A Death Doula (also termed "end-of-life") is similar to a childbirth/pregnancy doula but instead of for birth, it's for clients nearing death.
How are they trained, and who hires them?
Currently, death doulas are not regulated by a regulatory body and there is no "requirement" for proper doula training before practicing. With that said, most death doulas get certified through an end of life doula organization prior to working in the field, and many also volunteer in organizations such as hospice to gain better experience of the end-of-life/death work.
Death doulas can be hired by hospice organizations but many practice privately, work for hospitals, nursing homes, or even for funeral homes. There are also hospice nurses, volunteers, and others who have worked closely with the dying that still get certified to become an death doula because the role is very different and important to fully understand.
What are they trained in?
The end-of-life model of care
Deep active listening
Death and dying symptoms
Grief and reprocessing work
Rituals and ceremonies
Meaning and legacy work
Vigil planning and guided imagery
Self-care for doulas themselves
Death planning (paperwork, etc.)
And more!
How can they help?
Advance Health Care Planning - Many death doulas choose to become educated in their State/Province's advance healthcare directive and will process in order to help ease the burden for the families of the dying.
Practical Training for Family Caregivers - A big part of death doulas is to also educate on concerns clients/their families have. We are not healthcare practitioners, but there are symptoms and processes of the dying that we can help to educate clients on.
Creating a Plan for Support at the Patient’s Time of Death - Unfortunately many people die without a plan. A plan consists of more than the advance healthcare planning mentioned above - it consists of vigil planning and legacy work. Sometimes doulas are called closer to the end of the clients life. In this case, there may not be time to plan. This is where doulas "journey beside" the client and families. Their job is to simply be alongside clients and family member to provide grief and bereavement support and whatever else may be needed.
Help with Planning Funeral and Memorial Services - Again, many family members are too exhausted to start the planning process of funeral/memorial services, so the doula can assist with this to ease the burden.
Companionship to the Client/their Family - If the doula is called before the actively dying process, then they can be a companion to the client. This would include speaking to the client about how they are feeling, what they're thinking, how they're doing. This is where much of the planning occurs, to ensure that the dying client receives their end-of-life wishes. Doulas also support the family during this time, educating on end-of-life symptoms/signs, and starting grief work.
Needed Relief for Family Caregivers - Since many families take on the role of care-giving especially in hospice situations, doulas can assist in providing relief for the caregivers; sitting with the client while the caregiver sleeps, eats, shops, takes a break, etc., and anything else to help relieve some of their responsibility of care.
Grief/Reprocessing Support - Before death, during the active dying process and after death, doulas provide a lot of grief and reprocessing support for the client and their loved ones. This can look and be different for everyone and every family dynamic.
Vigil Support - If the doula is called before the actively dying phase it is a great time to plan for vigil and/or legacy wishes if the client would like anything specific to occur. Once the client is actively dying, many times they have wishes for who should present in the room, what they want to mood of the room to be like, how they want it to smell, any music or books to be read, etc. It allows clients to have a sense of control in their dying and gives them added comfort (I will be posting another blog post in the future on what vigil can further include).
Other services - Death doulas will make it known to clients what they are comfortable and not comfortable doing ahead of time. Some doulas have medical training so they are comfortable with changing linens/helping with direct physical-care support, while many doulas only assist with grief support and planning only. Check with your doula ahead of time to make sure they fit your needs.
Why did I get the training?
I decided to get doula training because not only will it help me in my future career as a naturopathic primary care doctor, but I also plan to get into naturopathic oncology where death and dying will be a part of patient education I give to my patients. I think as a healthcare provider you are doing a huge disservice to your patients if you're not properly educated in the death & dying process, as well as grief and how to properly support someone in all aspects of life, including death. These are topics that we are really not educated in, in medical school but are very needed.
When my dad was dying, my mom and sister (who's a nurse) primarily took care of him while my brother helped provide physical strength (in helping move my dad), while also planning a lot of the memorial service, burial, etc. I was able to provide the advance healthcare directive and power of attorney for my dad because of my previous law firm work experience, but looking back I wish I had the knowledge of how to help further. I also wish more emotional and mental support was available for my dad that was outside of the family, and more for myself and family members as we went through that process.
The training course I took was not easy. It brought up a lot of uncomfortable situations, conversations, and memories. In a way I think it has helped me grieve, but I do not recommend others to take the course if they just lost a loved one, unless they are 100% certain they can handle it well emotionally/mentally.
The course has taught me so much about death and dying, about how to emotionally support the dying and the grieving, as well as so many more life lessons. It helped me become comfortable with the thought of dying, with accepting my own mortality, and with speaking to others about the subject of life and death. It was an incredible experience and I know it'll serve me for the rest of my life as well as my future patients.
Next steps:
I am in the middle of hospice volunteer training here in Toronto, where I will be volunteering locally for the terminally ill. While doing this, I am going to be tracking client hours so I can become fully certified through the doula organization I did my training with. I'm continuing with school and once done will practice privately as a death doula alongside my naturopathic practice. Be on the lookout on my Facebook and Instagram account for more education on death & dying and general health!
Stay healthy, educated, humbled and prepared,
Loreal
*If you're interested in the course/organization I went through or more specific information as to how the course was laid out, please contact me and I will either give you the information or write a blog post about my experience.*
Comments