Are you curious about death doulas? Birth doulas are widely used, and death doulas are becoming more commonplace. Yet many people are unsure precisely what death doulas do, how to find one, and what it means to use one. Do you have to be close to death? Do death doulas provide medical care? How much does one cost? What kind of person is a death doula, anyway?
Who Is a Death Doula?
Death doulas – like birth doulas – work to support their clients through major life transitions. Not therapists, death doulas work to companion their clients as they begin to contemplate death. You don't need a terminal diagnosis to hire and work with a death doula – many people use them as they complete advance planning documents such as living wills, consider their legacies, or even just think about what they want the end of their lives to look like. "We get calls from people who are young and healthy and want to talk about death and dying…as well as those with a recent diagnosis who are grappling with what it means to know their death is more imminent,” says Diane Button, a Bay Area death doula and co-author of The Doula Toolkit, which defines a doula as “a trained, non-medical professional of extraordinary compassion and kindness, who brings emotional, practical, and unbiased support and expertise for those nearing death.”
Death doulas also work with families of those who have already died, helping them identify personalized ways to memorialize their loved ones. Doulas can assist in developing meaningful remembrance rituals and creating physical tributes, such as scrapbooks or memorial spaces in gardens. They can provide a sympathetic, receptive, non-therapeutic ear while those who have suffered a loss work through their feelings of grief. Essentially, anyone who is interested in exploring what death and loss means for them, regarding their own life or the lives of another, can benefit from working with a death doula.
What Doulas Do - and Do Not - Do
Doulas are not mental health professionals; while they can offer emotional support, they do not give advice or suggest possible courses of action. To do so would be the antithesis of a doula's work. A doula seeks to be a steadfast companion as their clients wrestle with their feelings about death and dying and come to their own place of reconciliation and peace. As a neutral sounding board, death doulas recognize that everyone comes to terms with and accepts the prospect of death in their own time and in their own way. Doulas are there to support their clients through this process. Diane tells me, "As a death doula, we are invited into a person’s life at a very intimate time…it is an honor that I will never take for granted.”
Death doulas help their clients with legacy work—writing goodbye letters, crafting their obituaries, planning funerals and vigils—and providing daily companionship. They may also help their clients with referrals to funeral directors, attorneys, home health aides, cleaning help, and work with families and friends to set up meal trains. In short, a doula will support the client in almost any way that the client feels would be helpful. Doulas do not, however, provide medical care or legal advice themselves.
How to Find - and Hire - a Doula
There is no certification or federal/state licensure for death doulas, so you'll want to carefully research a doula's background to be sure they fit your needs. Many doulas have previous training or education in healing arts, nursing, or a mental-health-related field. Some, however, become doulas only after having completed a doula training program. Others consider themselves self-trained. If it is important to you to work with a doula who has been formally trained, look closely at the training program itself so you get a sense of the educational requirements. Some training programs are weekend-long, while others span months, although the length of the program only sometimes speaks to its quality.
The National End of Life Doula Alliance (nedalliance.org) is an excellent resource for learning more about doulas. You’ll find a state-by-state directory and a list of doulas who have passed the NEDA proficiency exam, which covers all potential areas of practice. Word of mouth is also a wonderful way to find a doula. More and more funeral directors are affiliating with end-of-life doulas, so if you know a funeral director you like and trust, they may also be able to offer a referral. However you initially connect, it is recommended that you request an initial consultation to determine if the doula is right for you. Many will offer one at no cost.
What Does an End-of-life Doula Cost?
Costs for doula services vary, although many doulas base their fee schedule on comparable holistic providers such as reiki or energy healers. Most doulas offer packages or sliding scale fees; some may work pro bono. It is important to discuss compensation when you initially interview a doula – money is a sensitive subject in the best of circumstances, so it really pays to be clear on the fee arrangements from the beginning. Some doulas do not charge for vigil sitting, so if you think you’d be interested in having your doula at your vigil, confirm those specifics during the consultation. Many doulas work within local collectives to provide coverage should they be out of town or unavailable, just like a birth doula would.
Trust Your Instinct About the Best Doula for You
Finding the right doula takes time and thought. This person will be walking with you as you begin an important journey, and I believe that after checking the qualifications that are important to you, you should follow your gut instincts. You will likely be sharing sensitive information with them and engaging with them during times when you might feel extremely vulnerable, so trust is paramount. Everyone is different; even though a doula seemed perfect for a friend, you may not connect with them on a soul level. Trust your instincts, and if you can, interview more than one doula so you have options and some points of comparison.
Doulas can provide many levels of support for you as you begin to come to terms with your mortality, whether death is soon or not. As services can be customized between you and the doula, there is a lot of room for you to personalize this experience and find someone who can help you in just the ways you need. Working with a doula can be comforting and reduce anxiety during a challenging time. Most doulas take their work extremely seriously and are always striving to meet their client's needs as things change moment by moment. Many have felt called to this work. Diane says, "Doulas are curious and open-hearted…if our clients want to go deep, we can go deep alongside them as their companions. It is truly a gift."
For more information about Diane Button and her work, please visit www.dianebutton.com
