Exit Strategy: The Art of Consulting with a Death Doula

Death Doula Hospice Dying at home

You’ve probably heard the term doula before, but chances are you associate doula with childbirth and bringing new life into the world. But who says that a doula can only assist with the beginning of life, and not the end of a life? Death can be a terrifying, overwhelming, morbid life event for many people and loss can be hard to deal with, which is where death doulas can help. Death midwives are officially a thing, and it’s actually far less strange and way more beneficial than you might initially think. 

Before you go down a rabbit hole of false impressions and false information, let’s be clear: death doulas are not mediums. They are not psychics. They are not helping people cross over to the other side or speaking to those who have already died. They also don’t run funeral homes and they don’t only help you after someone has already died. If you were picturing Whoopi Goldberg as Oda Mae Brown in the epic 80s movie Ghost, then we’re sorry to burst your bubble. There is a lot of false information about what death doulas are and what they are not. So let’s get to know what this world of death positive professionals is all about. 

What Exactly Is a Death Doula?

Death doulas are not funeral home directors and they are not communicating with the dead. They are also not doctors or nurses or therapists. They are transition coaches. They are guides. They are sources of support at the end of one’s life, and they are trained, compassionate individuals who are there with a goal: to help individuals and families as they embrace their own mortality and face difficult decisions at the end of life. What is unique about death doulas is that they are present before, during and after death, which helps to bridge that gap between life and death, and helps ease the pain and trauma of that transition. 

Birthing doulas help offer support and care during pregnancy and childbirth. Similarly, death doulas offer support and care, but not specifically to a pregnant woman or mother, but to an entire family approaching the end of someone’s life.

According to Alua Arthur, the founder of the end-of-life planning service Going With Grace, “a death doula is a non-medical professional who provides holistic support for the dying person of the family and the family members. I help the people who are close to death on what it looks like. After that, I help family members deal with their affairs,” she explained in an interview for Fast Company. As a death doula, Arthur wears many hats as she juggles several responsibilities to her clients and their families. Her job revolves around helping others, both through administrative work as well as therapy and education. And she doesn’t only work with dying individuals. She also coaches healthy people who have a fear of death or who want to proactively plan a positive death experience. 

Death Doula Alua Arthur Belatina

She helps people to get their affairs in order today (where do they bank, where do they keep their birth certificate and social security information, what are their wishes for life support or burial, etc.) so that these matters are already taken care of and are not a burden to others once they have passed. She also leads a lot of open discussions about death, asking the hard questions and sharing the important information to help people wrap their heads around the death journey and the concept of mortality — What happens when you die? What does it feel like? What’s next? 

Just as a birth doula is available to women as a constant source of support before, during and after childbirth, a death doula offers a similar level of attention and care. A death doula is someone who is available to assist a dying individual and his or her family before, during and after a death occurs in order to provide all forms of support, including physical, emotional, psychological and even spiritual help, according to Very Well Health

How Does One Become a Death Doula?

When young people are asked what they want to be when they grow up, they don’t generally say they want to be a death coach. We imagine that if a 5-year-old told his or her kindergarten teacher that they want to help people cope with end-of-life experiences it would raise a few red flags. But this profession is actually an incredibly fulfilling job that helps others, according to Janie Rakow, president the International End of Life Doula Association (INELDA). Death doulas are not simply planning a funeral once someone has passed. They are there to bring joy and peace at the end of someone’s life. “By utilizing the services of an end of life doula, the days can be filled with love, deep meaning and a sense of the sacred,” she explains. Who could argue that bringing meaning, closure and joy to others is a bad thing?

Arthur agrees, and found her calling as a death doula after a chance encounter with a woman who changed her life. After becoming depressed because she couldn’t find her true passion or career path, she met a woman with cancer while traveling in Cuba. Their frank conversation about death, and the very real discussion they had, made her realize that she wanted to spend her career helping others have those same difficult talks. After losing a family member and being left with no answers or guidance of what to do next after his death, Arthur knew she was destined to support and guide others through that transition from life to death and beyond. 

As for who becomes a death coach, there is no one type of person or one type of training that prepares a death doula for his or her role. Sometimes doulas begin as grief counselors, hospice personnel or social workers. Sometimes they have a background in healthcare or medicine, though they are not necessarily trained medical professionals. Often death doulas can be members of the clergy. Or maybe they just experienced a transformative death experience in their personal lives, which inspired their desire to help others cope with death. Regardless, death doulas share a similar respect for death and an interest in offering comfort, support and care to the dying and their loved ones.

Death Doulas are Part of a Death Positive Movement

Part of the reason that so few of us have heard of death doulas is because there is a real stigma attached to talking about death. We fear death. Death means loss — it is the end of something good, and by default the beginning of something worse. But that’s not the way it has to be, and a new movement encouraging a positive death experience is changing the way people approach the end of life transition. 

Similarly to how people operate their lives with a proactive wellness approach — they eat well, exercise, focus on emotional and mental health etc. — people are starting to approach death with the same positivity and emotional acceptance rather than denial or fear. The movement is helping people to think of a good death as a key part of a good life. Death does not need to imply failure, but rather a fulfilling end to a fulfilling life. “Everything around dying is getting radically rethought–from making the experience more humane to mourning and funerals getting reimagined,” according to the Global Wellness Institute in its 2019 wellness trends report. 

Several organizations are helping to promote this shift in the way we talk about, confront and even embrace death; they offer education, training and support to encourage more openness around the end of life. For example, Death Over Dinner offers a set of tools to help families and friends address the difficult (and often off-limits) conversation about death, and how we want to die. According to their mission statement, “we suffer more when we don’t communicate our wishes, we suffer less when we know how to honor the wishes of our loved ones. As we build greater comfort and literacy around this important topic, every single one of us wins.” When you address the topic in a positive way, discussing death becomes more of a celebration of life and less an acceptance of inevitable loss.

According to Henry Fersko-Weiss, co-founder of INELDA, death does not need to be synonymous with despair or a loss of hope that life is over. “Meaning and legacy work are the antidotes to despair that is the root of hopelessness. When engaged in these activities the dying person feels enlivened, they believe they still matter, and they don’t feel alienated. While they see the power ebbing out of their body, they recognize another form of power: the ability to continue to shape their impact on those around them, up to and even beyond their death.” And that is what death doulas are all about – helping others continue their legacy long after they are gone.