The concept has many names and varying roles. A death doula, death midwife, or simply a death companion is enlisted, usually for a fee, to help with the end-of-life and dying process on an emotional and spiritual level rather than a medical one.
With the advent of the death positivity movement, and a willingness to discuss the dying process more openly, these companions are becoming more sought-after. A person might want to engage a professional death companion, or seek one for a loved one, if they sense that they'd benefit from additional support, especially from someone who is not only compassionate but experienced in and comfortable with death.
Most reputable death doulas complete a course or certification through a university or nonprofit training program. Many belong to the National End-of-Life Doula Alliance. These practitioners are typically compensated on an hourly basis or via a flat fee, and the cost is not covered by insurance. (Some volunteer their time.)
Death doulas will listen to a client, supporting them mentally and spiritually. They may help them write letters to loved ones, craft their own obituary, or work on legacy projects. They can also assist in forming a death plan and educate the client and family about end-of-life choices, including advance directives and other forms. A death companion might prepare simple snacks or tend to other practical matters but typically not household chores or personal hygiene needs. After death, the doula may also assist the family in the early stages of grief. Some will help with funeral planning and arrangements. During the coronavirus pandemic, death doulas have found a way to assist via Zoom, FaceTime, or other means.
While a death doula may offer a hand massage or a shoulder to lean on, they will not involve themselves in medical issues; that's the role of hospice care or palliative health care professionals. A death companion's main role is to develop a relationship with the client and advocate for them while providing support.
For many people, an end-of-life doula is as valuable as a doula at birth. Some people engage a death companion months or even years before death (especially if terminally ill), while others just do so for their last few days, as the doula can sit vigil and provide comfort and calm as the end nears.
