Life support

Death Doulas adapt to pandemic to offer end-of-life support


Studies have shown that about 80 percent of Americans would rather die at home if possible, according to the Stanford School of Medicine. That number may be higher now, after the pandemic has drawn people’s attention to death and the dying, but COVID-19 has certainly amplified interest in the role of death doulas, says Henry Fersko -Weiss, 73, a licensed clinical social worker who in 2003 created the first official end-of-life doula program in the United States, in a New York hospice, and co-founded the International End of Life Doula Association.

“It is increasingly recognized that death can be done differently, because there has been so much talk about death and death,” he observes.

Although the death doula work probably lasted for thousands of years and was called differently, Fersko-Weiss says, the death doula movement gained momentum two decades ago, offering services meaningful to those who felt limited by a traditional medical system.

“End of life requires more than crisis intervention,” he says. “It’s a missing piece during a very demanding time in people’s lives.”

Fersko-Weiss warns that those interested in working with a doula should be aware that there are currently no industry standards available and that certification by one organization does not have the same value as certification by another .

Chang, for example, heard of dying doulas after attending a lecture given by Fersko-Weiss. She has since been trained by the International End of Life Doula Association, the University of Vermont Doula End-of-Life Professional Certificate Program, and the Visiting Nurse Service of New York.

Ask lots of questions

Doulas support the dying, but they also provide services to those left behind.

Arlene Stepputat, 67, volunteers as a project leader for the National Nonprofit Hospice and Hospice and Palliative Care End-of-Life Advisory Council. The council’s Doula Grief Project, which provides free and confidential bereavement support services to those facing loss, grew out of COVID-19 restrictions and the fact that most doulas were unable to work in person with clients and families.

Experienced end-of-life doulas trained in compassionate listening provide hour-long sessions by phone or videoconference over four weeks as normal support systems continue to be taxed.

People considering the services of a death doula should ask plenty of questions, advises Stepputat, owner of Dying in Grace. “Interview this person as you would any other person you contract with,” she says.

The National End-of-Life Doula Alliance offers a state-by-state online directory of doulas.

Here are some questions to ask a death doula:

  • What is their experience?
  • What do they charge?
  • Where were they trained?
  • Why are they doing this work?

Stepputat, who lives in Santa Barbara, California, was drawn to the job because of multiple losses: four days before her 12th birthday, her father died in an accident; when Stepputat was 19, his girlfriend was murdered; and several street youth with whom she worked as a young adult died of suicide and other causes.

“Choose wisely because you are going to be using this person at one of the most difficult times of your life,” Stepputat says. “It can also be one of the most sacred and beautiful times of your life. Creating a peaceful transition for someone you love is a gift.”

And the benefits of a doula-patient relationship go both ways, according to Terry Bonebrake, 58, of Grand Rapids, Mich., A death doula who says he’s reaping the rewards of her labor.

“Every time you do service work, you focus on the other person, and yet you learn things that you might never have known otherwise,” he notes. “What affected me probably the most was seeing how much every moment matters. Those 60 minutes and the next 60 minutes will never be the same. “


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