What is an end-of-life doula?

By Michelle Churchman

Say the word doula, and most people think of the women who assist other women during childbirth. Birth doulas or midwives, while an ancient concept, became legitimized and recognized in this country in the past few decades. Today, many of those same people who pushed to give birth to their babies at home are aging and fighting to do the same when they die.

Like birth, death is an emotionally-taxing process for all those involved. It requires thoughtful medical, financial and legal planning; education about the physical, emotional and spiritual processes that happen during this time; access to community resources; and companionship and presence during the process. Death or end-of-life (EOL) doulas can provide all these things and more.

Hospice vs. Doula

It may appear that EOL doulas provide the same services as hospice or palliative care, but clients of death doulas and their loved ones gain significant benefits that differ in many ways.

One is time. The hospice team, including volunteers, hindered by caseload and requirements, can provide only a few hours a week of face-to-face time for patient care.

On the other hand, EOL doulas can work alongside the hospice team as its eyes and ears, teaching caregivers how to care for their loved ones more consistently, educating about the natural dying process as often as necessary, and being available to offer holistic care anytime and anywhere. Most importantly, death doulas can provide the respite needed for caregivers overwhelmed emotionally, mentally and physically by the round-the-clock care needed once a patient begins to transition.

In addition, EOL doulas help patients receive the holistic benefits of a hospice-style approach to care well before they are admitted to hospice service. A continuing problem for hospice care in the U.S. is that patients wait too long and live, on average, only 14 to 20 days on services.

Services such as caregiver respite, obtaining community resources, assisting with transportation or other activities of daily living can be provided by EOL doulas at any time in the disease process; keeping patients at home, healthier and happier for longer, another important benefit for patients and families using death doulas at this early stage.

Another key difference between hospice providers and EOL doulas is that doulas can help family and loved ones immediately after death. This time is often chaotic and scary for families, but death doulas help families gain some control during this time by helping plan and carry out rituals, home wakes, funerals and other personal ways to have quality sacred time with loved ones. These after death plans help facilitate healing and healthy grieving by being present and listening to offer support long after a client’s death.

By providing professional planning, elder care, end-of-life care and meaningful after death care, dedicated EOL doulas provide valuable resources throughout people’s life spans and in their communities, ultimately improving not just how people die, but also how people and communities live.

How Doulas Assist

Many end-of-life doulas, also known as death midwives, say they complement the care from hospitals, senior-care facilities and hospices, as well as fill in the gaps that occur during the dying process. End-of-life doulas can provide several services to your loved ones and their family:

  • Calming the terminally ill through guided visualization
  • Comfort for the dying through massage
  • Coordination of care
  • Helping with legacy projects to memorialize the life of the soon-to-be deceased
  • Respite care for family members
  • Vigil planning
  • Vigil sitting

Michelle Churchman is with Shoji Bridge.