End-of-life doulas support patients and their families through life’s final transition

Photo Cred: Rodnae Productions/Pexels

By Linda Childers

Andrea Deerheart, PhD, ELP, grew up in a family that didn’t discuss death. As a result, she became convinced illness and death were terrifying experiences. It wasn’t until she was an adult, with a successful career in marketing, that her perceptions began to change.

“A friend was serving on the board of directors for a hospice in San Diego County,” Deerheart said. “I found out they needed volunteers and offered to help. Caring for the first client who died in my arms changed my life, her death wasn’t at all what I imagined.”

That experience not only transformed Deerheart’s outlook on death, it also altered the trajectory of her career. She returned to college to pursue a master’s degree in counseling psychology and later went on to achieve a doctorate in mythology and depth psychology, comparative religions, and death, dying, and beyond.

In 1995, Deerheart founded The HeartWay, a non-profit that serves clients facing end-of-life transitions.

“We provide our clients, their caregivers, and family members, with end-of-life care, counseling, education, ministry, and more,” Deerheart said. “In addition, our end-of-life doula certification program gives integrative practitioners the training they need to provide non-medical holistic support to clients and their families.”

Deerheart said Reiki masters, hospice nurses, social workers, nurse practitioners, and other integrative practitioners are among her students that seek to become death doulas and provide end-of-life care.

“End-of-life, or death doulas, are non-medical professionals that care for a client’s emotional, spiritual, and emotional needs,” Deerheart said. “We often hear about doulas that work with clients to bring babies into the world, but doulas can also help during the death process.”

In addition, many end-of-life doulas also enroll in Deerheart’s yoga nidra trainings, a practice she describes as “the art of conscious deep relaxation that transcends fears, and inspires peace, love, and compassion.”

Using a guided meditation, Deerheart said end-of-life doulas can utilize yoga nidra to help clients manage their pain, anxiety, and depression.

“I’d love to see yoga nidra incorporated into every end-of-life practice,” she said. “It’s a great technique that allows a person’s body and mind to deeply relax.”

Filling a gap in end-of-life services

While end-of-life doulas aren’t a new concept, the National End-of-Life Doula Alliance (NEDA) notes the field is growing. As of May 2022, NEDA had almost 1,300 members from 49 states, the District of Columbia, and 12 other countries. Three years ago, NEDA only had 200 members. The organization attributes the rise to the COVID-19 pandemic’s high rates of mortality and the aging Baby Boomer generation.

While many end-of-life doulas work in conjunction with hospice organizations, providing their services as volunteers, others work as independent contractors charging families a sliding scale, flat fee or a daily or hourly rate.

After taking an early retirement from her job in government work, Jeannie Palermo began volunteering with hospice. In 2015, she learned Hospice of San Luis Obispo (SLO) County was offering their first end-of-life doula training and she enrolled.

“Prior to that training, I had been an in-home volunteer with hospice, doing bedside vigils,” Palermo said. “As a doula, I now assist clients and their families with preparation for their last days and hours.”

From helping to prepare wills, advanced directives, or even writing their own obituaries, to working on legacy projects such as videos and scrapbooks, Palermo serves as an important part of the end-of-life care team.

“End-of-life doulas compliment the medical services that clients are receiving,” Palermo said. “This may entail providing respite care to a client while their family members get some rest or ensuring a client’s last wishes regarding end-of-life treatment are honored.”

Palermo also helps many families begin to talk openly about death and grief. A survey by The Conversation Project found that although 90 percent of people believe that talking with a loved one about death is important, only 27 percent have actually done so.

“When I first meet with a client and their family, we discuss their priorities and the services I can provide,” Palermo said. “We cover every aspect of their last days and hours, ranging from who they would like with them, whether they’d like special music or prayer, or to have someone give them a gentle hand massage. “

An end-of-life doula’s work often continues after the patient is deceased. Palermo said that some families opt to have in-home funerals and death doulas often advise on how to care for the bodies of the dead, help plan a memorial service, and also provide grief support to family members.