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The Importance of Death Doulas and End of Life Care and Companionship.

There have been occasions in my life that people thanked me for being so open and honest with them, making note of my straight to the point nature but also having a great deal of compassion and empathy. It’s one of the things I appreciate in others. It doesn’t feel dishonest or underhanded but a faster road to acceptance when time is of the essence. On the other hand, acceptance is a hard pill to swallow when as living beings from humans, animals and plants, we are wired to fight to survive.

Death happens to all living things. We shouldn’t dwell on it or fear it, but we should have a healthy relationship with it. Knowing that it will happen to each of us, keeps us motivated throughout our lives. When we are kids, we think it’s so far away. As we age, we have moments that remind us that it can be closer to us and ideally makes us appreciate these lives. Every passing friend, coworker, family member reminds reminds us to appreciate the days, the people, the time. Death is a good reminder that there are people around us that love us. That there are places to see, conversations to have and moments to share. There are activities to participate in, no matter how simple they all may seem to us, each day we are here is opportunity.

One of my favorite sayings is “we have not yet met all the people who we will love or who will love us in return”. Even in our last breaths we may connect to those that bring us comfort.

When we are given news of a disease or sickness that may lessen our life expectancy and find that death may be closer to us or a loved one than we expected, most of us are unprepared. We don’t like to think about the end of our lives while we are busy living it. Many times it can be quite shocking and unexpected and we tend to freeze in disbelief. Thinking of what we want for our lives, especially at the end is important to plan with a clear head. These plans can of course change often, but planning ahead leaves less decision making under stressful circumstances or in the event of emergencies.

Although the term “Death Doula” was created in the 1990’s shortly after the term “Birth Doula” was used in the 1980’s, the purpose is quite similar. Birth doulas prepare and guide a mother for her infant to be brought into the world and begin life, as death doulas do just the opposite. A guide and companion to prepare to close out the final chapter of a life. A plan for your possessions, messages to loved ones, a plan for your remembrance such as funerals, memorials, wills, donations, what to do with your disposition (cremation, terramation, burial) and how you would like to plan your final chapter.


A doula can help plan the best way to handle family and friend visits, and how to make accommodations to stay in the comfort of your home til the end or as long as comfortably possible. A large part of remaining as comfortable as you can during this process is caring for the body and mind. Finding holistic resources for comfort such as massage, reiki, meditation, or more conventional options like speaking with your physician about comfort measures including medications. Death Doulas are not medical professionals but work alongside hospice staff to get the best care possible.


Death doulas are a professional support companion to a terminal person and their caretakers during a sometimes stressful and difficult time. We are here to lend an ear, a hand and occasionally some advice or support to an individual that need time or cannot handle the enormity of tasks needing completed in addition to daily life that continues on for families. Support can be physical, mental, emotional or spiritual.

Contemplating our lives and our relationships with others can create a desire for closure or expressions of gratitude with people that we have had through our lives. A doula can be a neutral and safe person to express wishes to create communications or legacy to share in the moment or plan once you are gone. Maybe you just want a person to tell your secrets to, that will just listen with a non judgmental ear.

Working in direct patient clinical care for nearly 20 years with those who were quite ill with advancing diseases and disabilities gave me an enormous amount of patience and understanding of the dynamics of end of life. I appreciate the differing family dynamics and the need and desire for personal autonomy that is important to those making end of of life decisions. It is so very important to have these wishes in place long before there are any questions so that the questioning from loved ones later on doesn’t end in anger and guilt. A doula can help prepare long in advance of the need.

A doula’s job begins far before a death occurs. Months, perhaps even years ahead of time of passing. A doula can be used without a terminal illness at all. In fact, you can make an end of life plan at any time as we all come to find out that tomorrow is never promised. Preparation can occur far in advance so that life can continue on and be appreciated until the last embrace.

This work can also continue far after a person has passed on. Coordinating the clearing out spaces from memory care units, hospitals, nursing facilities or even removing hospital beds from spaces in the home that are sometimes turned into the hospice space for ease of mobility is a daunting task family often does not have time or emotional capacity to do. Grieving families need support long after their loved one is gone.

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