Category: End-of-Life Education

Hello everyone! I get a lot of emails and in-person visits at my shop from people who are interested in becoming an end-of-life doula and if that’s you, please, read on. Let me first say, I applaud you. Anyone who wants to do this incredibly heartfelt, yet difficult, work gets my deepest respect and admiration and because of that, I have some sage wisdom to pass along.

First of all, people seek me out thinking that I’m a “successful” doula. They’re doing the right thing–always learn from people who are successful in the field that you want to go into–but they’re looking in the wrong place. Let me be fully transparent: I’m currently not doing any hands-on doula work. Lately, I’ve been mostly doing a lot of referral work by connecting people with local doulas other than myself. To make a long story short, for more than a decade, I’ve worked at Cornell University as a Medical Technologist and in my spare time I volunteered as a hospice volunteer. Then Covid hit, I had downtime from work, and I decided to pursue a doula certificate program. When I finished, I wrote and received a grant to start a doula business. I had one year to spend the funds and I quickly realized that no one in my area knew what a death doula was so how can they seek out what they don’t even know exists? So my part-time employee and I spent the first six months doing a lot of public education and then I used the rest of the funds to open up my shop, The Whimsy Mercantile. Amongst all of the crafts and thrifted treasures, the shop sells the end-of-life planner that I wrote, reimagined cremation urns, handmade home funeral kits, and a variety of other end-of-life related things. Plus, I host an end-of-life book club, a monthly letting-go ceremony, and office hours with a doula. Death is seamlessly blended into the shop and its activities because I believe that’s exactly where it belongs–in everyday life. You could say that I’ve put practical doula work aside for the time being and am embracing the more unconventional aspects of doulahood. My plan is to retire from Cornell in five years to continue with the shop and reconvene my hands-on doula care offerings when I have the full bandwidth to do so. 

Okay, with all of that out the way, I do have nuggets of insight to offer potential doulas. First is to not fall prey to the smoke and mirrors out there. Death sells. It’s made those in the funeral industry rich and capitalism is starting to sink its teeth into the death doula world as well. I know, I know…it was only a matter of time. Needless to say, I’m very grumpy about all of this. I wish with all of my heart that death care was a regular part of what we did as a community or that there was more caregiver support available to families so that it could remain a family-centered endeavor. Death care really should take a village, instead it’s now relegated to a single overburdened family member or gravely understaffed nursing homes. I know my sentimentality for eras gone by is not helpful at this point but I still struggle. The idea that dignified death care can only come at a price, makes me feel icky. I mean, doulas don’t get paid unless someone is in the throws of death and I’ve seen firsthand how this dynamic has led to predatory practices. I’ve heard of doulas volunteering with hospice just to poach their clients and push their services on to unsuspecting families. That is sooooooo not okay and yet it’s happening more and more. I’ve met these people walking through my door at the shop so I’m seen it firsthand and it makes me sick.

And speaking of predatory things, let’s discuss the end-of-life doula certification programs sprouting up everywhere. Just be aware that when you complete any of these certificate programs, you’re paying for a certificate through that specific program, not through any overarching governing body. There’s no agreed upon certification or accreditation for this kind of thing…yet. I’m sure it’s coming, for better or worse. So that leaves you with a confusing mess of which program to choose. I chose the University of Vermont (UVM) because they’re a legitimate university and they’re affiliated with a medical school. There are a lot of other doula certificate programs out there but you don’t know how skilled the people offering them really are. There are a lot of really slick looking programs available but I honestly think these people are more skilled at marketing than anything else. Just to use myself as an example, I once paid for a home funeral education course led by a popular online funeral director/death doula team. Within the first few minutes of viewing the course materials, I knew some of legal information was incorrect. I contacted the Home Funeral Alliance to fact check it and they confirmed that is was incorrect. So, buyer beware. In the future, I think this field will become more legitimized and will thus be subject to regulation. This is another reason that I went with UVM. If any program is going to get accreditation by a governing body, it will probably be them along with others like INELDA, and not some social media page that makes being a doula look like sunshine and roses. 

My next piece of advice is to not quit your day job, regardless of what the social media doulas are trying to sell you on. When you graduate, you’re not immediately going to be inundated with clients. Like I’ve said, most people don’t know what a death doula is so they don’t even know to seek one out. You’re going to have to become skilled at marketing your services, networking, and public education. With that being said, I’ve met some people who are full-time doulas and are doing great so please don’t be discouraged. There’s a caveat to that though: these full-time doulas usually reside in large cities like Chicago and Philadelphia and they also have significant others to fall back on during lean times. The current state of being a death doula is rocky because it’s in its infancy. So if you get into this field thinking that you’re going to be making bank as soon as you hang out your shingle, keep your regular job until you’re sure that you can pay your bills and put food on your table. I’ve seen people jump in with both feet and that’s when they resort to ambulance chasing just to survive.

I’ve already mentioned the necessity of marketing, networking, and public education. Those things aside, you also have to deal with the minutia of being self-employed such as taxes and setting your rates. None of the death doula programs truly prepare you for this stuff so be ready to need some more schooling. I’ve struggled with finding the sweet spot when setting my rates for services. Some doulas have zero problems turning people away who can’t afford to pay, but I feel like everyone should have the right to experience the most comfortable, dignified death possible. When I was writing the aforementioned grant, I fought with the funders to have a sliding fee scale. They wanted me to charge a flat fee of $100/hour across the board. I nearly choked! I asked them what if someone couldn’t afford it and they responded by simply saying that the dying person would be out of luck. I’m not a heartless c@nt, and thus didn’t listen to them. Instead, I adopted a sliding fee scale and thankfully they funded me regardless of my “unbusiness-like” thinking. I see this being less of an issue in the future because hopefully, like birth doulas, our vocation will be legitimized and we’ll be able to bill insurance and Medicare. Additionally, hospitals and hospices are starting to hire death doulas which will provide another avenue if you’re not keen on going the self-employment route. Thus, I really do see a bright future ahead. We just have to get through our wild west phase. 

I also want to strongly suggest getting hands-on experience. Honestly, I wish that this was a requirement of all certificate programs but sadly, it’s not. I’ve had about ten doulas cross my threshold at the shop and only one of them was actively working. The reason the other ones weren’t was because when it came down to it, they felt like frauds. They went through their programs, printed off their certificates, and then had no idea how to put what they’ve learned into practice. Each of them were understandably afraid of fumbling through their first clients, pretending to know what they were doing, but not really having a clue. Having some real world experience would alleviate this.

People online have come after me for saying this but I can’t recommend volunteering at hospice or an elder care facility enough. And do it before you go into a certificate program. I will shout that from the rooftops! You might find that companioning the dying or dealing with grieving family members is not as comfortable as you imagined it would be. Just because you helped your parent at the end of their life does not mean that you’re going to feel the same with strangers. Knowing before you pay for a certificate program will save you time and money.

Another reason to volunteer is that you gain experience companioning people dying with a variety of different ailments. Sure, the end result is the same but someone dying from dementia looks different from someone dying from COPD. Additionally, you gain experience working in different family situations and settings. You may be visiting one person in their home, the next person you may be visiting in a nursing facility, the next person you might be in a hospice residence, etc… All of this will get you comfortable with the variety inherent in doula work.

So in summary, if you plan to become an end-of-life doula:

1. Volunteer first. Being a doula is not the same as being a volunteer but it’ll get you comfortable with companioning, which is essentially at the core of doula work.
2. Pick your education wisely and with the future in mind. If or when the industry does become regulated, do you think your certificate will likely be grandfathered in? Just because the program has a cool online presence doesn’t mean they know what they’re talking about.
3. Once you graduate, don’t immediately quit your job. Play it safe until you’ve built up a great reputation in your community and you can ensure that you’ll have steady work.
4. Become good friends with your local Small Business Administration and Office of the Aging. The Small Business Administration can point you towards grants and classes to help fill in those entrepreneurial knowledge gaps. Your Office of the Aging is going to be the best place to promote your services. See if you can do a public seminar on your services and drop off a stack of brochures for them to have available.

So that’s my advice for future death doulas. Also, pursuing an end-of-life certificate is amazing even if you never plan to make it your vocation. Death is an inescapable part of life so the knowledge that you gain from this coursework will always be applicable. The more tools that you have in that toolbox of yours, the better. I could see this coursework being advantageous even if you just wanted to volunteer, or if you know that you’ll be taking care of your loved ones at the end of their lives, or if you want to work with the elderly or get into nursing. For example, if a CNA also had an end-of-life doula certificate, I’d think that would give them a leg-up in the job market. So there’s many great reasons to pursue this type of education and the fantastic thing is that it’s relatively affordable, at least for the time being. Hopefully it stays that way.

Okay, so I hope this helps and please, let me know if you have any questions.