End of Life Doulas, or EOLDs also called Death Doulas or Death Midwives, enrich the dying experience for patients, family members and friends, while strengthening the relationship between medical (the doctors, nurses, social workers) and non-medical support (the family or caretakers). We are trained professionals who provide assistance and guidance with holistic, culturally sensitive services to individuals and their families during transformative life changes.

Doula-client relationships engage the difficult and complex emotions while navigating the signs and symptoms of the dying process. An end-of-life care team is made up of multiple different professionals ranging from doctors, nurses, social workers, and End of Life Doulas to foster a culture of equity in order to facilitate a good death. We strive to be a support system for those who are terminally ill, elderly, or healthy and their families as they plan for their transition. A death doula’s work ranges from logistical planning for the time before, during and after of death; conducting rituals or comforting practices; helping the dying person reflect on their life and values; and explaining the bodily functions of dying to caregivers. End of Life Doulas seek to eliminate the silence around death-related topics, decrease anxiety surrounding death, and dismantle the foundation of inequality, racism, and social marginalization at end of life.

Although there is no federally mandated certification to become an End-of-Life Doula, there are many private organizations that offer education or certification programs.

Consumers and deathcare-related businesses can find an end-of-life doula at the National End of Life Alliance website. Because the industry is currently unregulated, it is recommended that people interview an End-of-Life Doula before hiring them, just as they likely would a Birth Doula.

Death doulas are NOT competitors with funeral service but rather complement the death care industry by providing additional support and community resources for deceased and their families. There are laws governing what death doulas can and cannot do just as with traditional death care. Funeral directors interact with families post death while end of life doulas are present with families before, during, and after death occurs.

In my own work with funeral homes, I have provided respite care to the families immediately after the death and provide periodic follow ups and aftercare. It’s the customer service that keeps families coming back. As we all know, people will not remember what you said but they will remember how you made them feel.

The difference between hospice and death doulas is that death doulas do not provide medical care. Instead, death doulas work in conjunction with hospice programs to provide interpersonal, social, logistical, and spiritual guidance that complements the care they receive in hospice.

Hospice care is regulated by Medicare rules, limiting the time staff is allowed to spend with patients and families. The National Hospice and Palliative Care Organization (NHPCO) has just put together an End-of-Life Doula Council to share with hospices and families the ways in which Professional End of Life Doulas can assist their work. NHPCO is encouraging hospices to hire doulas to complete the hospice team by filling in “the gaps in care” and allowing for the best end of life experience.

Death doulas also step into other areas where hospice and funeral homes may need help, such as:

• Advance Health Care Planning

• Practical Training for Family Caregivers

• Creating a Plan for Support at the Patient’s Time of Death

• Help with Planning Funeral and Memorial Services

• Companionship to Patients

• Needed Relief for Family Caregivers

• Grief Support

• Vigil presence for Actively Dying Patients

Death Doulas are here to serve humanity. We serve anyone ranging from young, elderly, terminally ill, healthy, caretakers and even pets. End of life doulas complement the care from hospitals, hospices, and funeral homes by filling in the gaps that occur during the dying process.

Every doula is different. Some assist only the healthy, some assist only the dying. This is why it is best to interview doula to see what their specialty is. Doulas may also be celebrants, hospice staff, or even massage therapists. Keep in mind each doula has their own specialty. Some may prefer to work only with advance directives while others may prefer legacy

End of Life Doulas are not simply a trend or a fad. Roughly 10,000 people turn 65 each day in the US, so more and more elderly people—as well as those with life-limiting illness—will need our services. Families are bringing new values, preferences, and opinions that are changing the world of funeral service. They are thinking differently about how they want to honor their loved ones and have new perceptions of the funeral service profession.

Death Doulas help bridge the gap between families and end of life care. Having a death doula is helpful when a family has little experience with death or when they are afraid of confronting death. The death doula can act as a liaison between the family and the medical professionals, Hospice and funeral home, helping to educate families about the options available to them and easing what can often be a difficult or painful arrangement process.

We offer a variety of services that include helping a person write their own obituary; assisting with legal paperwork, including advance directives, health care proxies, and wills; creating a peaceful, loving atmosphere at death; and, most importantly, providing grief care before, during, and after death of a loved one. Death doulas can help families reduce confusion. Doulas also educate people to know that they have choices.