What is a Death Doula?

A Non-Medical Resource for the Dying and Those Who Love and Care for Them

Death doulas help you and your loved ones navigate the end-of-life journey with dignity, comfort, and peace of mind. Tending to emotional, spiritual, and practical needs at a very difficult time.

Providing Compassionate End-of-Life Care

The History of Death Doulas

The term doula has traditionally meant a person trained to provide comfort and support to women during labor and childbirth. Today, it’s also used to describe those who are trained to provide support at the end of life.

Not all doulas deal with birth.

Caring for the sick and dying is an ancient role. In the past, people were more likely to die at home than in an institution. Most people had seen someone die. They knew the signs and how to give comfort and support.

As long as we’ve been living, we’ve been dying.

As medicine and health care advanced, more people died in hospitals than at home. Hospitals are designed to treat acute illness, not provide a safe and peaceful environment. They’re busy places by nature.

This gap in end-of-life care in an institutionalized setting is part of what has given rise to death doula programs. Death doulas fill that void. We’re trained to know the stages of death and dying, grief and grieving, and to advocate for patients’ needs. We’re also trained in comfort and compassion, in active listening, and in communication strategies to facilitate difficult conversations.

How We Got Our Name

Modern History of Death Doulas

In 1998, after attending a conference on end-of-life issues and care, Phyllis Farley, chairman of the board of the Maternity Center Association in Manhattan, got the idea for what became an NYU Medical Center pilot program called the “Doula to Accompany and Comfort Program.”

They began training “doulas” to support terminally ill patients who have limited support from family and friends, providing emotional, spiritual, and social companionship. Farley’s experience in the maternity center explains why she used the term doula, a term already used to describe support and comfort given during childbirth.

Why People Are Choosing to Die at Home

The Growing Need for Death Doulas

Bar chart showing that 71% of Americans would prefer to die at home if they had a choice from a Kaiser Family Foundation study in 2017.
Liz Hamel, Bryan Wu, Mollyann Brodie, Views and Experiences with
End-of-Life Medical Care in the U.S.
, (KFF, April 27, 2017)
Bar chart showing that 69% of Americans say death is a subject people generally avoid from a Kaiser Family Foundation study in 2017.
Liz Hamel, Bryan Wu, Mollyann Brodie, Views and Experiences with
End-of-Life Medical Care in the U.S.
, (KFF, April 27, 2017)

Respite for Caregivers and Peace of Mind for Patients

How Death Doulas Complement Hospice Care

Every year, more than 1.7 million Americans receive hospice care, which  is covered by Medicare, Medicaid, and most private insurance plans. They’re medically trained nurses who provide emotional support, comfort, and symptom management to terminally ill patients. They also help caregivers navigate the uncertainties of taking care of someone who is dying.

Doulas complement hospice with additional emotional and spiritual support. We provide companionship, practical and physical assistance, and respite for primary caregivers.

The main distinctions between hospice and doulas are: 

  • Hospice nurses are medically trained, while doulas are not.
  • Hospice workers visit once a day, while doulas can visit as often as you schedule us.
  • Hospice is only available to those no longer undergoing curative treatments, while doulas can support anyone.
  • Hospice is only available to patients with a life expectancy of six months or less, while doulas can help everyone.

For terminally ill patients who have decided to no longer seek life-prolonging or curative treatment, complementing hospice care with the support of a doula can bring peace of mind to the patient and their inner circle. 

Here For Everyone

Who Should Hire a Death Doula?

It’s not only the terminally ill and their loved ones that can benefit from what death doulas have to offer. We help clients of all ages whether they are experiencing a health issue or not. These are some of the people who hire us:

  • People who know they are advancing in age and want to make sure their documents are in order and in a safe place and that their support team knows of their decisions.
  • People who live alone and don’t know who will take care of them if they need help.
  • Caregivers who work and need someone they trust to be there when they’re gone.
  • Caregivers who don’t have other people helping them and could use a break or a person to talk to about what they’re going through.
  • The adult children of a person who needs assistance but isn’t at the stage of entering hospice care.
  • The adult children who live far away and can’t be there to provide the kind of care their parent needs.  
  • People who’ve lost a loved one and are mourning or in bereavement.
What Is a Death Doula, and When Should You Use One? – GoodRx
Apr 6, 2022 What Is a Death Doula, and What Do They Do? · Doulas provide support during major life transitions. · Death doulas can provide a broad range of …

There are plenty of reasons people hire death doulas. Mostly, they hire us to solve problems related to death and planning for death, to provide comfort and compassion, to listen and be there in times of need.

What Exactly Does a Death Doula Do?

Problems a Death Doula Can Help People Solve

Not all death doulas offer the same services and certainly not all clients have the same needs. The easiest way to explain what a death doula does is to highlight some of the problems we help solve:

  • Making sure documents are in order in the event of an unexpected health crisis or death (for example, advance directives, wills, a safe place for storing essential files, plans for what to do with social media profiles).
  • Discussing funeral options including help writing obituaries, deciding the music and who will give the eulogy, choosing where to be buried or even help finding green burial options.
  • Helping with legacy preparation which might look like writing letters to loved ones, creating a slideshow to show at the funeral, or more involved legacy projects to share after death.
  • Easing fear and anxiety about dying, what happens after death, what the dying process actually looks like.
  • Clearing up uncertainties about end-of-life decisions and offering non-medical guidance on options including where a person wants to die, what people they would like to be present, death with dignity options, and how they would like to spend their final days.
  • Advocating for your wishes with your health providers and your support team.
  • Accompanying the ill in times of loneliness which could include reading, watching tv, talking and visiting, sharing stories, or just listening. 
  • Giving caregivers a break whether on a regular basis or not which allows them to look after themselves and have an ear to talk to about the challenges of caregiving. 
  • Helping out with practical and physical tasks when our client can no longer do for themselves or just needs some help with things like walking the dog, giving a ride to an appointment, tidying up their nightstand or preparing a simple meal.
  • Where appropriate, planning and carrying out spiritual rituals
  • Planning a last hurrah for those who know when they are dying with more certainty because they’ve chosen medical aid in dying or voluntary stopping eating and drinking.
  • Talking to our clients’ inner circles when they’re confused or worried about their loved one.
  • Sitting vigil during the dying process and providing a calming and compassionate presence for everyone there. 
  • Facilitating difficult conversations and making sure everyone that should be included is involved and understands. 
  • Grief counseling which is just as important after a planned death as it is after an unexpected death.

You’ll want to determine your specific needs and ask the doula you’re considering what their services include.

Making Sure You’re a Good Fit

Questions to Ask Before Hiring a Death Doula

The end-of-life is a difficult time for everyone. For our clients. For their loved ones. Even for the hospice team and medical support. It’s so important to make sure the doula you are hiring is going to be a good fit

  • What services do you offer and how do you customize them to meet the individual needs of your clients?

I have three services pages: Doula Services, Assisted Death, and Talking About Death.

  • What is your training and experience as a death doula?

Read about my training on my About page.

  • How do you feel about my spiritual beliefs and how can you help me find peace? Can you ensure that your services are culturally sensitive and respectful of my beliefs and traditions?
  • How do you work with medical professionals, such as hospice, to ensure the best care possible?
  • What is your availability and how do you communicate with your clients and their families?
  • What kind of emotional and spiritual support do you provide to clients and their families during the dying process?
  • How do you approach end-of-life planning and decision-making with your clients?
  • How can I be sure you will keep our conversations confidential?
  • What is your fee structure and what’s included in your services?
  • Can you provide references or testimonials from previous clients?

Asking these questions can give you a better sense of a death doula’s approach, experience, and suitability for your needs.

The Most Frequently Asked Questions We Get

FAQs About Death Doulas

This is a somewhat new field even if it’s not a new concept. Here are a few additional questions not answered above about death doulas.

What type of training or qualification does a death doula need?

What are the benefits of hiring a death doula?

One of the most important benefits is the calm and reassuring presence doulas provide and the knowledge of the dying process they can explain with love and compassion. A number of other benefits are mentioned above in the section covering the problems a death doula can solve.

How much does it cost to hire a death doula?

The cost for doula services will vary depending on what the client needs, the length of time they are needed, and their experience and qualifications. That’s why it’s important to discuss fees up front. 

Do death doulas provide medical care?

No, death doulas provide non-medical support. But we can help caregivers keep track of medications and we are able to make sure our clients are getting the symptom relief they need from their medical team. 

What qualities do you need to be a death doula?

Empathy, love, and compassion, above all. Doulas also need to be organized and detail-oriented. 

Are death doulas only for people who want to die at home?

No, death doulas can provide support to anyone whether at home, in a hospital or other institution, and even via Zoom. 

What does sitting vigil mean?

The last days of life are referred to as a time of vigil. During the final days of one’s life, a doula can sit with you, by your side, providing comfort, support and rest for you and your family. 

How do I find a death doula? 

You can ask your doctor or hospice provider. Some funeral homes even recommend death doulas. Here are a few directories that list death doulas for hire: Deathwives, Going with Grace, Compassion & Choices, and the American Clinicians Academy on Medical Aid in Dying.

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