Most people associate a doula, from the ancient Greek word ‘doulē’ that means ‘a woman who serves’, to a person assisting mothers during childbirth. A doula is different from a midwife since the latter is a trained medical professional assisting women from pregnancy, labour and delivery until early postpartum period. Doulas, on the other hand, are non-medical professionals who provide emotional and physical support to women from pregnancy, labour and delivery until early postpartum period.
However, in recent years, more people have come to realise the importance of assisting patients near the end of life. Doulas have become a part of palliative care teams partnering with medical professionals, caregivers and social workers to provide emotional, physical, spiritual and philosophical support and care to a dying person. The International End of Life Doula Association describes their practice as bringing deep meaning to the dying experience of the person and to prepare their loved one for his or her passing.
Death doula in Australia
A death or end-of-life doula is a unique career that requires professional training and certification. In Australia, the Australian Skills Quality Authority provides a certificate program to become accredited as a professional end-of-life doula. Once they are certified, death doulas can also facilitate home-based after death care, vigil and ceremony to deliver grief and bereavement support to family members.
Part of the Certificate IV in End of Life Doula Services training includes holistic after death care, working with diverse people, providing care services using palliative approach, exploring the roles of an end-of-life doula, legal and ethical work practices, and research and business development plans among others. A number of training centres are also offering intensive courses to become a death doula.
Roles of a death doula
For the International End of Life Doula Association, a doula’s scope of practice involves:
❖ Educate the dying person, loved ones and paid caregivers to understand and accept that death is a natural part of life
❖ Assist the caregivers with providing physical care such as changing bed sheets, repositioning the dying person in bed, wiping the sweat, etc.
❖ Advocate and develop a death plan, called a vigil, for the dying person that will be implemented in the last days of his or her life
❖ Assist the dying person and loved ones in administering final wishes
❖ Encourage the loved ones to go through the process of grief and other bereavement support services
On the other hand, doulas are not allowed to:
❖ Perform or administer any medical assessment or intervention
❖ Perform or administer medication or any physical care that requires clinical training
❖ Establish an intimate relationship with anyone involved in the case
❖ Solicit business or offer non-related doula services
Death doula vigil
Death doulas understand that people who are near death long for comfort and to be hugged. Both the dying person and loved ones fear death which sometimes hinders them to express their true feelings. Doulas guide the people involved around the dying person to interact in different ways— through sound, smell, touch as well as perform readings and guided imagery to hold the space and bring comfort.
A doula vigil is held during the dying phase of the person. Regardless of religion or spiritual beliefs, creating a vigil plan is part of the doula’s responsibility. The doula will coordinate with the dying person and the family to prepare any activity or ritual such as storytelling, prayers, creative expressions, and things such as flowers, photographs, and items that will ease the pain of the dying as he or she goes through the process until the last breath.
Death Doula during Covid-19
Death doulas also became limited in their interaction and in-person assistance at the height of the pandemic. But this also became a way for more people to recognize the care services that death doulas provide. In the U.S.,the interest and memberships for death doula enrollment and training significantly grew in 2020 compared to previous years. Enrollees in the end-of-life doula program by the University of Vermont grew to 600 in 2021 compared to less than 200 when they first introduced the program in 2017. In Australia, death doulas are more concerned with people dying alone, especially those who are 65 and older. People aged 65 and over are 16% of Australia’s current total population. It will increase by 3.7% by 2058. Death doula is an emerging profession in the caregiving sector which will continue to grow in the next few years.
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