Introduction 

The non-medical death doula role has emerged over the past few years with inconsistency in how doulas work with people at the end of life. Death doulas work in different ways (models of care) with the potential for collaborative models to be developed as with birth doulas.

Methods

Two studies contribute to our understanding of how death doulas work. 1) Interviews with nurses who work concurrently as death doulas 2) A survey of death doula training organisations. 

Results 

Most death doulas are independent contractors working for patients and /or families although some volunteer their services. Some death doulas see patients at work and then see them as a death doula at home. One death doula is paid for via the National Disability Insurance Scheme and aged care packages. 

Potential new models include payment via Medicare or private insurance, or models whereby hospitals or hospices engage the services of death doulas. Death doulas are already starting to specialise (e.g, dementia doulas) and are working with those accessing Voluntary Assisted Dying - a specialised doula role in the USA.

 

New models of care would need to affirm how death doulas see their role within the health and social care systems and not just be incorporated into current systems. For example, some death doulas view rules and regulations (i.e, imposed by organisations) as impinging on their freedom of practice. There are also considerations of role overlap such as with palliative care volunteers, social workers.

 

Conclusion 

The interface between death doula models and existing models of care provision is of significant interest. The potential to incorporate death doulas into collaborative models of end-of-life care cannot be discounted, however the complexity associated with the lack of registration and standardised education for death doulas cannot be ignored.