Death doulas are working in end-of-life care providing non-medical support for the dying and their families. 

 

Aim 

 

To elicit the perspectives of death doula training organisations on working practices and models of care relevant to the death doula role.

 

Methods 

 

We identified 15 death doula training organisations in Australia, Canada, the UK, New Zealand and the USA. Electronic survey via publicly available email addresses were sent in August 2021. Ethics approval was received. 

 

 

Thirteen organisations based in Australia (4), the USA (4), Canada (2), the UK (1), Sweden (1) and New Zealand (1) responded. Diversity in views were received relevant to standardisation of death doula business models, role enactment, potential funding and reimbursement approaches.

 

 

Many death doula training organisations value individuality in role enactment, viewing standardisation as negating the ability to be flexible and responsive. For some, this may be seen as not in the ethos of the death doula philosophy. However, a lack of standardisation could result in a lack of consistency and clarity regarding client care, with consumers uncertain about how to integrate services to ensure they have all their needs met. From the perspective of some of the training organisations, models of care going forward would need to affirm how the role fits within the health and social care systems and not just incorporate it, without forethought, into current systems.

 

The death doula role continues to emerge and to evolve organically, mimicking the growth and trajectory of the birth doula role, albeit privileging independence, flexibility and fiscal independence. Death doula training organisations are particularly influential in shaping the direction of the role and any movements to interface with, or be incorporated into, existing models of health or social care. Visibility of these organisations in the media is also providing pseudo-legitimation of the role.