The Role of the End-of-Life Doula
- The essence of doula care is to provide non-medical, nonjudgmental support and guidance to individuals and families through times of critical, transformative life change.
- End-of-life doulas (EOLDs) nurture, inform, support, guide, empower and comfort.
- EOLDs 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, EOLDs 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 their 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.
Considerations Regarding Multi-Credentialed Doulas
While doulas naturally draw upon their full range of knowledge, skills, and life experience, it is essential to maintain clarity around their role. Offering enhanced or blended services may unintentionally confuse clients about the scope of non-clinical doula care. For example, a doula cannot simultaneously provide non-medical support and take on clinical responsibilities such as prescribing herbal remedies or managing wound care. If a doula holds additional professional credentials, such as nurse, social worker, pastor, herbalist, or massage therapist, and wishes to incorporate that expertise, they must clearly disclose these roles to the client. Transparency augments informed consent and helps preserve the integrity and trust central to doula care.