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Death Doulas: Guiding people through life’s final transition

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Better Place Forests creates and maintains conservation memorial forests for people who choose cremation and don’t want their ashes to end up in a traditional cemetery.

You may have heard of a birth doula, but what about a death doula? While a birth doula guides women through pregnancy and childbirth, a death doula provides care at the other end of life. Also known as an end-of-life doula, death midwife, transition guide, soul midwife, or death coach, their goals are all the same: to provide emotional and spiritual support at an intensely personal and critical time. 

While this practice is not a new concept, the death doula movement is gaining popularity as more people become aware of the possibilities surrounding end-of-life support. Under the guidance of a doula, dying patients and their families find comfort, peace, and reassurance during this final stage in life. 

What is a death doula?

Just like a birth doula offers support during the birthing process, a death doula helps someone deal with their impending death and any preparations they need to make. In many cases, an end-of-life doula picks up where hospice services end — due to the constraints of insurance, most medical care professionals are restricted in what services they can perform, and how much time they spend with each patient. A doula bridges the gap between medical staff and family caregivers by providing time, support, and help with non-medical tasks. Their ultimate goal is to assist patients and their families in creating a personal, peaceful, and special end-of-life transition. 

“As a society, we make a big deal when babies are born and brought into this life, but we neglect the process of shepherding people through the process of dying,” said Crissy R, who has served as a death doula for several loved ones. “The vast majority of people are afraid of death and dying. It is a profound privilege to help someone fulfill their final wishes or goodbyes, hold their hand, reassure them that it’s OK to go, or pray with them and over them as their consciousness leaves their body.” 

How a death doula helps patients & families 

Death and dying can be taboo topics that families tend to avoid. Then, when a loved one becomes ill, family members are emotionally unprepared on how to have delicate conversations about a person’s end-of-life desires. An end-of-life doula approaches these situations with empathy, helping families come together to have open conversations and ensure that nothing is left unsaid. This provides peace for the dying patient and a sense of closure for the grieving family, which aids in their healing process.  

“People really just want to talk, they have things to say about the topic of death,” said Meagan Hope, certified end-of-life and CareDoula® from Bridge the Gap, LLC. “There are some very real fears because we are not a society that talks about death. As a death doula, I let them lead the conversation. I answer directly; death is a natural part of life, so I don’t avoid the word, and I aim to help others feel more comfortable with it, too.” 

While a death doula may perform many tasks, the heart of their purpose is to offer non-medical support to patients and grieving families. Here are some of the helpful services doulas may provide during a patient’s transition to death:

  • Companionship and a safe space for patients to talk about what they believe comes after death, helping them to come to terms with this next phase of life. 
  • Assistance with end-of-life paperwork like healthcare directives, wills, listing accounts, and gathering online passwords. 
  • Works with the patient to create an end-of-life plan — because doulas get to know their patients intimately, they can offer unique, personalized suggestions that the family may not be familiar with, such as spreading ashes in a memorial forest
  • Helps the patient complete legacy projects to leave behind, such as writing letters, making art projects, creating scrapbooks, transcribing memories into a journal, or filming video messages. 
  • Handles arrangements to make their final days more joyful, such as obtaining permission to bring a pet into the hospice room. 
  • Relieves the burden on exhausted caregivers and offers emotional support to family members.  
  • Makes the dying process more meaningful for everyone involved. 

“Doulas can take some of the ‘work’ of the death experience off of the family so they can just be fully present with their loved one,” explained Becca Price, a certified end-of-life doula in San Diego. “That often means actually finding ways to encourage and arrange for that since, in our culture, we do not value being as much as we value doing.” 

How to choose a death doula

When it comes to choosing a death doula, the main criteria should be finding a personal fit. It’s imperative that the patient trust and be completely comfortable around their death doula in order to receive the most benefit from the experience. Likewise, family members must also feel comfortable confiding in the doula and having them be part of such a personal process. 

Look for a doula who not only understands the needs of the family and the patient but also has a welcoming presence that puts everyone at ease. Get a referral from someone you trust, or check the National End-of-Life Doula Alliance (NEDA) for a list of certified death doulas near you. 

“The process of guiding someone through the dying process is profoundly rewarding,” explained Crissy. “You come away knowing you faced head-on what the vast majority of people spend their whole lives fearing, and you realize this unique opportunity to be of service to another person when so many people shy away because of their own fears and feelings.”

How much do death doulas charge? 

The cost of hiring an end-of-life doula will depend on the patient’s specific needs and the doula’s pricing. Generally, death doulas are independent contractors, so some may charge an hourly rate, ranging from $25 to $100+ an hour, while others prefer to set a flat fee. As of right now, insurance, including Medicare and Medicaid, does not cover death doula costs. 

With that said, because the transition to death is such a delicate matter and each case is unique, some doulas are willing to provide rates on a sliding scale or even offer their services for free. When searching for the ideal doula, be sure to inquire about pricing before making your final decision. 

How to become a death doula

Becoming an end-of-life doula can be an immensely fulfilling and enlightening experience. If you wish to offer end-of-life support and care, you can join an institution that provides courses and certifications. But because no national accredited body or centralized organization oversees doula training, you won’t need to take any standardized state board or license exams to get certified. 

Each private doula program may differ slightly in training requirements and coursework, but they all provide an education grounded in helping you become the most compassionate and supportive end-of-life doula. 

Who can become a death doula?

Anyone can become a death doula, but before committing to the training, familiarize yourself with the mental and emotional demands of this career path. Of course, providing this kind of care can be extremely rewarding, but it can also take a toll on those who are not fully prepared for the intensity of experiencing death so closely. Consider educating yourself more on this position, interviewing other doulas, and exploring death studies before joining a program.

As for requirements, some aspiring end-of-life doulas have medical or spiritual backgrounds, but there are no prerequisites to join a training program. As long as you have a strong passion for listening to and caring for others, you will receive the tools you need to excel as a death coach.

A peaceful transition to death

End-of-life transitions are as personal and unique as the life lived. 

“The transition from this physical realm to whatever you believe the next realm is, is a sacred space out of time,” said Becca. “There are as many different ways to experience this sacred space as there are individuals. I see myself as a bridge, a bridge that is just there and ready when you are to use it to continue your soul’s journey.” 

You may not choose when you die, but you can take ownership of what comes after. While a death doula can guide you peacefully through life’s final moments, pre-planning your memorial brings its own kind of comfort. Many Better Place Forests customers have said that making end-of-life plans empowered them to make decisions that brought them peace and helped them feel good about the legacy they would leave for loved ones.  

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