None of us leaves this world alive, and as Dame Cicely Saunders once said, “How people die remains in the memory of those who live on.” We are therefore fortunate to live in an era when the option of having a “death doula” has become more commonplace in helping individuals and loved ones as death approaches. As we’ve previously discussed, death doulas provide holistic non-medical support and compassion for patients approaching death and their loved ones. The COVID epidemic spurred enhanced interest in both the use of an end-of-life doula and in becoming one (it’s common for someone to seek out this role after they’ve experienced a death in their own lives). Studies have shown the positive impact of involving an end-of-life doula and the availability of these sources of support is growing. There are several national and international organizations training and promoting the use of death doulas, and the University of Vermont now even has a certificate program for end-of-life doula training.

One pioneer in advancing the field of end-of-life doulas is Alua Arthur, someone we’ve previously highlighted. On her website, Going With Grace, Arthur provides resources for becoming a doula, finding a doula, and other death planning resources. Arthur is also the author of a new, much-praised memoir of her life entitled Briefly Perfectly Human: Making an Authentic Life by Getting Real About the End. A “recovering attorney,” Arthur came to become an end-of-life doula after dealing with a serious depression in her own life, experiencing a profound conversation about death while traveling and then experiencing the death of a loved one. As she has stated, “I saw how lonely it was to be dying and also felt how lonely it was to be somebody in the circle of support…I would have given anything to have someone there to answer questions, to bear witness, to let us know when we were doing it right, and to offer suggestions for when we weren’t. Someone to support us thru the practicalities so I could focus on my grief. And since I didn’t have the support when I wanted it, I decided to offer it to other people.” Arthur herself has trained over 2500 end-of-life doulas and has done the in-the-trenches work of being present for clients and families, dealing with death anxiety, advance care planning, offering what she calls “lucid compassion,” and helping clients and their loved ones face the inevitable in as peaceful and dignified a way as possible.

Arthur’s book raised the visibility of end-of-life doulas. Such notable journalists as Terry Gross from Fresh Air and Maria Shriver’s Sunday Paper have published interviews with Arthur and helped spread the word on the value of involving an end-of-life doula. Given that no 2 deaths are exactly alike, an end-of-life doula’s role can run the gamut from counseling after a terminal diagnosis, talking the client through the practicalities of what happens as death approaches, helping prepare a body for burial to supporting a family in the weeks after death (the “sadmin” as doula Aly Dickinson describes it). An end-of-life doula does not replace the valuable work of palliative care and hospice professionals, and offers no medical advice or pain management, but instead tries to help patients and their loved ones have the emotional and practical support they need, whenever and however they need it. The goal is to help ensure that each day is as meaningful and fulfilling as possible as death approaches. What a gift that is to patients, and to the family that lives with those memories.