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What is an End-of-Life Doula or a Death Doula?

making sense of life & death Apr 27, 2021

This post is part of Willow’s Information Series: Who provides end-of-life comfort and care?

When people ask Valoria Walker what an end-of-life doula is, she finds it easiest to explain it this way: “A doula is a woman supporting other women labouring and giving birth. An end-of-life doula is at the opposite end. I support aging adults who are near or at the end of life.”

When someone is in their final months or days, whether they’re in a hospice or receiving end-of-life care at home, a death doula compliments the patient’s care team but works directly with the person and often their family. Once hired, they can sit for hours if needed with no pressure to document anything or update others.

Valoria adds, “I’m there in the presence for that person. I allow them to obtain peace as they approach death. Most nurses don’t have that kind of time.”

Doula by destiny

Valoria’s doula story began with the negative experience her mother had during her end-of-life hospice stay. “I wasn’t looking for this career, but like so many other people who are impacted by the death of someone close to them, I got on that track.” Her mother’s death birthed Valoria’s current practice and that’s why it’s called Doula by Destiny.

Valoria began her training in 2016 with the International End-of-Life Doula Association (INELDA) and also completed caregiver training from the John Hopkins Medicine Program. “As a new and emerging field, there are no standard certifications,” she explained. “Doula’s typically mentor and train each other.”

Being of service to the whole family

Work with a client typically starts when the caregiver reaches out. Valoria’s first step is to assess the needs of both the caregiver and the dying person. “When someone is dying, we have a tendency to talk around them like they’re not in the room, and start making decisions for them as if they have no voice. So I listen to what the client is saying in one ear and what the caregiver or family member is saying in the other ear. Often they don’t match so you have to be a mediator to ease those family dynamics.”

Having a viable death doula business is not easy.

Most of Valoria’s experience with clients has been as a volunteer at her local hospice. She started getting some paid clients before COVID, but then of course it was impossible to visit any elders anywhere. 

“For African-American doulas it’s very difficult because we have white Americans that don’t necessarily trust a doula of color to support them because of their biases. And then our community is so structured around faith-based institutions, that they don’t think they need an end-of-life doula. So it’s a hard space to break through. “

These days most of the income Valoria generates from her end-of-life care services is from speaking engagements where she talks about advance-care planning, diversity, inclusion, and equity, as well as health-based disparities within African-American communities. 

Valoria is enrolled in the Willow EOL EducatorTM Program starting May 2nd, and is looking forward to leading Willow WorkshopsTM and using Willow tools and products inside her practice.

Death doulas can close the gap between intentions and action.

Valoria believes that the global pandemic has increased people’s awareness of their own mortality and along with it, the value of end-of-life doulas. She also knows that there remains a gap between those who say they want to do advance-care planning and those who actually do it, and she thinks that end-of-life doulas can play a critical role in closing that gap.

Now that death awareness and the demand for death doulas seems to have grown, Valoria wants to see hospices incorporating paid end-of-life doulas into their system. To get around administrative barriers, Valoria suggests hospices at least offer doula support as an a-la-carte service.

Learn more about Valoria and Doula by Destiny here.

Watch and listen to Valoria talk about what lights her up the most and about how her work has a ripple effect.


What about you?

What about Valoria’s story can you relate to?

What about Valoria’s story do you find interesting or surprising?