When most people hear the word “doula,” they think of a childbirth and post-partum coach. If you’re one of those people, you’re not wrong, but did you know that there are doulas for different life stages, including death? Many doulas help usher new life into the world, while death doulas help people leave this world peacefully.
What Is a Death Doula?
A death doula, also known as an end of life doula, death midwife, transition guide, or end-of-life coach, is a non-medical professional who cares for people who are dying and their families. Death doulas are trained in providing physical, emotional, and spiritual support for the terminally ill.
While some death doulas work independently, many of them work with hospitals, hospices, or senior-care facilities to provide full-coverage support and an easier transition from life to death. Most end of life doulas care for people who want to die at home and provide additional emotional support that not all medical professionals are equipped or able to give.
When a death doula starts working with a client and their family, they’ll first determine the level of service they’ll need to provide. Everyone experiences death differently, and doulas want to make sure they personalize their level of care as best as they can.
Families who hire death doulas usually come to them overwhelmed and needing physical and emotional support. Death doulas take the time to figure out how their clients and families are dealing with the death process and determine what level of services they can provide.
Death doulas offer a variety of different services, so before the terminally ill person becomes unable to make decisions about their own death, a doula will work with them to plan out each detail of their ideal death, including what will make them feel most at peace as they transition through the process of dying.
This is an important and meaningful step for many doulas’ clients and their families. Death is a hard subject to tackle especially with someone who is facing their own mortality. Engaging people in a conversation about how they want to die and offering deep regard for their final wishes helps ease the anxiety around the death process.
So you can imagine that a crucial part of a death doula’s job is to develop a deep sense of trust with their patients. At the end of the day, their job is to respect their clients’ wishes and refrain from trying to influence or sway their decisions.
While it’s not required to know a lot about end-of-life care options or the funeral process, many doulas act as resources for these subjects. The average person who is planning a funeral probably hasn’t done it before or hasn’t done it enough to always know how to advocate for themselves. Death doulas help families find inexpensive burial options, assist them in negotiating with providers like hospice workers, and aid in navigating palliative or hospice care. Some doulas have even been hired to help plan their patients’ funerals.
A death doula’s ultimate goal, though, is to do whatever they can to create a safe and peaceful environment that reflects their clients’ needs and empowers them to mentally and emotionally prepare for the end of their life.
Other services that doulas provide include:
- Taking family photos
- Helping patients write goodbye or forgiveness letters
- Aiding clients in creating legacy projects, such as scrapbooks
- Offering support to a patient’s family, such as encouraging or providing self-care and explaining the death and dying process
When Should You Hire a Death Doula?
If you or a family member are struggling with a recent terminal diagnosis, it might be time to seek out a death doula. There’s no shame in hiring someone to help you cope with such a challenging time in your life.
Due to the mobile nature of their job, doulas are able to work in hospice houses, hospitals, or any type of assisted or independent-living facilities, so if you or your family member have chosen not to die at home, that’s okay.
End-of-life doulas provide consistent care. Many terminally ill patients experience a tough transition between receiving treatment to accepting their diagnosis. Some people are admitted to a hospice house or place under hospice in their home, while others aren’t able to receive palliative care right away or “graduate” from it before they die.
There is a whole slew of circumstances where patients experience a shift in or loss of their medical support systems. Hiring a death doula helps terminally ill people by providing them someone who can not only help them navigate these challenging and disorienting changes but can also support them physically, mentally, and emotionally.
Death doulas can also help fill any gaps between care. Some people don’t qualify for hospice right away, so they hire a doula who can assist them in the interim.
The cost of an end of life coach varies from person to person. Some doulas offer weekly or monthly retainer fees, while others charge per session and offer packaged options. A package will usually cover a certain number of hours for a set fee, for example, 20 hours for $700 plus an hourly fee for any time over the 20 hours.
Most doulas are pretty flexible with their rates, though, and many even offer a sliding scale based on what people can afford. It’s best to check with the person you’re interested in hiring for their individual services and rates. Since the industry is unregulated, health insurance is unlikely to cover the cost of doula services.
Since there are no set government regulations for death doulas, we recommend interviewing a doula before you hire them to make sure they’re a good fit for your needs.
How to Become a Death Doula
If you’re feeling called to this vocation, you’re probably curious about death doula training, and the truth is, training varies depending on the certification program you choose.
While it is helpful to have medical experience, you’re not required to have any practice in the medical field to become a death doula since you most likely won’t be providing medical services. You also are not required to have any previous training in spiritual or mental health services, either.
As cliche as it sounds, the only thing you really need is an open mind and heart and a passion for helping people. Any program you choose will provide you with the tools necessary to work as an end of life coach.
National professional end of life doula certification is not required to be a practicing death doula due to the lack of regulation in the industry, but most people recommend certification since these programs will prepare you for what it’s like to work with someone who is dying.
Currently, there are a few certification programs in the United States; the most popular are from the International End of Life Doula Association (INELDA), the International Doulagivers Institute, and the Lifespan Doula Association (LDA), but several universities and hospice groups offer programs as well.
If you choose to become a certified death doula, you’ll need to complete a variety of requirements, including hands-on work with patients. Depending on the program you choose, this might take 2-3 days or up to six to nine months. While programs range from $750 to $3000+ depending on the time it takes to complete your training, many places offer scholarships to help with affordability.
Death doula salary
So you’re a certified death doula—how much do you charge your clients? As with everything else about being an end of life coach, it depends on the client. Death doulas work as independent contractors, charging either an hourly rate or a flat rate that covers a certain number of hours. While most doulas work independently, some work with hospices that budget for their services.
If you decide not to work with a hospice, you’ll have to track your hours on your own and invoice your clients in a timeframe that you’ve agreed on with them. The short answer is that the hourly rate for death doulas usually starts at around $25 an hour to over $100 depending on the services they’re providing.
If you’re interested in becoming a death doula, here are a few things to keep in mind:
- This is a mobile job, so you’ll do a lot of traveling from clients’ homes to see clients in a hospital, assisted living facility, or hospice house.
Helping someone through their final hours is a rewarding but often emotionally draining experience. You might work long shifts and provide some services that are mentally and emotionally intense. Remember to develop a consistent self-care practice so that you can avoid burnout and help your clients to the best of your ability.
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