Understanding How Death Doulas Are Changing Palliative Care

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As America's population ages, the need for better and more customized end-of-life care becomes greater. This need has led to a variety of new palliative care services that help the dying, either directly or indirectly. Death doulas, sometimes referred to as death midwives, are just one example of the way some patients are not only coming to terms with their mortality, but in some cases, embracing it as a valuable experience in its own right. In this article, you'll gain an understanding of what makes the death doula so unique within a palliative care setting.

What is a Death Doula?

A death doula is very similar to a birth doula, with one very obvious difference; the death doula is present for the end-of-life process, rather than the beginning. They may provide a range of services from simply being present and supportive during end-of-life care (sometimes referred to as "holding space"), to round-the-clock nursing care. Because this is an emerging profession, there can be a high degree of difference in the service provided patient-to-patient, but one thing is almost always true: the death doula's main role is to support the dying patient and their loved ones as best they possibly can from a neutral standpoint.

Most death doulas adhere to three main tenets:

1. That no one should have to die alone without the support and care they deserve
2. That death and dying is an important part of life that should be respected and even celebrated
3. That death doesn't have to be sterile or even difficult in all cases

Death doulas don't see death as an entirely negative experience; they recognize and respect the fact that it can induce a variety of emotions, both good and bad. They also hold up the importance of respecting each patient's right to approach death in their own way.

Are Death Doulas the Same as Nurses And/Or Doctors?

This is a complex question. Truthfully, from a legal standpoint, American death doulas are not considered to be true medical professionals in the same way that a nurse or doctor might be. This may change as the profession advances. Currently, there is no specific certification or degree required to become a death doula. The International End of Life Doula Association does offer several voluntary training programs for those who wish to become a death doula.

That said, many death doulas are nurses, personal care workers, or even doctors who have decided to branch out into the profession because they feel strongly about the need to change the way society views death and dying. These individuals may provide both death doula services and medical services depending on their level of education and certification. Some people also feel that hospice nurses are, in fact, a kind of "death doula" simply because of the type of work they do.

However, a death doula who is not a physician is not a replacement for the advice or guidance of a physician. If you choose a death doula to assist someone in your family with end-of-life care, they should integrate with your current care team to ensure that all avenues of care are covered.

How Can A Death Doula Benefit Palliative Care?

Death doulas provide specific types of support that may not otherwise be given by medical professionals. They can travel, and may work with patients from within a hospital, a hospice home, a palliative care ward, or even the patient's own home. They form a special and therapeutic relationship with both the patient and their loved ones, helping to ensure that the support provided is uniquely tailored to the dying patient's needs.

While the importance of a patient's medical care team and family/loved ones should not be understated, it's important to understand that both of these supportive groups have their own individual limitations. The death doula helps to overcome these limitations, effectively acting as a neutral third party.

Family members and loved ones may already be overwhelmed; it can be difficult for them to provide the level of care and constant support a patient needs. Furthermore, some patients are uncomfortable with the idea of discussing their fears, hopes, or wishes with family members--they worry about upsetting their loved ones unnecessarily.

In this instance, a death doula can provide much-needed respite, giving the dying patient someone to talk with freely about important concerns.

Doctors and nurses, while incredibly valuable to patients, also have their own set of limitations, even within a hospice or palliative care setting. They very often focus on the need to alleviate suffering or the need to find a cure, but this is not what every patient wants or needs. Doctors and nurses may also be required to follow specific rigid protocols that don't always fit the needs of an individual patient.

A doctor or nurse may also have a busy caseload, meaning that they simply don't often have the time to act as a companion or guide through the dying process. That's where the death doula comes in.

A talented death doula lets the patient lead--if he or she wants to talk about the meaning of life, that's something the doula will accommodate. If he or she just wants to relax and savor their end-of-life days, that can be accommodated, too. They may also link patients with the resources they need to handle legal, financial or spiritual issues. A death doula may even simply sit with a patient when family members can't, ensuring that they are never left alone or lonely.

Finally--and perhaps most importantly--death doulas help to create a comfortable and supportive atmosphere for the dying patient--an atmosphere that respects the individual's need to cope with dying in their own way.

If you or a loved one are facing a terminal illness or death, understand that you don't have to face it alone. There are a variety of supports available to help you weather the storm. For more information on whether hiring a death doula is right for you, consider websites like http://cornermedical.com/. 

17 May 2016