NEDA Scope of Practice

The Role of the End-of-Life Doula

• The essence of doula care is to provide non-medical, non-judgmental support and guidance to individuals and families through times of critical, transformative life change.
• EOL doulas nurture, inform, support, guide, empower and comfort.
• EOL doulas work with other caregivers and members of the medical team.
• Doulas foster self-determination in their clients by assisting them in gathering information and encouraging them to make informed choices that are right for them.
• For client needs outside of the doula’s scope of practice, the doula makes referrals to appropriate professionals and community resources.
• Doula support is focused on, and adapted to, the unique needs and requirements of each family served.

 
Limitations to Practice

• As non-medical care providers, end-of-life doulas do not perform clinical tasks (e.g., monitor vital signs, administer medication).
• The doula refrains from giving medical advice or from persuading clients to follow a specific course of action or treatment.
• The doula refrains from imposing his/her own values and beliefs on the client.
• Doulas do not undermine their clients’ confidence in their caregiver(s). Instead, the doula uses good listening skills to support clients who initiate a discussion about dissatisfaction with a caregiver's practice or attitudes.
• Doulas do not usurp the role of other professionals and caregivers such as the hospice nurse, social worker, chaplain, home health aide, etc.
• Doulas may be present at the request of the client, but doulas do not facilitate the medical aid-in-dying process

 
Considerations Regarding Multi-Credentialed Doulas

• While understanding that doulas will draw from their full range of knowledge, skills and life experience, it is important to realize that offering enhanced or blended services may send a mixed message to the consumer regarding the role of the doula. The doula cannot, for example, be a non-clinical care provider and simultaneously “prescribe” an herbal regimen or assume responsibility for wound care.
• If a doula wears more than one professional hat and is seeking to leverage a blended skill set (e.g., nurse, social worker, pastor, herbalist, massage therapist) in the course of providing doula services, then they are obligated to make those additional roles and credentials transparent to the client.

Gratitude to Patty Brennan of LifeSpan Doulas, LLC for sharing the basis for this Scope of Practice