The end of life is something few talk about, yet is one of the most universal truths we all live with. We will die, whether we like it or not.

Since few people talk about this natural phenomenon of life, it can leave many terminally-ill individuals and their families filled with unresolved questions and a lack of understanding for what to expect in the last chapter of life… death.

During the tough time of losing life, a death doula can help turn the hard situation into a much softer and more comfortable experience for everyone involved.

What is a Death Doula?

A death doula (also sometimes called end-of-life doula, or death midwife) is a trained nonmedical professional who provides emotional, physical, and educational support for someone nearing death. They can be considered a mentor for the final chapter of life and are typically brought in by the dying individual’s family.

While some doulas may be on call, others may do overnight care or regular scheduled visits. The death doula accompanies and provides comfort for the dying person, and makes the dying process more pleasant for everyone involved.

Death doulas foster relationships with individuals beyond their diagnosis and strive to minimize their loneliness and isolation through death, a role that is often too difficult to be played by close family members and friends.

People are Yearning for a Better Death

While many people shy away from thinking or talking about death, there’s a growing Death Wellness movement that’s shifting the conversation from avoidance to embracing the inevitable.

More people are witnessing the death of a loved one in hospitals or nursing homes and are unsure of how to best support their loved ones in their last days. This has led people to begin rethinking how they’d like their own death process to unravel when the time comes.

Nowadays, more people are talking about death, planning for end-of-life care, making decisions on what will happen with their body after death, and how their life will be remembered and honored.

What Does a Death Doula Do?

There’s no question that death brings up incomparable emotions for the dying as well as their family members and friends.

While the death and grieving process can be extreme for those going through it, a death doula is an educated third party who’s there to provide an enlightened outlook on the experience of death for everyone involved.

When a death doula enters an individual’s life specifically for the dying process, they bring expertise, resources, realistic expectations, and unbiased support to help make sense of it all.

Besides breaking the ice and serving as a conversation facilitator for end-of-life wishes, the death doula provides support in the following areas.

1. Facilitate end-of-life planning.

Death doulas allow the dying person and their family members to speak openly and frankly about dying by asking the questions that family members and hospital workers may feel uncomfortable, unready, or untrained to ask.

They ask the individual what they would consider to be a good death. This helps ensure preparations for the dying space looks and feels, the music or sounds, readings and rituals can be made for the final weeks and days of life.

While some people would like to die in their home, next to the window and surrounded by loved ones, others may prefer being outside on the porch next to their beloved pet with their favorite music playing.

Working directly with the dying individual, the doula creates a vigil plan for how they want to spend their final days and hours and then communicates that with the family and necessary hospital or nursing home staff.

2. Mediation and advocacy so that the dying person’s wishes are honored.

Regardless of what the individual wants for the end of their life, it’s up to the doula to respect their wishes and help the family plan accordingly.

The doula will also consult with the individual’s families about their wishes. For example, since many families are separated by distance, the doula can help ensure that the loved one will not be alone when they die.

The job of the doula is not to influence the requests of the individual and their family, but to respect and honor them. This often means reminding family members of the wishes of the dying individual.

3. Comfort measures for the dying.

The role of the doula is neither medical nor clinical and often coincides with the nature of medical staff and hospice care. That being said, the doula can help with making the individual more comfortable whenever possible.

The doula acts as an advocate for the needs and comforts of the dying individual, whether that be physical, emotional or spiritual.

For example, one doula helped her patient be more comfortable by playing cards with him and rubbing his legs. Doulas are also trained to model how to touch the dying person.

4. Emotional support.

When someone is dying, it’s common for family members to feel awkward, sad, and not know what to say to their loved ones.

Terminally-ill individuals can often become lonely in their last chapter of life. Family members, doctors, and nursing staff can begin to talk as if the individual is no longer there and this can leave them feeling very isolated.

The death doula is there for the dying individual, talks to them throughout the entire process, and allows them to have someone consistent with them as they stop receiving treatments and begin to exit this world.

Bringing a focused and intuitive presence to the final stage of life, the death doula encourages deeper engagement for the dying individual and their family.

The death doula doesn’t shy away from hard conversations and often helps facilitate conversations that help provide support both the emotional needs of the dying individual and their family members.

5. Life review and legacy project support.

When someone is facing death, an important part of the process is putting together legacy items to help carry on the memory of the individual.

Throughout this process, the doula gives the dying person a window to reflect on their life and an opportunity to explore the impact they had on others.

The doula often works with the family to put together a scroll of memories. This may include photos, videos, collages, and other keepsakes that will be passed on after the person’s death.

Some families have also started to coordinate a shared digital album that allows family members to contribute their personal memories from anywhere in the world.

As part of the end-of-life plan, the doula may also help facilitate what will happen with the body after death. For example, whether the body will be buried amongst past family members or turned into a diamond for the family to cherish forever.

6. Education, information and resources.

Since the death doula is fully trained in what to expect in the weeks, days, and hours leading up to death, they can help explain the symptoms and signs of the dying process as they occur.

This can help both the dying individual and their family members have an idea of what they can expect to help reduce uncertainty.

While death can be very overwhelming, having a sense of “what’s normal” during this time can be a big relief to everyone.

7. Respite for caregivers.

Depending on the specific situation, there will be family members or medical staff that will be acting as primary caregivers for the dying individual.

While the job of the doula isn’t to replace the primary caregiver, their role assisting with physical and practical care can certainly ease the burden.

Something as simple as getting water, opening the blinds, or brushing their hair can both help make the individual more comfortable and give caregivers a break from their taxing roles.

Some doulas may even sit by the individuals side for an evening so that the primary caregiver can take a night off to take care of themselves.

8. Logistical and household support.

If there are loose ends that need to be tied, such as decluttering an individual’s house and belongings, there are some doulas that also take on this responsibility.

Whether it’s helping to sell a car, figuring out what to do with a beloved pet, or packing lunches for the rest of the family, the death doula can step in to provide additional logistical and household support where needed.

It’s important to consider that no two death doula relationships will be the same as every scenario will require unique attention to ensure the dying individual and their family remain as comfortable as possible.

9. After death care.

Once the individual passes, the doula continues to be present for the family for 3-6 weeks and ensures the original end-of-life plans are completed.

The doula helps the family with processing the emotions and experiences after the person has died, guiding them in their early stages of grief.

Some doulas are also used to help coordinate the funeral, cremation, and burial process to help lessen the load for the grieving family members.

Life as a Death Doula

Becoming and practicing as a death doula can be an extremely rewarding and fulfilling role in someone’s life.

It’s an opportunity for a person to work through their own fears of death while helping others through a very important and often overlooked part of life.

In fact, many people have turned to being a doula after losing a loved one and finding the desire to make the process better for others.

Just see how this 25 year old found his calling to be a doula after his brother passed away.

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According to the InternalEnd of Life Doula Association, practicing as a doula also allows people:

  • The deep satisfaction of knowing that you are helping people at an extremely difficult time
  • The knowledge of how to help friends and family when they reach the end of their lives
  • The opportunity to face your own mortality and model that for the people in your life
  • Learning from the dying how to live your life and personal relationships in a profound way
  • Earning income from work that you feel passionate about
  • Membership in a community of like-minded people who know how to open their hearts to each other
  • The acquisition of powerful new life skills that you can put to work in other areas of your life

Now, if you or someone you know is interested in becoming a doula to help soften the death experience for others, there are a few organizations that administer training and certifications for death doulas.

  • The Internal End of Life Doula Association (INELDA) is a nonprofit organization dedicated to bringing deeper meaning and greater comfort to dying people and loved ones in the last days of life. Their mission is to transform the end of life experience so it brings greater meaning and sacredness to every dying person and their loved ones.
  • Lifespan Doulas offers comprehensive, professional doula training and guidance for creating a sustainable birth, postpartum or end-of-life doula businesses. Their mission is to provide professional training and development for end-of-life doulas and support their integration into the home and mainstream care settings.
  • The Doula Program recruits, screens, specially trains, carefully matches and supervises Doula Volunteers who visit individuals facing life-threatening illness in area hospitals, healthcare facilities (nursing homes/assisted living) and at home. Their mission is to minimize the isolation and loneliness experienced by individuals with life threatening illness who are facing the end of their lives alone.
  • The Conscious Dying Institute cultivates an authentic caring healing presence in caregivers, restoring emotional integrity and spiritual sanctity to relationships and increasing life satisfaction for all involved. Their mission is to restore death and dying to its natural place in the sacred circle of life by creating a new wisdom-based culture of healing caregivers and professionals, practicing across all health care settings, who elevate the experience of end of life care.
  • Quality of Life Care has been devoted to easing suffering at the end of life since 2005. They believe that with information comes empowerment, and with excellent training and experience comes confidence. They are dedicated to giving doulas a powerful, nourishing experience as they gain the tools necessary to accompany others through advanced illness and dying.

Conclusion

Whether we call it a death doula, end-of-life doula or a death midwife, one thing remains the same… it’s possible to plan a good death and get trained assistance with the process.

While that still might sound scary to many people, the more we open up and begin to utilize death doula services, the more pleasant the death process will become.

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