Seeking the services of a death doula

What role is filled by a death doula?

• A death doula is there to tend to your loved one’s and your family’s emotional, spiritual, informational, and logistical needs.

• They assist in preparing for death, including listening to fears and wishes, soothing the former while helping the latter to be fulfilled.

• Doulas can help run errands and take tasks off the family’s hands.

• The doula will be there just before, during, and after the actual moment of death to make the transition as comfortable as possible for everyone.

When your loved one is nearing the end of their life, it is natural to want to seek out any help that might be available to make their transition easier and more comfortable. You may have heard of the concept of a death doula, and may be wondering if their services would be beneficial to your loved one and your family. Or perhaps you are new to the idea, but are seeking more avenues of support during this difficult time.

Though relatively new, the death doula profession is becoming more and more common in the U.S. Here are some things to keep in mind before you decide whether a death doula could be right for your loved one.

What is a death doula?

The concept of a death doula evolved from that of a birth doula—a person who helps a mother through her experience of childbirth by providing spiritual, emotional, informational, and hands-on support and comfort before, during, and after the birth. Death doulas do essentially the same thing, but for the end-of-life process. They stay with the terminally ill patient and their family before, during, and after the death, providing emotional and logistical support and guidance.

Much like a birth doula, death doulas tailor their services to the needs of the individual or family, so not everyone’s experience with a doula will look the same. Generally, you can think of a death doula as an expert in all areas of dying—someone you can depend on for emotional support and valuable information, and who you can go to for physical help running errands or accompanying your loved one to hospital visits.

A death doula is an empathetic but neutral, calm, level-headed presence who can guide you and your family through some of the end-of-life preparations that may feel too overwhelming to embark on alone, or that you may not even have known that you need to do.

Besides offering their expertise in the logistics of preparing for death, a death doula will listen to your loved one’s feelings, fears, and wishes, and talk with them about how to envision their ideal way of passing. Families find it very helpful to have this professional, third-party presence to facilitate the honoring and carrying out of your loved one’s wishes during this time. A death doula can also help your family come up with creative and beautiful legacy projects so that you can have meaningful objects by which to remember your loved one.

Are death doulas affordable? 

The cost of a death doula’s services can range from $25 to $100 an hour. It is important to note that these services are not currently covered by any major insurance plans, but many doulas offer payment plans and/or affordable, sliding-scale rates based on your financial situation and need.

If you cannot afford a particular doula’s rate, it is still worth reaching out to see if they will work with you, or if they might be able to recommend a colleague. Death doulas do this work because their hearts are in it; they genuinely want to connect with you and help your loved one and your family get through this difficult time in the most meaningful and comfortable way possible. 

There are various certification programs for becoming a death doula, but it is not a regulated industry and there is no requirement to be certified in order to practice. Death doulas who are still in training or who work in volunteer programs will often provide their services free of charge.

How do death doulas differ from hospice staff?

While most hospices provide care that goes beyond the medical, a hospice team is first and foremost there to tend to a patient’s medical and palliative care needs. Death doulas, on the other hand, are non-medical caregivers whose focus is on the person’s emotional and even existential well-being. They also can pay more attention to the needs and emotions of the family; hospice staff can be an amazing resource for family members, but their primary focus is on their own patient.

This often extends to the death doula becoming a support in other ways, such as going shopping for the family or running other errands, or relieving them so that the primary caregiver can get some rest or take time for themselves.

In general, death doulas have a great deal more time to spend with the patient and their family than hospice staff. Though everyone’s goal is also to help your loved one have the most comfortable experience possible, there are limits to the amount of support that hospice staff can offer, including those placed on them by insurance requirements.

Hospice staff will often work together with a death doula to coordinate care; the doula will be alert for when medical treatments and palliative care may be called for and can contact the hospice team.

In many cases, death doulas also begin their relationship with the family before the person has gone into hospice, and maintains that relationship after they have passed. Often they are there during the death itself to comfort everyone emotionally and ease the transition, and stay with the family in the immediate aftermath to support them and help them with how they are feeling.

Knowing that your loved one is nearing the end of their life is an extremely difficult thing to grapple with. Many families feel grateful, upon looking back, for the support of a death doula who helped them understand what to expect, took care of their needs, and made sure both their loved one and they were as comforted as possible ●