Embracing the End: The Vital Role of Death Doulas in Our Community

As I sit at my kitchen table, surrounded by course materials, notes on end-of-life care, and a growing stack of books on grief and spirituality, I realize that the journey I’ve embarked on to become a death doula is not just about learning how to support the dying. It’s also about recognizing the deep and unsettling gaps in how our society approaches death and dying, and why these gaps demand our attention—now more than ever.

I’m currently in training to become a certified death doula, a role that is as sacred as it is necessary. What started as a personal calling to help those facing the end of life has quickly turned into a profound awakening about the systemic inadequacies that leave dying people and their families without the emotional and spiritual care they deserve. In the process of this training, I've been forced to confront not just the technicalities of this work, but the stark absence of support within our community and the healthcare system at large.

The Invisible Work of Death Doulas

At this stage in my training, I am still finding my footing—learning to listen deeply, offering comfort, and helping families navigate the complex emotions that arise during the end-of-life process. As part of the program, I have shadowed experienced doulas, read extensively about the dying process, and practiced holding space for people who are preparing to leave this world. While all of this has been eye-opening and enriching, what strikes me most is the lack of recognition and awareness of what death doulas actually do.

Despite the growing awareness of holistic healthcare, the role of a death doula is still shrouded in mystery for many people. For those who have never heard of the role, it can seem foreign and unnecessary, especially when hospitals and hospices often provide traditional medical care. But death doulas do far more than manage pain or administer medications; we offer emotional and spiritual support, help with end-of-life planning, and serve as advocates for the dying when their voices can no longer be heard. This emotional labor, often invisible and unspoken, is crucial—but it’s also largely unacknowledged in the communities I’ve encountered so far.

The Silence Around Death

One of the most difficult aspects of being in training is coming to terms with how uncomfortable society is with the concept of death. We live in a culture that often ignores or avoids discussions about dying, and this avoidance has left families and individuals to cope alone, with little external support. Many people find themselves at a loss when a loved one is nearing the end of life. And when they do seek help, it is often limited to medical or palliative care services, with minimal focus on the emotional and spiritual needs of the dying person and their loved ones.

During my training, I’ve heard stories from classmates about their own experiences with death, and the overwhelming sense is that society has a tendency to sweep death under the rug. People don’t know where to turn, what questions to ask, or how to process the emotional and spiritual weight of the situation. Families are often left scrambling to find the right resources, but they don’t know where to look. And in a way, I find myself equally unsure of how to fill the need.

The Growing Need for Death Doulas

What’s become increasingly clear to me is that the role of death doulas is not just a niche service—it is a vital part of a larger movement toward compassionate, holistic care at the end of life. While there are some who are fortunate enough to have hospice care and a support network in place, many others do not. In these instances, the absence of a death doula can leave families struggling, without clear guidance, to navigate their loved one’s final days.

The community needs more doulas—there’s no doubt about that. What is equally clear is that we need to build awareness about this work and ensure that it becomes an integral part of healthcare conversations. It’s not just about supporting people through their last moments. It’s about providing dignity, respect, and emotional presence to the dying, who often face loneliness, confusion, or anxiety about what lies ahead. And it’s about supporting families, who may feel helpless and overwhelmed.

The Gaps I See and Feel

In my local community, I’ve encountered an overwhelming need for end-of-life care that goes beyond just the basics of medical assistance. I’ve seen families in distress, unsure of how to approach difficult conversations about death, unable to fulfill the wishes of their loved one because they haven’t had the right resources to guide them through the process. They often don’t know that a death doula could be the answer they need to help them navigate these emotional and spiritual challenges.

But there are more systemic gaps, too. Many healthcare systems don’t integrate death doulas into their care teams, leaving it up to individuals to find doulas on their own. The financial cost of hiring a doula can also be prohibitive for some families, especially when insurance doesn’t cover this type of care. Even when people are aware of the option, they often don’t know how to access the support they need or how to find a trained and qualified doula.

These gaps are felt deeply in the communities I’ve encountered through my training—places where people need connection, compassion, and guidance, but are instead left with a sense of isolation at one of the most critical points in their lives.

Looking Toward the Future

As I move closer to completing my certification (fingers crossed), I find myself driven not only by the desire to support the dying but by the need to bridge these gaps in the community. I hope to raise awareness, speak out about the benefits of having death doulas in every community, and help create more access to this deeply valuable service.

What I’ve learned so far is that being a death doula is about more than just assisting with death—it’s about helping people live fully, even in their final moments. And for that, our communities must begin to recognize and embrace the role that doulas can play in supporting a more compassionate, holistic approach to the dying process. It's time we stop avoiding the subject of death and start making room for the sacred, tender work that it takes to guide people through this universal experience.

For any inquires do contact me at: 

Holly Bartley

hbar2703@homehospiceassociation.org