Doula is an ancient Greek word meaning “woman who serves.” Today, a doula (of any gender) brings their caring presence, comfort, and experience to the threshold times of life that they serve – birth, death, and other major transitions.

An EOL doula is a supporter who provides warm, professional care that suits your needs – practical, emotional, and spiritual. The end-of-life doula care I provide can include planning in alignment with medical care plans, advocacy and gathering resources, preparing people and spaces for end-of-life care, keeping company and vigil, conversations large and small, in-person visits and phone consults – so much is possible.

EOL doulas can help you understand your options and complete documents including Advance Care Directives and Health Care Proxy forms. They can be an objective guide through burial or cremation planning and cost considerations. A doula can serve as a liaison and advocate interfacing with hospice and palliative care.

EOL doulas offer support to the dying individual and their family or caregivers. I have provided these services as well as giving my clients a reprieve from the overwhelming and exhausting tasks of caregiving and practical assistance such as light housework, running errands, decluttering, and making a “sick space” feel more homey. I can also help after death occurs, guiding survivors through tying up loose ends, dealing with belongings, and being a caring presence during the adjustment period after.

Family dynamics vary, and navigating the emotional challenges of relationships can get even more complicated during times of stress and crisis. An EOL doula can be a supportive presence during difficult family conversations, offering non-judgmental support through meaningful conversations and decision-making. This can be particularly helpful when family members disagree with the dying person or each other about wishes for care, stopping treatment, and funeral plans.

I can sit vigil with family who may be uncomfortable doing so alone or take a turn at the bedside when caregivers need a break. I can tend to practical needs (pet care, running errands, etc.) outside of the dying space to make it possible for others to be there. As death nears, I provide reassurance and education about the dying process, suggest comfort measures, and offer suggestions for what to do in the immediate time after dying occurs, to soften the transition as much as possible for the bereaved.

As humans, it’s almost universal for us to feel that this life we’ve been living has served some purpose. My emphasis is on respecting the beliefs of all and finding creative ways to meet different needs within the framework of an individual's existing belief system.

As we contemplate the end of life, it is common to spend time thinking about what it has meant to be alive, how we feel about dying, what happens after we die, and especially, what feels incomplete or is bringing up worries and fears. What’s not as common is talking about these things, so it’s difficult to bring up even if we want to talk about them, yet keeping the thoughts inside can create undue burden and stress. I follow clients' lead on how much "death talk" they desire. This can be especially helpful if there is something weighing on them or something that feels incomplete that I can help them to accomplish. This could be anything from listening to past hurts to rehoming a beloved pet or sorting through belongings.

I listen to the values of the client and help them access that meaning and find comfort. This may include making connections with the dying person’s faith community to provide spiritual support. One particularly meaningful thing clients have enjoyed is having creative, personalized end-of-life rituals and ceremonies before death, or as part of immediate after-death body care, in alignment with your values.

I meet wherever I'm needed or wherever feels comfortable to the person who needs me. I can go to the hospital, hospice home, skilled nursing facility, or home to meet with the dying person. Caregivers or other family members sometimes like to meet separately, and we can do Zoom, phone, or in-person someplace private. I've met family members at work, over walks in the park, over lunch or tea, really anywhere!

Many people feel a call to establish a legacy that shows who they have been in the world as a way of having their life remembered. It could be a tangible memorial project (such as a video or book “life review,” collection of family recipes, quilt, meditation garden…the possibilities are endless!). I encourage families to think about what they might like to do based on interests, values, skills, finances, etc. and help make it possible. For families that don’t feel comfortable talking so directly, having someone outside the circle can actually make it easy to get those remembrances happening in a way that feels comfortable.

We all have a need for meaning, purpose, and to be remembered. For clients who are able, I ask them about themselves and their lives. Having someone new to talk about the life that’s been lived can be a comfort, even if it’s to express regrets and sadnesses. Reflecting on past events and seeing how the world is different and better in some ways for having been here can help people have a concrete sense of the meaning their life has held. Some clients choose to record or write down their life review, while others may just want to talk.

Where there is conflict, hurt, or a lack of closeness, family members might want to talk out some of the feelings they’re having to someone neutral, and I can be a buffer when boundaries are necessary. I can also help navigate even apparently conflicting needs within the family by listening to the concerns of all involved and helping to find a path forward that works for the dying person and those around them.

For the greater part of the several decades, Americans have typically died in the hospital, unless the death was unexpected. That’s left us without a good cultural understanding of what is normal as the body begins to go through the dying process, what comfort measures are helpful (and what things are not helpful) near the end of life. Also, many people aren’t comfortable talking about death, or more commonly, they wish they could talk about what’s happening, but no one knows how to start the conversations. Or there might be challenging family dynamics at play. Even in the best of circumstances, it’s a great help to have one person who isn’t grieving the impending loss who can carry some of the burden and be a listening ear and a shoulder for all those involved.

Understanding what’s happening can mean the difference between a traumatic memory of the experience and a meaningful one for the bereaved. And even with the most support, people get burned out or may feel frustrated or guilty and have feelings they may not want to talk about within the family.

Sometimes people don’t show up to help because they don’t know what’s needed or don’t want to intrude, and it can leave us feeling isolated and alone. I can help you identify a care circle to draw on as needs change and the situation evolves, or if there isn’t anyone, there are resources in the community who could fill in gaps, and I can make myself more available if needed.

It’s never too early. Doula support can be helpful at many stages, whether you need hands-on death doula care this week for a person in their last days or want to consciously traverse a life-changing illness in supportive, knowledgeable company. It can begin when your elderly family members are ailing and ready to mindfully down-size or when you know that you are nearing your last days and want to ensure that the funeral plans you choose are followed.

Doulas are not medical providers, but they can fill in gaps not addressed by medical care. Both hospice and palliative care are medical treatment paths carried out by a team that includes medical professionals and may also include social workers and chaplains for psychosocial and spiritual support. Both strategies include pain management and quality of life as a key goal. However, hospice care is exclusively for terminal patients who are no longer undergoing curative treatments and whose prognosis is less than six months of life if the disease process continues in the expected way. The term “hospice” may also be used to mean hospice centers, which are 24-hour care facilities, but hospice care can actually be provided in hospitals, in the home, or in nursing homes. Palliative care is pain control and symptom relief for anyone with a serious medical ailment, even if the diagnosis is not terminal and the patient is undergoing treatment intended to cure them.

As an EOL doula, one way that I can help you is by helping you understand and consider all your options, including entering hospice care. I can also help you adjust to the new routines and changing needs that you will experience during this time. I can supplement the services and work alongside hospice being a liaison with hospice and palliative care providers, whether the setting is at home or in a care facility. I’m skilled at navigating relationships and conversations, and creating a more peaceful and comfortable setting wherever care is taking place.

Medical aid in dying (MAID), the act of ending one’s own life by taking a lethal dose of medication prescribed by a physician, is not legal in New York State at this time. Voluntary stopping of eating and drinking (VSED) is a legal option, one which is best carried out under physician care for the greatest degree of comfort throughout the process. I don’t plan to offer MAID support should it become legal, but in some circumstances would feel comfortable supporting someone who is hospice-eligible (anticipated to die within six months) through medically supervised VSED. I am always happy to help families find resources and support to deal with the natural changes that can take place with aging and disease progression.

Click on the contact page and fill out the form. We'll reach out to schedule a complimentary call to discuss your circumstances and the support you need right now, in the coming weeks, and in preparation for the future, and make a plan for going forward. What exactly the support looks like will depend on your circumstances, your budget, and your plans.