What is a Death Doula?
Death doulas are people who help others transition from life to death. Find out more about what this unique position entails.
Table of Contents
- What is a Death Doula?
- Learning the History
- What Do Death Doulas Do?
- How to Become a Death Doula
- What is the Difference Between a Death Doula and a Hospice Worker?
- Are Death Doulas in Demand?
- Opal Cremation Can Coordinate with Death Doulas for Afterlife Planning
- FAQs
- Additional Resources
Key Takeaways
- Death doulas are people who help others transition from life to death. They facilitate difficult conversations, offer comfort and support care planning, provide companionship, plan and conduct rituals and ceremonies, and assist with legacy projects.
- A death doula is nothing new- throughout history, different cultures have had members who guide others through death. However, the position has recently. become more popular as a modern approach to deathcare.
- Several institutions offer training, helping people become death doulas. They learn about the dying process, are taught communication skills, and ethics.
What is a Death Doula?
The word “doula” is often associated with the birth of a child. These people offer support for families when a new person enters the world. But what about a death doula? Death doulas do what birthing doulas do…only for leaving this world.
While this might seem like a new concept, death doulas have been around throughout history. The concept of end-of-life care can be traced back to ancient African and indigenous societies, where women guided the dying as part of life. However, it emerged as a formalized role in the early 2000s. Los Angeles and Orange County families are increasingly turning to death doulas as part of a broader shift toward more personalized, compassionate end-of-life care.
Find out how these individuals can help loved ones transition and families cope with loss.
Learning the History
Doula is a Greek term for ‘female servant’. For some time, the most common type of doula was a birth doula. These non-medical companions would provide physical, emotional, and informational support to women during labor and postpartum.
While the concept was common in African, Asian, and indigenous communities since ancient times, it was formalized as a modern profession from the 1960s to the 1990s, largely due to the founding of DONA International in 1992, a nonprofit that trains and certifies birth and postpartum doulas.
Death doulas were popularized in a similar fashion in the early 2000s as part of a movement for holistic end-of-life care. Key milestones include:
- The 2000 founding of the Doula Program to Accompany and Comfort volunteer program
- The 2010 development of the first End-of-Life Doula Certificate Program in the U.S.
- The 2015 book Die Wise, by Dr. Stephen Jenkinson, which popularized the term and emphasized the importance of death as a meaningful and sacred experience
What Do Death Doulas Do?
Also known as End-of-Life Doulas (EOLDs) and Death Midwives, the death doula acts as a mediator, helping the individual who is dying make sense of their life and providing comfort and transparency throughout the situation. They offer the following services.
- Advance care planning: This may include anything from helping the individual create a will and advance directive, assigning power of attorney, and prearranging funerals, cremations, and celebrations of life.
- Facilitate discussions about death and dying: Many people don’t like to discuss death and dying, but when it’s imminent, families should get together to discuss plans, say goodbye, and find meaning behind their actions. Doulas can facilitate these conversations.
- Provide comfort and companionship: While doulas are not licensed to dispense medications, they can do simple things like fluff a pillow, offer a soft blanket, or sit quietly and hold your hand.
- Offer assistance with end-of-life tasks, such as creating legacy projects, gathering materials for scrapbooks, writing letters to family members, and creating symbolic items.
- Rituals and practices: Some may find comfort in engaging in rituals and practices toward the end of life. A doula can guide these practices, performing them by the book or customizing them to the individual’s preferences.
Death doulas are part of a growing trend known as the Death Positive Movement, which aims to encourage people to speak more openly and freely about death and dying.
“(Death doulas are) companions to walk people through the process of dying. (They give patients the) heart and hands, but also the information that they need.”
Natalie Ann Evans, birth and death doula, from the article The Demand for End-of-Life Doulas is Rising. Here’s How They Address the Physical and Emotional Needs of Those Nearing Death.
Cremation providers, such as ourselves, realize that death doulas address a major gap: they encourage families to make death arrangements before death occurs, easing burdens during a difficult time.
When families don’t preplan, they are vulnerable to providers who may take advantage of their emotional state, lack of industry knowledge, and need to plan quickly, and charge hidden fees. Preplanning allows Los Angeles and Orange County families to research, shop around, and focus on healing when death arrives.
What to Ask Before Hiring a Death Doula
This table will provide questions to ask a death doula before hiring them, to ensure you make the right choice.
| Topic | What to Ask | Green Flags | Red Flags |
| Training & Experience | Where did you train? How many families have you supported? | Can clearly describe past experiences and education | Provides vague answers |
| Scope of Practice | What do you do and not do? | Names non-medical tasks, explains how they coordinate with medical teams on other types of treatment | Includes medical administration in their scope of service |
| Service & Availability | What’s included, how often will you visit? | Provides concrete examples and clear availability | Doesn’t specify tasks or limits |
| Fees & Payments | What do you charge and how do you bill? | Witten pricing stating what’s including and payment options | Hesitant to discuss costs, no written agreement- could lead to hidden fees |
| Coordination with Care Team | How do you work with hospice, doctors. and funeral homes? | Comfortable being part of team and talking to other providers | Criticizes or undermines other team members |
| Beliefs & Cultural Fit | How do you handle different religious or cultural practices? | Asks about your preferences without pushing beliefs | Insists on their own spiritual practices |
| Contracts & Boundaries | Do you use a service agreement? | Provides a simple, written agreement outlining services, hours, refunds, and cancellations | No contract, everything is verbal |
How to Become a Death Doula
While there is no federally mandated training for death doulas, there are some private organizations that provide training in this area. Prospective death doulas are encouraged to take classes in end-of-life programs, gain experience in hospice care, and pass an exam on the core competencies. While funeral director training is not required, it may look attractive on a resume.
Programs teach the following:
- Active listening and presence: Doulas learn to enhance their listening skills and become compassionate companions.
- Understanding the dying process: They are taught the physical signs and systems of dying, common terminal conditions, and pain assessment.
- Grief and Bereavement: Education about supporting families through loss.
- Practical End-of-Life Skills: They learn to create legacy projects, facilitate life reviews, assist with planning, and how to conduct certain rituals.
- Spiritual and Cultural Perspectives: Doulas must understand diverse spiritual and cultural perspectives and honor them with respect.
- Non-Medical Comfort Measures: While doulas do not administer medications, they learn how to reduce pain through breathwork, aromatherapy, visualization exercises, guided imagery, meditation, and prayer.
- Ethical Tasks: Part of the process is learning how to set professional boundaries, understanding the scope of practice, and finding the best way to integrate with care teams.
- Communication Skills: Doulas learn how to read body language and take facial cues to communicate with respect and understanding.
Institutions that offer doula training include INELDA (International End-of-Life Doula Association), Doulagivers Institute, and the Conscious Dying Collective.
What’s the Difference Between a Death Doula and a Hospice Worker?
Like hospice workers, death doulas guide people through the end of life, providing comfort during this difficult time. This distinction matters particularly for SoCal families choosing between hospice and doula support, or considering both. But there are some key differences, as follows:
- Medical Training: Hospice workers are trained to administer pain medications, with a focus on comfort care. Death doulas have a non-medical, more spiritual role.
- Training and Regulation: Medical training is typically required for hospice workers, with many holding RN or LPN certification. Death doulas are trained through private programs with no standard degree.
- Who Hires Them: Death doulas are typically hired by families and paid out of pocket. Hospice workers are paid by their facilities, through insurance, or through private pay plans.
- When They’re Involved: A hospice worker is typically involved a few months before death, when patients are terminal. Death doulas can come in months or years before death and continue supporting the family well into bereavement.
- Time and Presence: Doulas can spend extended time with the family, focusing on conversation and rituals. Hospice workers are typically available for limited-time visits due to clinical demand.
Are Death Doulas in Demand?
Death doulas have become more in demand over the years, including throughout Southern California. A WSBTV report reveals that the number of INELDA members increased to 1,500 in 2023, up from 300 just a few years prior. The trend is thought to be driven by aging baby boomers, cultural shifts toward open conversations about death, COVID-19, and social media trends like the Funeral Theory and DeathTok. Gaps and rising prices in hospice care also play a role.
“Everyone deserves ‘good death,’ and families need proper closure.”
-Ashley Johnson, End of Life Doula (EOLD), Member of Cremation Association of North America (C ANA)
Death doulas can benefit families, but because the position is not regulated or certified, confusion can occur. Los Angeles and Orange County families should understand how they get paid (typically out of pocket), their rates, what they do, and how they work alongside care teams. Some families may even sign a contract with their doula, outlining when they will work, the tasks they will perform, and cancellation and refund policies.
Opal Cremation Can Coordinate with Death Doulas for Afterlife Planning
Death doulas play an important role in afterlife planning. Opal Cremation can assist with that process.
We offer direct cremation in Southern California, the simplest and most inexpensive type of cremation, with no hidden fees, reducing stress, and simplifying the process. Though a service is not included, families often celebrate their loved one’s life after the fact- and we can help with that as well. We offer guidance for sea scattering, military arrangements, ash diamonds, cremation jewelry, cremation fireworks, and much more.
Opal Cremation is happy to help you explore your options and answer any questions that might come up. Our compassionate professionals are available 24/7 and can provide the information you’re looking for. Contact us to learn about our comprehensive approach, serving families throughout Los Angeles and Orange County.
FAQs
How do I find a death doula for my family?
Organizations that train death doulas can refer them. Many have directories that simplify the referral process.
When is the right time to hire a death doula?
Many families hire a death doula as soon as a loved one gets a serious diagnosis. However, some bring doulas in earlier, and others wait for the final weeks.
How much does a death doula cost?
Rates vary, but many death doulas charge hourly with rates of $25 to $125. They may also charge flat rates of $500 to $6000, including services such as 24-hour vigils and multi-day support.
Is a death doula covered by insurance or Medicare?
In most cases, death doulas are not covered by insurance or Medicare. They are private pay. However, some may be funded through community programs or nonprofits, or bundled with hospice or funeral services.
Can a death doula work with my hospice and medical team?
Yes, most death doulas will coordinate care with the family’s hospice or medical team to ensure a seamless approach.
