Death Doulas – A Guide at the End of Life

The term doula has been around for centuries. In ancient Greece, it was used to describe both a household servant and a woman who serves.  They were usually the wise women or the herbalist of the village. In modern times, a doula has mostly been associated with pregnancy, and being a birth companion and post-birth supporter.

More recently, it has also been associated with those trained to provide support at the end of life. Death Doulas provide a service described ascompanions who help dying people and their loved ones clear the air, face their fears and feel supported in an environment that is often confronting and overwhelmingly medicalised.” They are known by many names including end of life doulas, soul midwives or transition coaches.

So why is the demand for Death Doulas on the increase?

When a terminal diagnosis is given, a doctor usually provides referrals to a hospice/palliative care facility to arrange assistance in the home environment and/or care within the facility.

Palliative care teams, hospice workers and home carers do an amazing job. However, economics do not always allow them the time needed to be available for patients when they are experiencing a difficult period. Patients can sometimes experience a confusing and disconnected array of health services and relationships with health professionals at their end of life stages, regardless of whether they are at home, or in a hospital, hospice or residential care facility.

The role of a Doula is different to that of a carer. They work as an adjunct to other services, helping to fill in the hours of care and guidance for both patients and families at the end of life. Doulas work alongside medical professionals using skills which are not medically oriented…rather compassion and people skills oriented. They usually work with someone who has 18 months or less in which to live.

Training courses for varying levels of expertise to become a Death Doula, are offered through private organisations worldwide.

They can provide a range of services, depending on the patient’s individual needs, encompassing –

  • Providing information and assistance in what is required to complete your legal documents, so you can have your medical choices known and final wishes followed.
  • Providing information about the many end of life choices you have, for both before and after death.
  • Support for the patient’s right to choose an end of life that is meaningful to them, and consistent with their belief system and values (ethical, cultural, religious/spiritual or personal).
  • Is an advocate and guide for the patient and family through the maze of medical, hospital and nursing options available.
  • Can be a liaison person and interpreter with medical and other support teams.
  • Arranges access to the support services and other resources that are needed or preferred.
  • Assists in the provision of a private and peaceful ‘space’ and experience for everyone involved, either in the home, hospice or residential facility.
  • Provides emotional and spiritual support to all involved, before, during and after death, or arranges access to professional services.

Whether the patient chooses to have a Doula in the background as a guide, or more deeply involved with day to day challenges, it will allow them to continue living as they choose. When they are fully informed as to the resources and support available, it gives them the power of choice with regard to their own needs and values.

Many Doulas will stay to provide assistance after death and throughout the funeral process, if requested to do so. Some do follow-up visits with family members in the weeks and months after the death to talk about the experience.

Doulas can offer something that is desperately needed in today’s highly medicalised and hectic world — genuine human companionship at the end of life, most especially for those who have no one to care for them.

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