What are end-of-life doulas?
End-of-life doulas provide a broad range of non-medical, holistic support and comfort to those preparing for or experiencing end of life. People who desire such support may engage with doulas 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. Doulas may provide informational resources, hands-on comfort measures, respite, facilitation, advocacy, and many other services. Above all, doulas seek to help those dying, and their loved ones, achieve an end-of-life experience that is as meaningful, peaceful, and well-prepared as possible for all involved. Learn more about the doula’s Scope of Practice and Codes of Ethics.
How are EOL Doulas paid?
Doulas are compensated for their services in varying ways. Some are paid by the hour, some offer a sliding scale, and some make other arrangements depending on the types of services provided, whether they are on-call, staying overnight, or traveling great distances. Some doulas don’t charge any fees for their services but instead provide support in a volunteer or pro bono capacity. In most cases, the individual or family contracts directly with the doula; 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.
How do doulas train?
Many doulas obtain their training through an end-of-life doula training program, and there are many in the US and elsewhere. There are doulas who have obtained their training through other end-of-life-related educational offerings, hospice volunteer training, or through practical experience by serving in their community for years or by working in other related professions. An individual doula may choose to obtain the NEDA Proficiency Badge, based on NEDA Core Competencies, to assess whether their knowledge and skills meet the Scope of Practice and Codes of Ethics for doula care. A NEDA Proficiency Badge is voluntary. Please note: NEDA does not accredit or evaluate any individual doula training program. Some training programs fully prepare doulas 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.
If I am a birth doula, can I be an EOL doula?
Certainly. Those experienced as birth and postpartum doulas are well-equipped to become EOL doulas, 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 know. We recommend additional training and experience for those birth doulas who wish to become EOL doulas.
Is licensing or certification available for EOL doulas?
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 doulas and standards of practice, so licensure is not available and therefore not required to practice in any state. In other words, the practice of end-of-life doula is unregulated. This means that anyone can call themselves an end-of-life doula. The term “certified” generally means that one has obtained a certificate of completion from one of many training programs available. It is up to the individual or family to discern whether a doula is right for them or not. NEDA provides information about how to select an end-of-life doula.
However, because there is no overseeing or accrediting body that licenses or certifies EOL doulas, NEDA has developed and advocates for practical standards and practices as outlined in a Doula Model of Care, Scope of Practice, Code of Ethics, as well as a carefully constructed Proficiency Assessment Process for doulas who wish to obtain a NEDA proficiency badge. This “micro-credential” helps families, hospice agencies, and doulas know that a certain standard has been met.
What is the Doula Model of Care?
According to Patty Brennan, one of NEDA’s founding members and author of The Doula Business Guide: How to Succeed as a Birth, Postpartum or End-of-Life Doula, 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.