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What Does a Death Doula Really Do?

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End-of-life care educator and grief worker

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Death and birth are two sides of the same coin. You’re probably familiar with the term birth doula. It inched its way into mainstream medicine during a birthing movement in the 1960s. 

With a doula by their side, women discovered that they felt more supported during pregnancy, while in labor, and in their first few weeks as a new mother. There was a person with the education, knowledge, and modern medicine to advocate for both the mother and baby.

On the flip-side of this coin, you have death. For many years, people were left to die in isolation. It was almost unheard of for people to sit at the bedside of a dying person in their final days. But when a new death movement emerged, this tradition began to change. 

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But, many people still aren’t educated on how to help someone that’s dying. death doulas play a critical role in the acceptance and management of the dying process for both the dying and their family and friends

Death Doula Duties

A death doula's primary role is to offer a continual and unbiased presence at the bedside of a dying person. Death doulas embrace the unique journey with no judgment of what a good or bad death looks like. They’re there to be present and hold space for whatever unfolds.

While no two deaths are the same, here are some common services a death doula might provide you. 

Presence 

Holding space for a dying person takes a lot of mindfulness and courage. This means removing individual judgment and opinions from interactions and focusing solely on the client's journey.

A death doula approaches their client with attention and reverence. They show up ready to serve in whatever capacity the dying person and their family needs. At times, they may sit in silence, but they might also work with the family to help them process and better support the dying person. 

Advocacy 

Death doulas get to know the dying person and spend a good bit of time assessing their situation, including their decline and death journey. They often spend the beginning of their time quietly observing the client and their interactions with family and friends. 

In turn, the death doula can help uncover unmet needs, be it emotional, physical, or spiritual. When the dying person’s needs become established, a death doula advocates on the dying person’s behalf. This advocacy is especially helpful when they wish to suspend or end treatment for their illness. 

Doulas help their client’s family understand how their client wishes to spend their final days and provides support to make sure those wishes are met. 

End-of-life Planning Assistance 

A common role for a death doula is to help with death planning. This service can range from organizing logistical tasks to picking out funeral songs

They educate their clients about all end-of-life process. This allows their clients to be present, rather than being concerned about finalizing details. A death doula can also help mediate difficult family conversations, like funeral arrangements or financial discussions.

Companionship 

If the dying person has a small family or relatives out of state, the dying person may need companionship. A death doula can keep their clients company, listen and offer their time, give emotional support, and even form a meaningful bond. 

The death doula may attend regular hospice visits and take notes to share with their clients’ relatives who are unable to be there in person. 

Death education 

Some may feel uncomfortable talking about death and turn away from the dying experience. As you may already know, It’s common to avoid talking about it until it shows up at your doorstep. 

A death doula tells their clients what they might experience while they die. And, they’ll welcome all questions, fears, joys, and concerns about the dying process. By acting as a guide, they encourage clients to explore what death looks and feels like. 

In this process, dying people can become more comfortable with the idea of death. And, in the end, they may be able to approach death with joy rather than fear.

Provide respite for family 

Watching a loved one die can be a very intense process. The loved ones of a dying person need breaks and time for quiet reflection. Death doulas serve the dying person first, but they also help console and support the family and other loved ones. 

In this role, death doulas help reduce caregiver burnout and displaced grief. The doula is often the only unbiased person in the room. A neutral presence can ensure everyone has a voice, especially the dying person. 

Death doulas can help families better understand the needs of the dying person, so they can assist them to move towards death more easily.   

Death Doula Fees

The price of a death doula varies based on location and an individual’s needs. Depending on community resources, some death doulas are volunteers, while others charge an hourly rate or flat fee. A standard rate for death doulas is about $20 to $25 an hour. Most doulas will request a deposit upfront. 

Medicare and insurance companies don’t currently cover or reimburse for these services. Without the means to pay for a death doula, many people miss out on the opportunity for this unique care. However, the National Hospice and Palliative Care Organization recently formed an end-of-life doula council to educate the general public and advocate for funding. 

If a dying person needs support but can’t pay, some doulas will offer support pro bono. Other death doulas offer a sliding scale fee structure. Most death doulas will work with the financial needs of the dying person. 

Some hospices offer death doula support as a voluntary service, too.

How to Decide if a Death Doula is Worth It

You may be considering a death doula for yourself, a family member, or another loved one. They might be worth using in these situations. 

  • If you need a high level of support and presence that many family members and care staff may not be able to provide. 
  • You want to focus on the spiritual, emotional, and physical aspects of death, not just one or the other. A death doula can helps balance these needs. 
  • You want relief from those who push their agenda for dying. A doula can help the dying person find a place of peace amidst a journey into the unknown. 

There are also a few things you’ll need to consider before you pick a death doula. 

  • Do your research and find someone whose practices align with your beliefs and needs. 
  • If you need extra help with end-of-life planning and logistics, look for a doula that has a history with this type of planning.
  • Think about if the cost is worth it. Though death doulas offer a wide array of services, not every dying person needs this type of care. For example, those who are already well-versed in death and people who need more individual support. 

Also, remember that a death doula may not always come in the form of a trained professional. A family friend or community member may offer respite or companionship.

How to Find a Death Doula Near You 

The International End of Life Doula Association has a directory where you can find a local doula.

A local hospice or palliative care business will also have a list of doulas that work in your community. You can contact the National Hospice and Palliative Care Organization. 

If you search around the web, you’ll find several death doula training websites with similar directories. Keep in mind that not all death doula training programs are equal. Do your research to find the death doula training programs that align best with your needs.

Note that it’s important to interview more than one doula before signing any agreements. This doula will serve in an intimate time in your lifeyou want to make sure it's a good fit. 

Death Doulas are On the Rise 

Like the booming rise of birth doulas, we’re beginning more death doulas in mainstream health. Death doulas can fill gaps that may be missed by medical professionals. By attending to the dying person, they’ve revealed the primary need for human connection at the end of life.


Sources

  1. Dellner, Alexia. “Death Doulas Are A Thing - Here’s What You Need To Know” MSN, February 2, 2019,www.msn.com/en-us/health/medical/death-doulas-are-a-thing%E2%80%94heres-what-you-need-to-know/ar-BBTNUBa