end-of-life plan and ensure that they feel they are dying well, with their requests and end-of-life demands being voiced properly.

- They help both the patient and the family deal with the process of grief, know what to expect, and can help those who are struggling more than others to deal with the loss.

- They can connect you and your loved ones with resources you may not have had the opportunity to look at.

- They help with the logistical side of dying, including closing accounts, gathering passwords, finding healthcare directives, handling arrangements, and other tasks that need to be taken care of when someone dies.

- They provide emotional and spiritual (depending on the death doula) support to the patient and the family through an incredibly difficult time.

- They have knowledge that you may find extremely helpful during your time of need.

- They act as a go-between for the person who is dying and the family members.

The Benefits of Hiring a Death Doula

A death doula may be able to assist your loved one and their family in several ways.

Come Up With Unique Ways to Honor Your Loved One

If you want to make sure your loved one is remembered especially, your death doula may be able to assist you in coming up with some unique ideas. They might suggest encapsulating your loved one in an Eterneva diamond or planting them with a tree seed or sapling.

Ask Your Loved One How They Want to be Remembered

If your death doula can ask your loved one how they want to be remembered, they may have access to particular information that fulfills their unique wishes. This is especially likely because your death doula will likely spend a significant amount of time with your loved one, especially if you or your family are struggling to set aside time with them on your own. Instead of making your loved one feel as if they are not special or properly tended to, your death doula can ensure they are as comfortable as possible.

Extra Knowledge for Care

In many cases, your death doula may also be able to educate you on how to care for your loved one while they’re away. This might bring you significant comfort in your abilities, as you’ll know precisely what steps you need to take in given circumstances.

Trust

A death doula’s profession revolves around specialized care for the elderly, which is likely to provide you with a great deal of comfort and care. Being able to trust someone who knows exactly what they’re doing may give you a great deal of peace of mind, and many will find this is well worth the cost.

Less Stress

If you’re feeling stressed about taking care of your loved one, a death doula may help you lower these levels of worry or anxiety. They often have specialized experience and knowledge in elderly care and can fill in the hours when you cannot tend to your loved one personally.

Don’t Have to Organize End-of-Life Care

If you’re stressed about other end-of-life care, a death doula may be extremely helpful in this process. This is because many doulas will offer to take care of many aspects that relate to the death and care of your loved one, and they might offer to organize excess care that falls out of their expertise for you.

Assist in Family Grieving

If you or other family members are well-known for struggling with loss and grief, a death doula may be of significant help in this area. That means, instead of only providing care for your loved one, your death doula is likely to provide care for you and your family while you’re grieving the new loss and trying to return to your everyday life. Many families feel this is incredibly appreciated and helpful.

Ease Into Funeral Planning

Your death doula is also likely to help ease you into funeral planning following the death of your loved one. They may be able to refer you to reputable funeral homes, come up with new ways to honor your loved one, and personalize any parties or services dedicated to the person you might want to remember. While doulas are not the same as funeral directors, the two often work together. You may find your doula through a funeral home.

How a Death Doula Helps Patients & Families 

Death and dying can be taboo topics that families tend to avoid. Then, when a loved one becomes ill, family members are emotionally unprepared for how to have delicate conversations about a person’s end-of-life desires. An end-of-life doula approaches these situations with empathy, helping families come together to have open conversations and ensure that nothing is left unsaid. This provides peace for the dying patient and a sense of closure for the grieving family, which aids in their healing process. People just want to talk, they have things to say about the topic of death. There are some very real fears because we are not a society that talks about death.

While a death doula may perform many tasks, the heart of their purpose is to offer non-medical support to patients and grieving families. Here are some of the helpful services doulas may provide during a patient’s transition to death:

- Companionship and a safe space for patients to talk about what they believe comes after death, helping them to come to terms with this next phase of life. 

- Assistance with end-of-life paperwork like healthcare directives, wills, listing accounts, and gathering online passwords. 

- Works with the patient to create an end-of-life plan — because doulas get to know their patients intimately, they can offer unique, personalized suggestions that the family may not be familiar with, such as spreading ashes in a memorial forest. 

- Helps the patient complete legacy projects to leave behind, such as writing letters, making art projects, creating scrapbooks, transcribing memories into a journal, or filming video messages. 

- Handles arrangements to make their final days more joyful, such as obtaining permission to bring a pet into the hospice room. 

- Relieves the burden on exhausted caregivers and offers emotional support to family members.  

- Makes the dying process more meaningful for everyone involved. 

Doulas can take some of the ‘work’ of the death experience off of the family so they can just be fully present with their loved ones. That often means finding ways to encourage and arrange for that since, in our culture, we do not value being as much as we value doing.

How to Choose a Death Doula

If you decide to hire a death doula, there are a few things to keep in mind as you begin the process.

Consider their education and training background

We’re used to seeing terms like board-certified when choosing a physician (so for instance, an internist might be board-certified in geriatric medicine or oncology by the American Board of Internal Medicine), but when it comes to looking for an end-of-life doula, it’s a little different. 

Research their specific offerings

When choosing a death doula, it’s smart to research the doula’s specific offerings. “As in many professions, end-of-life doulas specialize in many different areas. As people are called to this work from many different walks of life, many come to it with a whole host of skills and talents that they can incorporate to enhance or focus their doula work,” she says. “For instance, a lawyer called to this work might specialize in the advance care and estate planning aspects of end of life, whereas someone [who has] experience in the healing arts might incorporate energy work, mindfulness meditation or breathwork into theirs.”

Talk to people in your network

And in terms of where to find an end-of-life doula that fits your family’s needs, Marek personally recommends word of mouth as a first step.

How Do You Hire a Death Doula?

It’s an individualized process. Some doulas have private practices while others work in connection with hospices, hospitals, or other community organizations. But no matter how you find a doula, you should sit down and interview them first. After all, if the doula is going to walk through weeks or even months with you and be privy to intimate details of your family’s life, you’ll want to choose someone you feel comfortable with, who honors your personal beliefs and is trustworthy.

Before securing the services of a doula, you can review what types of assistance you want (which days/hours of the week, cooking meals, sitting with the dying person, working on legacy projects, etc.). Most often the doula will tailor their work to suit your needs and preferences. So, go over everything before you sign anything. Also, a conversation about compensation will need to occur, with the doula letting you know their current rates. Each doula sets their rates, so you will simply need to ask.

How to Prepare Before Meeting a Death Doula

EOLDs spread the word through mutual contacts and other support channels, neighbors and friends, members of their faith community, and family. As more doulas become trained and active where they live and work, more families and communities will benefit.

The world does not yet know much about EOLDs, but as each of these specially called people goes out into their community to serve, they will touch more lives. Those they work with will in turn help spread the word about EOLD care, and the movement will grow. Just as the development of birth doulas has grown in the past 50 years, so will the next years see the blossoming of the end-of-life doula profession. 

• Have a meeting with the potential EOLD and be sure to describe your needs and what you are looking for, specifically.

• Ask the EOLD what services they provide, why they do this work, how long have they been doing it, how they are trained, and if they work with any other doulas. The initial meeting should give you a good idea of your comfort level with this person and whether you will be able to ask for what you need and get your needs met.

• If you decide to work together, ask for a written agreement that includes details, including fees, and review it periodically.

Why Should Home Hospice Providers Partner with a Death Doula?

Your home health and hospice agency may need extra support during the end-of-life phase, as the act of dying can be a time for all hands on deck to ensure patient and family comfort. In this case, you should reach out to a death doula. They will listen to both your agency’s needs and the patient’s needs to create an end-of-life care plan that works for you and the patient. It’s important to find a doula that you and the family feel a certain chemistry with, as this person will be involved while care services are performed.

Home hospice providers who have experience working with death doulas find that it’s great for enhancing the end-of-life experience. A death doula will coordinate with your agency’s hospice nurses and workers to fill care gaps and provide more emotionally oriented activities for the family and patient. They should work closely with family and professional caregivers, taking the time to understand the caregivers involved and coordinate with them to provide end-of-life care. It’s also common for doulas to get a clear sense of caregiver gaps, such as respite care. You should work together to make sure that their services complement those your agency already provides. The overarching goal is for each patient to receive an enriching end-of-life experience.

Sources:

Cleveland Clinic

Better Place Forest

USA Today

CARE

Space Coast Daily

Sacred Crossings

Healthnews

Bonnie Evans Doula

Funeral Basics

ASA Aging

ECU Libraries

HomeCare

Doulagivers Institute

Ever Loved

CAKE

 

The content herein is provided for general informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Medical information changes constantly, and therefore the content on this website should not be assumed to be current, complete or exhaustive. Always seek the advice of your doctor before starting or changing treatment. If you think you may have a medical emergency, please call your doctor or 9-1-1 (in the United States) immediately.