Death Doulas: Like a Birth Doula, but The Other Side

Story by Valeria Cloës

Graphics by Emily Pack

When people hear the word “doula,” they typically associate it with birth doulas. But when Asheville end-of-life doula Trish Rux mentions her work, she is met with confusion.

“As soon as you say ‘like a birth doula, but the other side,’” Rux said. “They get it.”

End-of-life doulas are there for individuals in the process of dying and their families to make the process easier by providing comfort and support. They can also assist with end-of-life planning for people who want to get ahead of their wills and advance directives, among other projects.

End-of-life doula Jane Dornemann of Durham said she meets clients – not patients because end-of-life doulas cannot give medical or legal advice – where they are with their care needs and wants.

“Clients tell me what they are looking for, and as long as it fits into my scope and training, then that leads our engagement,” said Dornemann, who was trained at the International End-of-Life Doula Association and gained her professional certificate from The University of Vermont’s The Robert Larner, M.D. College of Medicine. “The idea is that I am a facilitator and an educator and a resource.”

Filling the gaps

“Some doulas specialize in certain areas while others (like me) are able to offer the full range of doula practice,” Rux said in an email.

This can include teaching courses, supporting clients, emphasizing bedside care, sitting vigil, and helping grieving family members and friends after a client’s passing, she said.

While end-of-life doulas do not give legal advice, some help guide people – dying or not – to understand the logistics of dying. Dornemann said she uses her own comprehensive checklist with clients that includes, but is not limited to, discussing and deciding on power of attorney, will and advance directives.

The three specific areas of care that she offers to clients are end-of-life preparedness, vigil services and early grief processing, she said.

Holly Menard, an end-of-life doula in the Triangle who also worked as a nurse, offers “companionship, emotional & spiritual support, advocacy, leaving a legacy, planning and holding a sacred space,” as seen on her website.

During care, Menard said she uses a bluetooth speaker to play her own playlist or music the client requests, candles, essential oils and anointing oils.  End-of-life doula services can also include massages, reiki, healing touch, mindfulness and meditation and guided imagery.

Culture in NC

North Carolina has end-of-life doulas spread across the state, some of which can be found through end-of-life doula directories, like the one for National End-of-Life Doula Alliance, International End-of-Life Doula Association and the Death Doula Collective.

North Carolina, compared to other states like Tennessee or South Carolina, has more end-of-life doulas, said Loren Talbot, director of communications and partnerships with the International End-of-Life Doula Association. She attributed that to the trainings they provide in North Carolina and to the state’s progressive perspective relating to deathcare.

The non-profit has 64 members from North Carolina.

Though there are a number of end-of-life doulas in the area, it is difficult to work as a full-time doula in the state.

“Not enough people know about it to enable full-time work,” said Dornemann, who has a full-time job on top of her hospice volunteer work.

Motivations and lack of end-of-life conversations

Most end-of-life doulas chose the career for one of two reasons, Dornemann said.

“Either they experienced what you call a ‘bad death,’” she said. “Or they’re hospice nurses and social workers who are like ‘Hey, there’s a gap in the system here.’”

According to Aliyah Baruchin at the Association of American Medical Colleges, which also summarizes the 2015 report “Dying in America,” medical schools across the nation do not offer much training in end-of-life conversations or palliative care in comparison with the other medical training offered.

In addition, “Dying in America” reported that there are not many people who specialize in hospice or palliative care. Many different training and certification programs exist since there is no greater governing body managing the profession.

Dornemann said she suggests that anyone looking for an end-of-life doula should interview and speak with multiple doulas to see who is best suited to their needs and personality.

“One thing is that I’m a safe and steady presence,” Menard said. “That I am someone that this person and their family can count on to be there and to be an advocate, to inform, to educate.”

Valeria Cloës

Valeria Cloës is a senior living in Raleigh, NC, but is originally from Buenos Aires, Argentina. She is majoring in Journalism with a minor in Music. She has experience in copy editing, reporting and writing in a newsroom and magazine setting, and fact-checking. In addition to her writing for Media Hub, Valeria has also taken on editing. Valeria hopes to pursue a career in editing.

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