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I’m often asked; what exactly do you do as an end of life doula? And I usually begin my answer with an explanation of what hospice does, because this helps to identify the differences and to understand the unique role of an end of life doula.


So in order to understand hospice better, we need to know that it is a medical model. In other words, the care and services are based on a medical diagnosis. In fact, a terminal medical diagnosis with a prognosis of six months or less. That is to say that two physicians must attest that the person has a condition that will likely–if untreated– result in the loss of life.


The framework of hospice services is a multidisciplinary team comprised of a hospice physician, a case manager, a social worker, a clergy member, a hospice health aid, and a volunteer. The services are provided in the place where the hospice patient calls home, or a residential hospice.


When on hospice services, the patient’s medications are delivered, as well as other supplies and equipment, and medical care comes to the patient. No more doctor visits, trips to the lab, picking up prescriptions and so forth.


The case manager will visit weekly (more often if needed), the hospice health aid will visit to help with bathing and light housekeeping once a week (more often as needed), and less frequent visits from the social worker. The clergy visits are only by request and if the family would like a volunteer, this person usually visits weekly.


Now let’s take a look at the role of the end of life doula (EOLD)! First and foremost, the EOLD approaches the care from a holistic model. That is to say, unlike the focus of care in hospice being approached from a medical view, the care provided by the doula is from an understanding that the dying event is a natural life occurrence. The dying person is seen as multifaceted, so all needs and concerns (physical, mental, emotional and spiritual) are addressed. And this care is provided to everyone involved, because the dying event is understood to be a shared event that involves everyone who is present.


So you are asking; what exactly does an EOLD do? Answer; anything desired or required to create the best dying experience possible! As an EOLD, I am prepared to be comfort, support, guidance, knowledge, reassurance and anything and everything else I am able to be. I understand that– for many–this is a journey not taken before–or not taken often–therefore not well understood and sometimes just plain frightful. My knowledge and experience becomes a source of comfort.


When circumstances are right–and I strive to make them so–I am able to help all those present to understand death and dying better, which just naturally makes the journey easier. My efforts are to help the dying person and the loved ones understand that life is a two part deal. Life comes with the death provision! And when we are able to see death as the natural conclusion of the life experience, we can lessen the suffering so many of us experience. And when the fear and anxiety is managed, the life event we call dying can be full of love, joy, laughter, peace, and a source for pleasant memories of a sacred time in life.


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