(As many of you know I was unable to attend the UVM End of Life Doula Grad Weekend because of a family health crisis and didn’t get a chance to speak on the panel that was to address “The Direction of Doula Work.” As this is not unique to graduates of the UVM Program, I want to share some of my thoughts here.)
Most people I interact with who have completed a Death Doula training reach out to me because they want to know the next steps to actually becoming a Death Doula. While my advice will always, always, include become a hospice volunteer in order to practice your skills and bear witness to the dying, I’d like to dive a little deeper into why becoming a Death Doula may be difficult.
Death Doulas are part of a movement to reclaim death from the medicalized event it has become. That doesn’t, however, mean that Death Doulas need to be a new profession in death work. I believe that a great way to be a Death Doula is to find out what our individual communities need us to be as death doulas.
Having just spent nearly a week in one of the best hospitals in the world I can tell you that there is a need for people with familiarity with hospitals and Death Doula skills to be patient advocates. ESPECIALLY as people navigate the time just before hospice and are making medical decisions that slow down and eventually stop aggressive treatment.
But notice that I said that this is a need for “people with familiarity with hospitals and Death Doula skills.” Becoming a Death Doula doesn’t need to be a career pivot. In finding out what your community needs you can always check back in with yourself and your skills from your previous career and life to see what unique Death Doula solution you can bring to meet the need.
As more people answer the call to become a Death Doula we will have more and more Death Doulas practicing in proximity to each other. Which does raise important questions about how Death Doulas can work together without competing. This comes back to every Death Doula having a unique skillset and finding ways to honor that in each other’s work.
Not everyone interested in being a Death Doula is interested in charging for their services, but for those who are there are several things to consider- especially with other doulas practicing in our communities. How do you decide the value of your work? How do you make sure the value of your work does not undervalue someone else’s? What are our ethical obligations as doulas to “put ourselves out of business” by returning certain skills, such a being present with the dying, back to the community and what skills should remain skills it is ethical to charge for?
What existing care models do we look to to determine the structure of our work and how we are reimbursed for it? Although we share “doula” with birth doulas our work is too different to offer much as a model. Lately I’ve been looking at Physical Therapy as a model because of the way it offers special skills in a time of acute need while at the same time teaching skills to the patient to care for themselves.
Lastly, I believe there is the need for Death Doulas to be advocates for the work we do. In our circles we know we exist and we know we offer something of value. With the creation of the NHPCO End Of Life Doula Council we may find much needed forward momentum in integrating Death Doulas into hospice care models, but we need similar momentum in hospitals, doctors’ offices, skilled nursing facilities, and senior centers. We need to become an integrated part of of any institution that supports the dying and we need the help of people who want our services to do so.
As a Death Doula you are at the forefront of a new movement. As your get started be sure to introduce yourself to both the medical institutions and the people in your community. Hold workshops so people know who you are and what you offer. Not only will this be a great way for your community to learn about you- but it will be an excellent way to learn what your community needs from you.