What is a Death Doula?
Unless you have been living under a rock, you’ve probably heard of the hit HBO tv show, The Pitt. As a family nurse practitioner, I love everything about the show. The writing, the dialogue, the medical terminology, the patients. It is a brutally honest look at the inner workings of a busy, metropolitan city emergency department. I thought I could start writing about some of the topics that are discussed on the tv show from my perspective as a healthcare provider.
One of the recurring patient story lines in the second season is about a mother dealing with terminal cancer. I feel like the general population has heard of hospice and palliative care services (if not, I’ll have another blog post about them soon), but a death doula may be a new one. For me, a doula makes me think of pregnancy and childbirth. A birthing doula is a non medically trained person, usually a female, that supports a woman before, during, and after childbirth. In essence, a childbirth doula is an advocate for the pregnant woman. The doula provides emotional and physical support through one of the hardest seasons in a woman’s life.
When I was pregnant with my second child, I hired a hypno-birthing doula. I’ll admit, I was pretty skeptical about the hypnosis working, but I was willing to give it a try. I really wanted to try a non medicated birth. With hypno-birthing, I was to listen to the audio meditations and narratives each day for the whole pregnancy. We had a run through in my last trimester and it was at that point, I was totally convinced hypnosis works. That child is now eight. To this day, I can tune into the hypnosis practice and exponentially decrease painful situations. Was that childbirth experience pain free and peaceful? Absolutely not, but I was so appreciative of my doula’s support and encouragement during that time in my life. Did I use a doula for my 3rd child? Nope. I went straight for an epidural. I lived and learned.
A death doula, as you probably figured out, is a doula for dying. The death doula in The Pitt is also one of the nurses in the emergency department, but they are usually non medically trained persons. A death doula provides emotional and physical support and advocates for the terminal patient and their family. Having a terminally ill family member is extremely hard. There are usually a wide range of emotions from anger to denial to extreme sadness. A death doula can help the patient and family members process some of these emotions and walk with them through this transition.
A death doula is typically not covered by Medicare/medicaid or private insurance, so I understand this is a luxury for most. Some death doulas charge by the hour, but a flat fee package is most common. For patients that utilize a death doula, most of them are already on hospice as well. The ideal situation is when the hospice team and the death doula can work collaboratively to best serve the patient. The death doula can focus on advocating for quality of life services for the patient, while the patient’s family members can focus on spending time with the patient in their last days. Death doula’s are not a 24/7 hour service, but for the patient in The Pitt, having a doula with her in the emergency department is so nice. Death doula’s can advocate for minimal interventions, appropriate pain management, and make sure the patient’s advance directives are being followed.
I have never worked with a death doula, nor do I know anyone that has hired one, but their place is so very needed in the healthcare world. A lot of people are very hesitant to utilize hospice and palliative care services. In my opinion, it is one of the kindest things we can do for a loved one or family member for a terminal illness.
Would you consider a death doula? Have you ever heard of one before today?
