What is an end-of-life doula?
An end-of-life doula provides non-medical guidance, support, education, advocacy and companionship, to individuals and their families during the end-of-life journey. We offer emotional, psychological, and spiritual guidance, helping individuals prepare for death, and navigate the dying process with dignity and peace.
​
​
​
​
​
​
​
How is an end-of-life doula different from a hospice nurse?
Time and roles. The hospice nurse is the medical manager of the patient with limited time at the bedside.
Hospice care provides medical and nursing services and is typically covered by Medicare. Hospice nursing services are typically provided one hour per day during the final weeks of life. Volunteer services may also be available through hospice, as available.
The end-of-life doula is a non-medical professional who is the eyes and ears for the hospice team/medical team with no time limitations. We hold this space like a birth doula. The doula alerts the hospice team to any changes in the patient’s presentation so that the hospice nurse can come back, reassess, and update the care plan for maximum daily comfort of the patient.
What is the difference between an end-of-life doula and a hospice volunteer?
​
Time, roles, and training. The hospice volunteer in most states is limited to a maximum weekly bedside maximum of four hours. The average hospice volunteer will visit 1-2 hours per week. The doula can spend as much time with the patient and family as requested. The doula is only limited in that he/she can not provide medical treatment, nor administer medications, nor provide wound care. The hospice volunteer is governed by Medicare regulations which prohibit medical care, moving, feeding, and bathing.
In addition, the end-of-life doula should have extensive training and practice to be present during end of life, with intense and difficult emotions. The end of life doula‘s presence, companionship, advocacy in hospitals, or at home, education and coaching, allow for customized end of life care plans, focused on spiritual, physical, practical, and life review needs.
What services and support will hospice offer me after my loved one has died? What grief support can an end-of-life doula provide?
​
Hospice does offer bereavement services for up to a year or fifteen months in most states. The family is typically contacted by a volunteer and notified that they can participate in weekly/monthly grief support groups. The original team that worked with the family is typically not involved in this grief support. This is sometimes felt as another loss by the family. End-of-life doulas’ services are available before, during and after the death.
​​​​​
Are end-of-life doulas covered by insurance?
No, at this time end-of-life doula services are paid for by the dying person/their family.
Can an end-of-life doula be present while someone is dying?
Yes, if desired, an end-of-life doula can be present, bedside.
When should I contact an end-of-life doula?
Working with an end-of-life doula can occur at any stage of life. For example, all adults (18 and older) should create thoughtful advance directives and this can be accomplished with the help of a trained end-of-life doula. Unfortunately, only 1 in 3 American adults complete advance directives, failing to provide clear wishes about the treatments they desire to have and not have when they become terminally ill/incapacitated. This failure to create clear advance directives often places families and loved ones in conflict and lack of clarity about appropriate treatment decisions.
The sooner a doula can enter the process, the more time can be spent creating quality care plans, prioritizing end-of-life needs, creating meaning and legacy, for the individual and family/loved ones.
