Doula: Spiritual support at end of life

The most undeniable fact of life is that it will end. However, too often families and caregivers go to extraordinary lengths to avoid end-of-life planning until it is too late. I have already written about hospice and bereavement counseling as valuable services to caregivers coping with dementia. Another is Doula.

Doula is a Greek word that means “servant.” For centuries, doulas have served as mid-wife assistants, providers, and supporters to women bringing life into the world. End-of-life doulas, which are a more recent phenomenon, are individuals trained and certified to help support and guide individuals and their loved ones through the death and dying process.

Doulas will become more important in a society where our aged population (65 and older) is expected to grow from the current 75 million to 92 million by 2060! Furthermore, 20 percent of the members of this growing population have no children, which further necessitates their reliance on outside support.

Here are some of the services doulas provide:
They educate in the natural end-of-life processes, a knowledge that too many of us carefully but unwisely avoid.
They provide respite care, allowing needed rest and recuperation for caregivers and their families.
They provide a compassionate presence throughout the dying process.
They provide assistance with funeral arrangements, obituaries, memorials, and locating bereavement resources.

They work with providers and family members to face end-of-life issues and develop plans on a timely basis so they will not be caught up in disagreements at a time of crisis when they are least able to make critical and rational decisions.

In short, they provide palliative care to assure the best possible quality of life at the most critical moment in our existence.
They can also provide after-death counseling to help loved ones and families get their lives back on track.

Doula is not competitive with hospice. They each provide valuable services and support, and I would never suggest that one is more important than the other. Typically, hospice follows a more medical model; doula follows a more spiritual model, and a client can benefit from both. Doulas are not nurses, nurse assistants, or social workers, though some doulas may also carry those credentials.

While much of doula work is with families and the care providers, they also are trained in the skills needed to communicate and support the dying. In respect to individuals living with dementia, this requires special skills since that person quite often lacks the ability to think rationally or respond verbally. In these cases, doulas use music, verbal reassurance, and compassionate touch to communicate with a person living with dementia. In this way, they work with a person’s feelings rather than rational thought processes.

I have spoken and met with two end-of-life doulas in the Nature Coast Region: Mary Ellen Shea and Saundra Piercy. About working with individuals living with dementia, Mary Ellen said, “We must create a relationship of the heart. We know that those living in the late stages of dementia still have feelings, and by reaching them on a feeling level, we can contribute to their quality of life.” She added, “These techniques can also be taught to their caregivers and families; they are simple and basic techniques of kindness, loving voice, and compassionate touch.”
Reminding us that doula is for all – not just those living with dementia – Saundra told me, “Our task with the dying is to be fully present; to hold their hand, to touch, to talk, to play the music we know they love. Families often find this difficult, so we can model this role for them, or even share this task with them.”
To reach Mary Ellen Shea, call 352-615-9981. To reach Saundra Piercy, call 352-346-7267. To learn more about doula, go to or to

I always end my column by reminding that “We All Deserve the Best.” This is true also at the end of life, perhaps more so than any other time.

Until next time remember: “We all deserve the Best”

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