Death doulas could lead end-of-life care

Abstract

Hospice and palliative care can only do so much. Doulas—non-medical, community based practitioners—could have a central role in demedicalising and deinstitutionalising dying to help people navigate the holistic care they need at the end of life, writes Marian Krawczyk More people are ageing and dying than ever before. Hospice and palliative care services alone cannot meet the increasing complexities of ageing and dying in the global north.12 We need new ways to support people who are approaching death. End-of-life doulas could have a key role in creating community-led supports, including cooperative end-of-life care networks. End-of-life doulas, or death doulas or death midwives, offer non-medical, holistic support to people with serious or terminal illness and their loved ones, including education, guidance, and practical, emotional, and sometimes spiritual assistance.3 Support might include after-death care of the body and funeral planning education or services, along with bereavement follow-up. The end-of-life doula role has emerged as an independent lay practice, rooted in a grassroots movement that echoes historical traditions of community members supporting dying individuals and their families. Opinions vary widely about its nature and scope. Although the role remains unregulated, many doulas advocate for professionalisation by establishing core competencies, practice guidelines, and accreditation. The end-of-life doula movement has sparked public interest and has begun to integrate into healthcare systems in countries such as Australia, Canada, the UK, and the US. Simultaneously, the movement is expanding in countries such as Brazil, Portugal, and Sweden, accompanied by a growing number of training programmes provided by entrepreneurial individuals, non-profit organisations, and higher education institutions. Cicely Saunders gave legitimacy to end-of-life care and laid the foundation for hospice and palliative care. She framed this work as both a science and an art, emphasising a dual foundation in rigorous medical knowledge and compassionate, individualised care …