Training As An End-Of-Life Doula, A Profound Experience By Kathleen M. Rehl, Ph.D., CFP®, CeFT® Emeritus

By Kathleen M. Rehl, Ph.D., CFP®, CeFT® Emeritus

The last few minutes of my late husband’s life were the most intimate we ever experienced—quiet moments where words were unnecessary, replaced by the warmth of holding hands and a shared presence that spoke more deeply than language. Just a month later, my brother and I sat beside our mother as she took her last breaths, embracing a similar, sacred closeness that left a lasting impression on me. These final minutes with my loved ones were extraordinary, and years later, I began to feel that my life experiences were guiding me toward a new direction.

In my prior career as a CERTIFIED FINANCIAL PLANNER™ professional, I often accompanied clients through their later years, helping them plan for the future and create lasting legacies. Those experiences gave me insight into how deeply people want to be remembered, cared for, and understood as they approach the close of life. Becoming an end-of-life doula now feels like a natural extension of that work—a way to offer support, presence, and comfort during life’s closing chapter. This training has shown me that being a doula is not only about end-of-life care but also about honoring life itself with compassion and dignity.

According to the International End-of-Life Doula Association (INELDA), doulas “provide companionship, comfort, and guidance to those facing a terminal illness or death. Our non-medical holistic support encompasses emotional, spiritual, and practical care. We offer resources to help the dying person and their family and loved ones make informed decisions in a supportive environment. Doulas normalize deathcare by creating spaces for conversations, leading to increased communication and spiritual and emotional well-being.”

As I explained in a previous article, I decided to train with INELDA, one of the most respected organizations in this field. I’m excited to briefly discuss my intense training experience, which was emotionally moving and intellectually stimulating.

Preparing for the Journey: Pre-Training Work

Before starting the rigorous, in-person training, I needed to complete important preparation work. INELDA provided me with various tools to help begin the process of reflection, including videos, readings, movies, online resources, and journaling exercises. This was not merely intellectual preparation; it was also an emotional and spiritual effort to understand my feelings about death and dying. INELDA consistently emphasized the scope of practice and the code of ethics.

As part of the prework, I watched videos of end-of-life doulas discussing their experiences. Hearing those stories was both inspiring and challenging. These compassionate and wise individuals addressed how they carefully combined providing care for the terminally ill with respecting the autonomy of those they looked after. Their stories made it clear that, besides practical skills, this work requires a deep commitment to helping individuals in their time of great need.

One of the most poignant films I was assigned to watch was Prognosis: Notes on Living. You can view a trailer for this documentary movie that follows the award-winning filmmaker Debra Chasnoff’s diagnosis of breast cancer and the progression of her life that follows. 

This pre-training work was about much more than guiding others through one of life’s most challenging transitions. It was also about confronting my own thoughts and emotions around death, loss, and grief, with an immense responsibility to approach this work with compassion, presence, and humility. After finishing the pre-training assignments, I felt ready to embark on the upcoming three-day INELDA training at the Omega Institute with others who were beginning this journey with me. 

Immersion Training at the Omega Institute

I chose to complete my program in person at the Omega Institute in Rhinebeck, New York. (I had the option to complete my program virtually if desired.) The site, with its natural surroundings and sense of serenity, was perfect for this deeply reflective work. Our long weekend training group met on Friday evening, Saturday including that evening, and most of Sunday. It was an intense and rewarding three days.

The curriculum was built upon three core concepts, which formed the cornerstone of our education:

1. Self-awareness: Doulas must know their own biases, fears, and feelings toward death. We received encouragement to assess ourselves and face our emotions to create safe, nonjudgmental spaces for the dying and their loved ones.
2. Autonomy of the dying: One of the core tenets of being an end-of-life doula is honoring people’s autonomy in their last days. We discussed ways to ensure that the dying person’s wishes are fulfilled, even if they are difficult for family members or caregivers to accept. The aim is to give people autonomy to decide how they wish to spend their final time.
3. The dying process: Examining the psychological, spiritual, and physical aspects of dying, we learned that each person’s path to the end of life is unique. This comprehensive approach emphasized that death is not just a medical event but also a highly personal human experience.

A Trip Together: Attending Training with a Friend

It wasn’t just me on the road. I invited a wonderful friend from my congregation to join me for the training. As a member of our congregation’s care team, she was already assisting elderly members, including individuals nearing the end of their lives. In addition to allowing us to support one another along the way, we thought that working together would help us hold each other accountable for applying what we learned later.

Group Projects and Practical Exercises

Partner work and small-group exercises comprised a significant amount of our experiential training. Through these exercises, we practiced the core skills needed by end-of-life doulas, including deep active listening, establishing a safe space for emotional expression, and facilitating difficult conversations about death and dying. Role-playing activities that showed us how to have productive discussions with families, provide them with emotional support, and give guidance during the dying process were quite impactful.

We discussed creating and using rituals and providing practical assistance with arrangements before and after a death. As appropriate, we prepared to offer information about end-of-life options, grief support, life review exercises, and extended family involvement. We engaged in guided imagery and were encouraged to consider this technique with our care receivers. We also learned how to conclude a care partnership after death.

We examined numerous real-world and hypothetical cases, gaining insight into the practical application of various techniques and approaches. Our instructors shared a wealth of their personal experiences with participants. 

One of the advantageous aspects of the training was the opportunity to interact directly with others from various professional backgrounds. Working through these exercises, we built solid bonds that allowed us to be vulnerable and open. We cried together, supported each other, and learned from each other’s experiences. It was a powerful reminder that we need the support of a community, be it friends, colleagues, or other doulas, to successfully complete this role.

Effects on Soul and Emotions

The INELDA training was not only instructive but also very emotional and intense. This included facing my mortality in ways I had never experienced before during the weekend. We had to carefully consider our final wishes and the care we desired in our final days.

The training encouraged me to face some anxieties and sadness I’d avoided and consider how I could support others going through similar experiences. But it was also incredibly powerful. The training has given me a greater ability to confront death with compassion and acceptance—certainly not fear. After the weekend’s training, I had a new outlook about how I can assist others as they approach death.

A Growing Doula Network

INELDA has trained over 7,500 people to become end-of-life doulas. I’m pleased to be part of a rapidly growing community dedicated to offering compassionate, individualized care to people nearing the end of their lives.

The training session in which I participated drew over 90 registrants. Their diversity was astounding. I met people ranging in age from their early 20s to their 80s. Most were women, with only a few men in attendance. Some, like me, were retired or semi-retired, but most had professional backgrounds in various “helping professions.” That included nurses, therapists, counselors, pastors, social workers, hospice staff, authors, caregivers, retirement home personnel, business owners, educators, grief coaches, researchers, and even a veterinarian interested in learning meaningful ways to support the dying and their families. Despite having previously served in fields related to end-of-life care, many of these individuals aimed to expand their skill set and adopt a more holistic approach to death and dying. Although some participants planned to do doula work as paid professionals, this training program did not include information about establishing a revenue-generating business. I will do this work as a volunteer rather than for compensation.

These attendees, who were of various ages and backgrounds, created a stimulating learning atmosphere. Everyone was encouraged to incorporate their perspectives and life experiences into this work.

Important Considerations: Cost and Training Location

While there are significant academic and emotional components to the INELDA curriculum, it’s equally important to consider the practical necessities. The training I completed required both time and financial investment. The in-person INELDA training program, including course materials, costs several hundred dollars. Then, two nights of lodging and farm-to-table healthy cuisine meals with many vegetarian options at the Omega Institute added more to my expenses. Although the total cost would have been less for the virtual course format, I paid extra for the in-person experience. The practical aspect of the work and the bonds formed with other participants made the in-person experience invaluable for me. Since my upstate New York residence was less than two hours away, meeting in person for training was a fantastic option for me.

After Training—Reflection and Moving Forward

Several days after I returned home, I finished three required additional hours of virtual post-training work, including readings and journaling activities. This final step helped me integrate what I learned over the weekend, giving me a sense of closure.

After that, I received a certificate from INELDA for completing my 40 hours of training. I now have the right to list my credential as an “INELDA-trained end-of-life doula.” Although I have lots more to learn, this step is a significant achievement in my journey. I have a solid foundation of initial skills and knowledge to support me in this work.

This doula training was a deeply transformative experience that left a significant imprint on how I approach not only death but life itself. I’ve gained a profound respect for the intricate, sacred nature of each person’s final moments and the courage required to navigate them with empathy and grace. Stepping into this role allows me to extend the gifts of presence and understanding to others, as my friend and I now explore ways to bring this care to our congregation and the wider community.

I look forward to writing about how these experiences unfold in the future, whether through supporting families, offering solace at a bedside, or educating others on facing end-of-life journeys with compassion and purpose. This is the work I feel called to do, and I am thankful for the meaningful preparation that brought me to it.

Kathleen M. Rehl, Ph.D., CFP®, CeFT®, wrote the award-winning book, Moving Forward on Your Own: A Financial Guidebook for Widows. She owned Rehl Financial Advisors for 18 years, followed by an encore career empowering widows. Now “reFired,” Rehl writes legacy stories and assists nonprofits. Her work has appeared in the New York Times, Wall Street Journal, Kiplinger’s, CNBC, agebuzz, and more. She’s adjunct faculty at The American College of Financial Services. Kathleen is a recent INELDA-trained end-of-life doula. As a zesty Boomer practicing positive aging, she gratefully continues to create and contribute . . . happily using her skills and experiences to encourage others to live their best lives. Her website is www.KathleenRehl.com.