End-of-Life Doula

Scope of Practice

Professionalism, confidentiality, and the highest ethical standards are of utmost importance for a doula practitioner. Every patient and family served is unique, and services will be tailored to their individual needs providing physical, emotional, and spiritual support to the patient, family, loved ones, friends, and their support communities. It is important to know that an end-of-life doula does not impose their own personal values or beliefs on patients and families. The role is specifically designed to assist the patient and the family with understanding the natural process of death (before, during, and after) while providing suggestions for comfort and support as well as advocating for autonomy in choices of the client and encouraging the best communication possible with family, caregivers, and professionals working in direct care of the patient.
 
There are certain limits to the scope of what your doula can offer in care. Your doulas will carry insurance, but they do not perform any medical tasks such as administering medication, checking vital signs, wound care, or incontinence care. While a doula cannot carry out these specific tasks, she has been trained to provide education regarding the end-of-life process and the options available so that families can make informed decisions about their care. The goal of a doula is to collaborate with the hospice and any other healthcare professionals on your case to create a dynamic support system to ensure the highest level of care in the end-of-life process. During each visit, your doula will assess any outstanding acute and safety issues to be addressed and will be equipped with referral resources in order to maximize the necessary support that is outside of the trained doula’s scope of practice. An end-of-life doula will follow any laws and guidelines for a home aid/companion aid under them.

Your Doula Is Trained in These Three Phases for End-of-Life Care:

Shock Phase: This is the first phase after a terminal diagnosis is given. Shock can present itself in many ways such as depression, denial, anger, and withdrawal.
 
Stabilization Phase: While this phase is not always reached due to the shock of a terminal illness, it can be a time where tremendous acceptance and peace can be found. Unresolved issues can be worked out with pain management and comfort care in place allowing for the highest quality of daily living for the patient and the family.
 
Transition Phase: This is the period right before death. It can last anywhere from hours to days as the body physically shuts down. The transition phase can be the most stressful period of care due to the changes the body goes through. A knowledge of what is happening and support during this time can be lifelines for caregivers and family.
Doulas are educated in the progression of the following end-of-life diseases. Understanding the disease process is very important for comfort interventions and care plans.
  • End Stage COPD/Emphysema
  • Lung Cancer
  • Liver Disease
  • Pancreatic Cancer
  • Breast Cancer
  • Stroke
  • Colon Cancer
  • Brain Cancer
  • Dementia/Alzheimer’s Disease
  • Amyotrophic Lateral Sclerosis (ALS) or “Lou Gehrig’s Disease”
 
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At the end of the day, an end-of-life doula’s job is to be a supportive presence to the dying and their loved ones. A doula’s work can include all or any of the following:
  • Providing companionship to the dying and their loved ones through the entire end-of-life journey
  • Helping facilitate unresolved issues and find peace and acceptance of death through grace and the patient’s own story
  • Following advance directives
  • End-of-life planning upholding the highest dignity for the patient
  • Vigil planning
  • Complete funeral or memorial planning
  • Creating remembrances
  • Facilitating comfort interventions and care plans
  • Supporting grieving family members, loved ones, friends, and the community before and after death

A Sister At a Loss
Anonymous|​California 

"“She got it! Who could comprehend a passed one's past as one who loved his soul through a bereaved sister's words?

Laurel's coordinated responsiveness toward me and my family created a funereal milieu of inspiring beauty and hope for many...
​It was unforgettable and priceless in its timely -- and timeless -- bold statement in elegance and simplicity."

Connect With an

End-of-Life Doula
More Americans are dying at home than in hospitals, but many families are unprepared to care for the seriously ill at home. Read more about this historical reversal. End of Life Doulas are a vital supplement to end of life care. The NEDA certification is important for consistent EOLD industry standards. Ask me about my credentials!