By Rosalind Coleman

An end-of-life doula is someone who compassionately accompanies individuals, their families and loved ones, before, during and after death.

The overarching aim is to ensure that the dying person experiences a peaceful end to life, in harmony with their desires and beliefs. Non-judgemental listening, alignment with the individual’s priorities, and smoothing the way to achieving their final wishes are the basis of effective doula accompaniment. This approach can free people to have the loving conversations they want, express their fears, concerns, and regrets, engage with the issues that they choose and make decisions that are important to them.

Constructive and mutually beneficial involvement of family members and loved ones can be facilitated through the doula’s position as an objective member of the dying person’s entourage.

End-of-life doulas do not provide medical or nursing interventions, and will orient the dying person, their family and loved ones to seek professional health care as necessary. The recommended ways to get in touch with a certified end-of-life doula would be either through a national doula organisation or via the oncology or palliative care team caring for the individual.

Concrete examples of a doula’s activities combine emotional, physical, and informational support including :

• Helping to identify what the dying person and the family or close friends would like to say to each other and facilitating these conversations.
• Supporting end-of-life decisions and the drawing up of advanced directives.
• Accompanying the individual to their appointments, facilitating communication with the health care staff and supporting informed decision-making around medical care.
• Helping people manage and prepare for the practical aspects of dying, by explaining the end-of-life process, the stages of death and the physical changes that may occur.
• Facilitating the intervention of a palliative care team at home as desired and feasible.
• Accompanying the family in preparing for the bereavement and grieving.
• Writing letters or creating memory books.
• Equipping the dying person and their carers with relaxation techniques such as meditation and massage.
• Suggesting an end-of-life ritual.

– The terms “end-of-life doula” and “thanadoula” can be used interchangeably. The term thanadoula comes from Greek thanatos (death) and doula (caregiver or helper).

– Rawlings D. et al 2019 What role do death doulas play in end-of-life care? A systematic review Health Soc Care Community .  27(3):e82-e94.  doi: 10.1111/hsc.12660. Epub 2018 Sep 26.