What is a Death Doula?

The services a death doula provides and how this differs from a funeral director

Hands clasped
Often, the greatest gift offered by a death doula is that of companionship. Photo © Squaredpixels/E+/Getty Images

What is a Death Doula?
A death doula is someone who makes him or herself available to assist a dying individual and, typically, also the family before, during and after a death occurs -- often referred to as the pan-death "spectrum," "process" or "journey" -- in order to provide physical, emotional, psychological and even spiritual support.

Sometimes associated with the home-death or home-funeral movements, a death doula generally offers/assists in a wide range of services that can vary greatly, depending upon the circumstances, but generally seeks to provide a holistic, hands-on, non-medical approach to the fundamentally natural process of dying for all parties involved.

While it can assume many forms, the intent of a death doula is typically to help transition or "bridge the gap" for both the living and the dead created by the focus of medical practitioners on saving lives versus the role of funeral directors and others whose functions begin after death occurs.

Often referred to by different names -- such as death midwife, end-of-life coach, funeral guide, death-and-dying guide, thanadoula (a linguistic combination of thanatology and doula), etc. -- a death doula might offer any of the following services, among many others:

For the dying individual: Whether in the family's home, hospice, hospital or some other setting, a death doula often provides the profound gift of companionship. Among many things, this might comprise simply holding the dying person's hand; actively listening to his or her comments; conversing and attempting to offer answers/comfort to the individual's questions/concerns/needs; watching television or reading a book aloud; discussing end-of-life wishes; helping the dying individual resolve/find peace about real or imagined wrongs; etc.

For the family members: Whether in the family's home, hospice, hospital or some other setting, a death doula often provides the gift of continuity across the pan-death spectrum, i.e., before, during and after a death occurs. Among many things, this might comprise performing various basic tasks usually conducted by a home caregiver; staying with the dying individual while family members are away; facilitating supportive communication and/or conversations between all parties; assisting in the creation of meaningful goodbyes during the remaining hours of life; helping the family bathe and dress the deceased; serving as a resource for funeral/interment planning and estate settlement; etc.

How are Death Doulas and Funeral Directors the Same/Different?
As noted above, death doulas generally bridge the gap between efforts to prevent a death from happening and after a death occurs. This continuity of presence on the part of death doulas during the transition between life and death differs markedly from the role of funeral directors, whose responsibilities typically begin post-death (unless the deceased or his or her family prearranged and, possibly, prefunded those post-death arrangements -- a preneed situation).

Depending upon the circumstances and the level of trust that exist, some death doulas might assist a family in performing various post-death functions typically performed by funeral directors, such as washing and dressing the body; conducting a wake/viewing of the (unembalmed) body; assisting the family in arranging the funeral/interment services desired; accessing and filling out necessary paperwork; providing grief support; etc.

Who Becomes a Death Doula?
People from all walks of life can choose to become a death doula, including grief counselors, hospice personnel, social workers, healthcare professionals, members of the clergy, individuals who witnessed a transformative death experience personally, etc.

The reasons vary but, generally, anyone who feels the calling to help both the dying and their surviving loved ones during the transition from life to death might decide to become a death doula.

Why Would I Use a Death Doula?
While the reasons vary, people can find turning over control and care of their deceased loved one to strangers following a death (an at-need situation) an unpleasant or off-putting thought. This might particularly occur when a family member has served as a home caregiver during a prolonged illness or disease and, therefore, anticipated death to occur at some point. Others might desire to conduct a home funeral for personal, cultural, environmental or spiritual reasons.

Regardless of the specific reason, a death doula can provide the comforting continuity of presence that some families need when facing the death of a loved one, as well as serve as a trusted resource/facilitator.

Can Death Doulas Embalm Bodies?
A death doula cannot embalm a body, unless he or she has received the medical training and professional licensure necessary to do so in a specific U.S. state. Embalming instruction is not part of the death doula-training process.

Are Death Doulas Licensed?
Death doulas might, but not necessarily, receive training from a for-profit or not-for-profit organization or individual, but there is neither a standardized educational or training program death doulas must pass nor are they subject to government oversight, regulation or licensure.

Does a Death Doula Charge a Fee?
It depends. Some death doulas work independently and might quote a flat fee for their services, or a per-day or even a per-hour cost. Each death doula sets his or her own fees, so make sure you ask about all of the costs involved up front. Conversely, some death doulas volunteer their time, often in conjunction with a hospital, hospice or other caregiving facility, at no charge to the family.

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