End-of-Life Doula

Do you have questions? Let me help answer the most obvious ones…

What is a death doula and what does “doula” mean?

Doula is Greek in origin, and it means “woman who serves.” However, nowadays, more than just women are getting into doula work, which I think is totally awesome! To me, a doula is someone who supports people through life’s biggest transitions. Birth doulas are becoming increasingly popular, and they are those who help mother, baby and family through the birthing process. I see very little difference with the dying process and the need for support is just as great. A death doula is similar to a birth doula. One compassionately assists those coming into this world and one compassionately assists those leaving this world.  This includes providing emotional, spiritual, informational, and physical support with the goal being a low stress, comfortable, personalized–even, dare I say, positive–experience for clients and their loved ones. Death Doulas work alongside family members, friends and even medical, palliative and hospice workers in hospitals, senior care facilities and private home settings.

Death Doula vs End-of-Life Doula vs Death Midwife…is there a difference? 

You will find these terms commonly used interchangeably and to most doulas they mean the exact same thing. I prefer the term “end-of-life doula” (sometimes it’s even shortened to EOL doula) because to me it seems to be the gentlest yet descriptive term. However, I want to cover all of my bases as far as internet searches are concerned so you’ll see me use a variety of terms on this website.

Terms and Definitions for End-of-Life Service Providers
There is an overabundance of confusing terms in the death care industry but luckily some standards have been set to help the general public better navigate who does what. After careful consideration of the data and research from a wide variety of resources and individuals, the National Home Funeral Alliance (NHFA) has chosen to employ the following terms and they are the ones that I have adopted for my business:

• Death and Dying Guide —One who works with the dying person and family to accompany them throughout the death experience, facilitates family-led after-death home or facility care, and may attend to spiritual and ceremonial needs as requested
• End-of-Life Doula — One who accompanies a dying person and/or family and friends through a personal, intentional, and conscious dying process to achieve a conscious death
• Home Funeral Guide — One who empowers families and/or friends to care for their own dead, including educating, consulting, and guiding them through after-death care
• Celebrant — One who works with family and/or friends to co-create a highly customized ceremony (for funeral, memorial, celebration of life)

Terms and Definitions for Advocates and Educators

• Home Funeral Advocate, Home Funeral Educator — While not included in the lexicon of end-of-life care providers who educate families through consulting, coaching, demonstration and myriad other means privately, home funeral advocates/educators do vitally important work by educating publicly through presentations, workshops, local tabling opportunities, and other events aimed at developing a global understanding of the home funeral movement.

(Glossary respectfully taken from The National Home Funeral Alliance)

How is a doula different than a hospice volunteer or home health aide?

We are there to offer a calming presence and emotional support to the client, their partners and family members. We are to there to offer non-biased, evidence-based information and empower our clients to make informed decisions that are right for them. We anticipate emotional, spiritual, informational and physical needs and make plans accordingly. We are generalists usually with some relevant specialties (ex. law, nursing, massage therapy experience). We are prepared to make referrals to community resources and assist with making connections. We offer non-medical comfort measures and physical support. Lastly, we offer logistical support such as family respite, meal preparation, household help, errand running, etc… Home health aides fulfill basic personal and health care needs whereas hospice volunteers primarily companion the dying but are usually available for a limited number of hours.

Potential doula offerings:

• Vigil sitting while someone is dying
• Providing respite for family members
• Aromatherapy
• Energy work (reiki, tuning forks, crystal bowls)
• Massage
• Fixing meals or getting groceries
• Going for walks
• Transportation to appointments
• Running errands
• Taking care of a client’s pet
• Playing cards or games
• Arts and crafts activities
• Maintaining a garden space
• Reading aloud from favorite books or magazines
• Word searches, crossword puzzles, board games
• Looking at photo albums or organizing photos to be gifted to loved ones
• Household jobs: folding laundry, washing dishes, watering plants, stacking wood
• Helping clients complete tasks like advance directives, 5 Wishes, writing an obituary
• Assisting with legacy and completion work (helping to write letters and cards, wrapping gifts to be shared after a person’s passing or to be send on important dates, arranging last visits with loved ones)
• Conducting a Dignity Therapy session
• Care coordination
• Conflict resolution
• Organizing and cleaning out spaces (Swedish death cleaning)

Can a doula help you plan a funeral? Are doulas the same as funeral directors?

Doulas can assist you in creating a highly personalized celebration of life or memorial service for yourself, a loved one or even a beloved pet. These events can be in-person or virtually. Virtual services are increasing in popularity due to the pandemic and family travel constraints. Unfortunately, in many states, like my home state of New York, they cannot assist you in planning a funeral because planning a service where a body is present is considered funeral directing and is illegal for someone unlicensed to participate in these activities. In lieu of that, I do offer home funeral consulting services and home funeral kits.

Are doulas certified or licensed?

End-of-life doula work is a relatively new, unregulated field. A few states have passed legislation licensing birth doulas; however, there are currently no regulations for end-of-life doulas. This is a rather exciting time for the field because it’s in its infancy and is being shaped by those doing the work. Doulas have the flexibility to offer services that are specifically tailored to their unique skill sets instead of being prescribed by a certification board.

Are doulas covered under health insurance or Medicaid?

Since some states are requiring licensure of birth doulas, those states are also enabling their services to be eligible for Medicaid reimbursement. I’m hoping this trend continues and that insurance companies do the math and realize doulas save them a considerable amount of money. Our services keep patients in their homes and out of the hospital. This cost savings alone is worth reimbursing.