Q. What are end-of-life doulas?
A. End-of-life doulas provide non-medical, holistic support and comfort to the dying person and their family, which may include education and guidance as well as emotional, spiritual or practical care. EOLDs are people from a variety of backgrounds and experiences with a desire to educate, guide and companion the dying and their families in myriad ways. They may provide education, resources, hands-on comfort measures, facilitation, advocacy, or one or more services they may specialize in. Not all EOLDs offer the same modalities or expertise; if an individual or family desires services that they cannot provide, the EOLD endeavors to make referrals and help them find what they need. Above all, EOLDs assist the dying individual in achieving an end of life experience that is as meaningful, peaceful, and well-prepared as possible for all involved. Learn more about the EOLD Scope of Practice and Codes of Ethics.

Q. How are they paid?
A. EOLDs charge for their services is varying ways. Some are paid by the hour and some make other arrangements, depending on types of services provided, whether they are on-call, staying overnight, traveling great distance, or other concerns. Some EOLDs serve their communities in a volunteer capacity, especially if they are just beginning. Families and individuals contact EOLDs as early as initial diagnosis, or as late as the beginning of the active dying phase or even after death, if bereavement care is what they are seeking. In most cases, the individual or family contracts directly with the EOLD; however, as more and more hospice and palliative care organizations are utilizing doulas, this may vary. At this time, we know of no third-party reimbursement for EOL doula care.

Q. How do EOLDs train?
A. Many EOLDs obtain their training through an EOLD training program, of which there are many in the US and elsewhere. Some of them are solely on-line, some are solely in-person, and some are a hybrid of both approaches. In addition, there are EOLDs who have obtained their training through practical experience, either by having served in their community for years or by having worked in other related professions. An individual EOLD may choose to obtain the NEDA Proficiency Badge, based on NEDA Core Competencies, to assess whether his or her knowledge and skill is comparable to other EOLDs that meets an agreed upon standard. However, this is voluntary. Please note: NEDA does not accredit or evaluate any individual EOLD training program. Some training programs fully prepare EOLDs to take the assessment and obtain a proficiency badge, while others may not address all of the core competencies established by NEDA. Please inquire about this before taking training.

Q. If I am a birth doula, can I be an EOL doula?
A. Certainly. Those experienced in the Doula Model of Care, as developed by birth and postpartum doulas, are very well-equipped to become EOLDs, and many have made this career change. However, even though there are similarities, families at the end of life have very different needs that the doula should become familiar with. We recommend additional training and experience for those birth doulas who wish to become EOLDs. 

Q. What do students learn in the average training?
A. Trainings vary widely. The general categories of doula training include knowledge of: scope of practice, HIPAA requirements, hospice conditions of participation; communication skills, personal and professional boundaries, needs assessments; the doula model of care, hands-on, non-medical comfort care modalities, self-care; the dying process, legacy and life review; developing community resources; vigiling;  respite care, immediate after-death care; and bereavement. Throughout, doulas learn how to recognize and address the physical, emotional, and spiritual needs and desires of both the patient and the caregivers within the end-of-life doula's scope of practice. Look here for more on what training entails; for training opportunities

Q. Is licensing or certification available for EOLDs?
A. Licensure refers to being granted permission to legally practice or work in a profession that is tied to legislation on a state-by-state basis. There is no national, regional or state governing body that oversees EOLDs, and therefore, licensure is not available and therefore not required for end-of-life doulas to practice in any state. In other words, the practice of end-of-life doula is un-regulated. This means that anyone can call themselves an end-of-life doula. It is up to the individual or family to discern whether a doula is right for them or not.

Likewise, there is no overseeing or accrediting body that certifies EOLDs. However, obtaining a NEDA proficiency badge helps families, hospice agencies, and doulas know that a certain standard has been met. Look here for more on certification and proficiency badges.

Q. What is the Doula Model of Care?
A. According to Patty Brennan, author of The Doula Business Guide: How to Succeed as a Birth, Postpartum or End-of-Life Doula, 3rd Edition, any model of care "broadly defines the way services are delivered. It outlines best practices for a person, population group or patient cohort as they progress through the stages of a condition or event. It aims to ensure people get the right care, at the right time, by the right team and in the right place." The Doula Model of Care defines appropriate end-of-life doula practice in service to the dying, their families, and others in their ambit.