Death Doula FAQs
What is The Difference Between a Death Doula and an End Of Life Doula?
There is no difference between a Death Doula and an End of Life Doula. These terms are used interchangeably, along with Death Midwife, referring to people who accompany those living with a serious illness, and their loved ones, as they approach death. You will find that individual Doulas tend to prefer one term over another to describe themselves. This is a matter of personal preference, and may speak to their particular work philosophy. For example, “End of Life Doula” implies that the Doula is there not just for a person’s death, but also in the months, weeks or days beforehand, and possibly in the weeks and months afterwards as grief support for the bereaved. We use both of these terms on our website to ensure that people searching for a Doula can find us on the Web.
Why Hire a Death Doula?
More people are hiring End Of Life Doulas as they would a Birth Doula. This is not a new concept –the word “Doula” literally means, “Woman Who Serves” in ancient Greek! Compassionate and skilled humans of all genders have always been there to help at a birth or a death: people who have accompanied others on this path many times, and know the territory. Death Doulas can best be understood as people who feel comfortable with, and accepting of, death and dying as a normal part of life. They are familiar with the choices as well as the emotions that come along with this life transition, for the dying person, their loved ones and their caregivers. Doulas can help fill gaps in hospice services, including bedside vigil and Aid-in-Dying (MAiD) assistance.
What Can I Expect From a Death Doula Session?
Your first meeting with an End of Life Doula will likely be a free, 30-minute phone or video call. After that, you will meet in person. You will be asked to review and sign an Agreement (contract) with one or two Doulas, one being the Lead Doula (primary Doula) and one being a second, or back-up Doula, in case the Lead Doula is unable to respond, should there be an urgent need. A second Doula is also advised for complex situations, situations with many people involved, or Aid-in-Dying (MAiD).
An End of Life Doula session can look many different ways. Most Doulas are skilled in helping you sort out your to-do list of business items including, but not limited to: your advance healthcare directives, your wishes for what happens to your body after you die, and your selection of a hospice organization, caregiver agency, or estate planning attorney. Your Doula might facilitate a meeting in person or on Zoom for all the adult children involved to make sure everyone is on the same page, or to plan a Celebration of Life. The Doula might meet privately with the dying person and their spouse to facilitate open communication, or to craft a ritual. A session might involve the Doula meeting with the client 1:1 to talk about fears of death and dying in a confidential, safe space. Some Death Doulas have training and skills in a variety of modalities such as bodywork, energy work, psychedelic integration, pet therapy, music therapy, acupuncture, guided visualizations and more. Ask your Doulas what their specialities are, and utilize what sounds like a good match for you.
How Do I Find an End of Life Doula?
The National End-Of-Life Doula Alliance (NEDA) is a respected, 501c6 non-profit membership business league that most Doulas retain a membership with. You can find a listing of Doulas in their directory. Another helpful directory can be found on the INELDA (International End of Life Doula Association, a training organization) website. Use these directories to cross-check with local and regional networks such as the East Bay End Of Life Doula Network (EBEOLDN).
How Do I Select an End Of Life Doula?
When selecting a Doula or Doulas that are right for you (Our Doulas often work in teams to increase flexibility and availability), think about what is most important to you in this relationship. Would you like your Doulas to have a specific background, skill set, or personality type? Do you have a need for Doulas who can work with low-income clients, or in a certain geographic location? Since each Doula is unique, you will want to learn about them and their areas of expertise before confirming your Doula choice and signing a contract. Most Doulas offer a free, 30-minute phone or video consultation, followed up by an in-person visit. It’s perfectly okay to interview multiple Doulas, but be up front with them about your timeline for choosing who to work with. It can be confusing to all parties involved if you start working with multiple Doulas at the same time. They might wind up duplicating efforts to help you.
When Should I Contract With an End of Life Doula?
Although you may contact a Doula at any time, you are encouraged to reach out to a Doula before there is any type of emergency or crisis. We encourage contacting a Doula upon receiving a serious medical diagnosis, or after celebrating a milestone birthday over 60. Start the conversation with your questions, concerns and wishes surrounding your, or your loved one’s death, now. If you are hoping for Doula support for an Aid-in-Dying death (MAiD), please contact a Doula as soon as possible. Contacting Doulas early on means that you are more likely to have a trusting bond established, and also that they will be available when you need them. You may wind up meeting with your Doula(s) for purposes of education, counseling and planning several times over the course of weeks or months, and then not again until the time of death is closer.
How Often Will You Meet With Your End of Life Doula?
You may wind up working with a Doula for a few days, weeks, months or years. YOU get to decide how often you see your Doula, and the length of your sessions. Many clients choose to have a biweekly or monthly check-in with their Doula until there is a change in condition, at which point they utilize the Doula more frequently. Other clients use Doula services more intensively up front, and get what they need from their Doula before their death.
What Is the Scope Of Death Doula Services?
Support
Emotional support is the cornerstone of the Death Doula’s role. Doulas support the dying person and their loved ones through the many emotions that arise during the illness and hospice period. Doulas offer this support with deep and active listening skills, giving feedback, holding space, holding a hand, or offering a hug. Doulas can facilitate difficult conversations, host family meetings, and share stories from their wealth of experience. Other forms of support that Doulas offer, depending on their areas of expertise.
Vigil
Vigil is the term used for the period of “active dying” when the dying person is often bedbound, verbally unresponsive, no longer eating or drinking, and the body is in an active process of shutting down. Doulas can help you plan for this vigil time (the final phase of dying) which can last anywhere from 1-30 days, but most often 3-4 days. Doulas can help you understand the dying process, and how the circle of care might offer loving support. Your Doulas will talk to you about the setting: how to make the physical environment as comfortable and peaceful as possible for the dying person and their loved ones, and who you would like to be there. Sometimes, shifts are coordinated around the clock to assure someone is always by the bedside, and Doulas can help with coordinating these shifts and/or by taking some of the in-person shifts, themselves.
Choices
When it comes to dying from an illness or medical condition, you may feel that the loss of control is overwhelming. But there are always choices: choices about where you want to die, how you want to die, and who you want to be with you when you are dying. When we say, “how you want to die,” that refers both to your mindset: do you want to die with peace of mind? What would that look like, and how can we help you achieve it? It also refers to whether you will choose Palliative or Hospice care, and whether you’d like a safe, conversational and non-judgmental space to explore the California End of Life Option Act for medical aid-in-dying, or Voluntary Stopping of Eating and Drinking (VSED). Doulas are an excellent resource for exploring these questions and talking them through as you go through your own decision-making process about choosing the dying experience that is right for YOU.
Legacy
No matter whether or not we are leaving children, grandchildren, nieces and nephews, students, clients or friends to survive us when we die, we ALL have a legacy. What are the things: material, ethical, cultural and spiritual that you have cultivated in your lifetime, that will live on when your body dies? How can your stories, your wisdom and values best be passed on to the next generations so that other lives can benefit, and your memory be preserved? Doulas can help you create one or more legacy projects that can enrich the lives of those who will mourn your death and honor your life. A legacy project can be in the form of a digital, electronic or other written document, video, art or photo collection, audio file, exhibit, donation, charitable fund, etc.
Ritual
When you think of ritual, think of religious, spiritual or cultural ceremonies that mark transitions and significant life events. Rituals can happen both before and after a death and can involve a circle of people, two people, or just one. They can be as simple as softly touching someone’s forehead with essential oil and whispering “Go in Peace,” after they have taken their last breath. Or, may include offering a home funeral/family-involved death care, and facilitating Celebrations of Life. We support people of every faith, and no faith. Doulas are there to help you create or fulfill any requests YOU may have at any point in the journey towards death and dying.
Comfort
A Doula’s quintessential task is to provide comfort, empathy and understanding to those who are approaching end of life, and their circle of care. Doulas have walked the path towards death and dying with countless individuals, families and caregivers before. Doulas provide a non-anxious presence in the room, helping everyone take a deep breath. Bringing as much ease, comfort and support to the situation at hand as possible are the cornerstones of Doula care.
Are Death Doulas Covered by Insurance?
The End of Life Doula field has grown exponentially since the International End of Life Doula Association (INELDA)’s training programs began enrolling participants in 2015. As of 2025, there are now many Doula training programs across the United States but not yet a single governing body or certification/licensure. Therefore, Doula services are not covered by Medicare or other insurance at this time. Clients pay Doulas out of pocket.
Do I Need to Sign a Contract?
Yes. In almost all cases with few exceptions, Doulas will ask you to sign a written agreement or contract that outlines their scope of services, their fees and their method of working. By signing this contract, you are agreeing to work with this specific Doula or Doulas, and to pay them in a timely manner. This agreement provides all parties with a critical framework for the work you will do with your Doula or Doulas.
How Much Does An End of Life Doula Cost?
Doula fees in the San Francisco Bay Area (as of 2025) are based on an hourly rate in the range of $100-150 per hour plus mileage, bridge tolls and other expenses, such as parking. Doulas choose this field of work because they are passionate about helping others. At the same time, they must earn enough to sustain their ability to provide these services. Doulas tend to do a significant amount of free community education and service in the end-of-life arena, and rely on clients who can pay the actual cost to continue doing this work.
What If I Am Low-Income?
Most Doulas offer a sliding scale upon request for low-income clients. Many Doulas also accept a percentage of pro bono clients at any given time, when the client has no ability to pay. Even if a client is low-income, there may be something they can offer in return to recognize the Doula’s time and efforts. It may also be possible for someone in the client’s orbit to organize a fundraising campaign to help cover Doula costs. Trained Doulas who are new to the field and looking for experience are another great way to go. And there are volunteer organizations, such as End of Life Choices California, that may be able to provide what you’re looking for.
How Are Doulas Different From Hospice Workers?
Sometimes the Death Doula’s role seems to overlap with that of Chaplain, Social Worker, Therapist or Funeral Professional. But Doulas are not a replacement for those licensed professionals, nor are they a replacement for hospice care, or any nursing or hands-on physical care (toileting, bathing, dressing, wound care, feeding, etc.). They never administer medications, even when supporting a client who has chosen aid-in-dying (MAiD) where the client must self-administer the medication. Doulas do not serve as Powers of Attorney for their clients and they do not sign as witnesses to medical aid-in-dying requests, as these would be conflicts of interest. Rather, End of Life Doulas augment the services provided by these professionals, make referrals to these professionals, and can provide a critical communication link to them on behalf of the dying individual and their caregivers.