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We all must face death one day, and before that, we will likely experience the loss of several loved ones along the way.
Does this seem too bleak? Perhaps our collective discomfort with the concept of death is why it's rarely discussed, planned for, or taught in terms of how to handle it.
“Many people in our society are death phobic and do not want to talk about it,” said Marady Duran, a social worker, doula, and educator with the International End-of-Life Doula Association. “Being an end-of-life doula has been so much more than just my bedside experiences. I am able to talk with friends, family, and strangers about death and what scares them or what plans they have. Being a doula is also about educating our communities that there are many options for how end-of-life decisions can be made.”
When facing the inevitable end of life, whether for yourself or a loved one, you may be overwhelmed by the questions: What should I do now? How do I handle these emotions… and the endless paperwork? End-of-life doulas (also known as death doulas or death coaches) are empathetic and well-informed guides who accompany you through the stages of death and grieving.
Ashley Johnson, president of the National End-of-life Doula Alliance, was deeply moved to pursue this path after helping a childhood friend navigate her death at the age of 27.
“As I supported her through her journey, I saw a profound need for education, care, and companionship for those and their families confronting end-of-life situations,” Johnson shared. “The passing of my beloved friend only deepened my commitment to this cause. I now view it as my calling to offer the same level of care and assistance to others navigating the challenges of the end-of-life process. I firmly believe that everyone deserves a dignified and well-supported end-of-life experience, and that begins with demystifying the process, easing fear, and helping families find the closure they need to heal.”
What to anticipate from a death doula
The offerings of an end-of-life doula are diverse and adaptable. Similar to birth doulas, they do not provide medical care. Here are some of the services Johnson described in her work:
Planning for advanced health care. This might involve setting up a living will, assigning a durable power of attorney for health care, and making decisions regarding advance directives. “We assist individuals and their families in navigating the intricate process of advance healthcare planning, ensuring that their desires and choices are documented and honored,” Johnson shared.
Hands-on training for family caregivers. End-of-life doulas offer guidance to family members and caretakers on how to properly care for their loved ones during their final days.
Companionship for patients. “We provide emotional support and companionship to patients, helping alleviate feelings of loneliness and anxiety,” Johnson explained.
Relief for family caregivers. Taking care of a dying family member can be overwhelming, but caregivers need moments to step away and tend to their own needs as well.
Creating a support plan for the time of death. A person nearing the end of life may find comfort in many aspects of their surroundings, such as lighting, music, aromatherapy, and the people present. A doula can help coordinate all these details to create a peaceful environment.
Grief support. “Our role extends into the grief process, offering support to both the dying individual’s loved ones and the patient as they journey through the end-of-life phase and beyond,” Johnson stated.
Vigil presence for those actively dying. “We ensure that no one faces the end of life alone by being a compassionate and comforting presence during the active dying process,” Johnson shared.
Assistance with planning funeral and memorial services. Planning services while deeply grieving can be an overwhelming task. Doulas, experienced in this process, provide a steady hand to help make the necessary decisions.
“Our goal as death doulas is to enhance the quality of life and death for all involved,” Johnson said. “We provide a variety of non-medical support, cultivating an environment where individuals and their loved ones can find solace, direction, and peace during this profoundly delicate stage of life.”
When should a doula be brought in?
Death doulas offer comfort and assistance to both the dying individual and their loved ones at any stage of the process. They can step in to offer help before, during, or after the death occurs.
At any time, even before a terminal diagnosis, doulas can support you emotionally and practically with preparations for end-of-life wishes, advance care planning, and creating a nurturing environment.
During the end-of-life phase, doulas are more engaged, offering emotional, spiritual, and practical support. They may be available on a daily or weekly basis, depending on your needs.
After death, doula services continue to support the family of the deceased.
Grief has no set timetable, as Duran explained. "Some may feel the need to meet once or twice after a loss, while others might not want to engage in any grief work at all. It’s a personal journey, and some people may take years to process it," she said.
Assistance in the face of an unexpected death
Death doesn't always come with a warning or time for preparation. Even in instances of sudden death, an end-of-life doula can assist with managing practical tasks and coping with grief. They offer the following support:
Offer emotional support
Help you comprehend the grief journey
Teach you strategies for coping
Assist with arrangements, legal, and financial concerns
Help create meaningful memorials to honor the deceased
Foster connection and community
Listen attentively and validate your emotions
Provide long-term assistance
"Grief is just another form of love," as my mentor Ocean Phillips, also a doula, often says. Duran shared, "Grief often carries a negative connotation, and many avoid experiencing it, but it can be transformative for those who face it. Those grieving an unexpected loss may feel guilt, thinking, 'If only I... I could have...' The doula's role is to create space for them to express this, to share their feelings. We cannot fix or change the past, but we can stand beside them and offer compassion throughout the journey."
Other experts who can guide you through the process of death
Death doulas collaborate with a variety of other professionals, such as healthcare providers and hospice teams, to assist families in navigating the process of death and all that follows.
"Every member of the team contributes to connecting with those who are grieving and facing death. I always remind myself that I am just one part of a much larger network that provides support to those experiencing death and loss," Duran shared.
Here are some additional professionals you may want to contact when coping with the death of a loved one:
Grief counselor
Social worker
Chaplain
Community leaders
Estate planning lawyer
Probate lawyer
Funeral service provider
Financial planner
Tax accountant (to assist with filing for the deceased and their estate)
Estate liquidator or clean-out service
