This is one of the most common inquiries I get from aspiring end-of-life doulas in the Triangle who come across my site, so I am answering it here. If you're interested in becoming a death doula, you may be wondering where to start. A death doula, also known as an end-of-life doula, is a person who provides emotional, spiritual, and practical support to individuals and their families as they approach the end of life. This role can be incredibly rewarding, as you have the opportunity to help people during one of the most challenging times in their lives.
The typical path to becoming a death doula starts with some sort of training and certification in the necessary skills. There are several organizations that offer training programs, certification, memberships, ongoing professional development courses, online groups, and professional resources. Such organizations include:
The International End of Life Doula Association (INELDA)
The National End of Life Doula Alliance (NEDA)
These organizations provide a variety of training programs ranging from online courses to in-person workshops to microcertifications, so you can choose the option that best fits your schedule and needs. They are differently priced and involve differing time commitments. My personal recommendation is to first complete the INELDA intensive training course. Not all of these courses cover the exact same material. For example, the certificate I earned at University of Vermont focused more on the emotional, spiritual, and cultural aspects of death and dying--and approached material from a more reflective standpoint--whereas INELDA's training runs the gamut from the physical signs of common in the months to hours before death, to developing communication skills and running guided mediations. The University of Vermont's course had me build out a valuable directory of regional resources, whereas INELDA advised people to do so but did not require it. The NEDA program (and its assessment to earn a proficiency badge) ensures you understand things like Medicare and know the ethics of a doula practice. All of these are valuable, and you can starting learning outside of these courses, on your own, if you wish to do so.
My path was first completing the INELDA training, then volunteering with hospice, then completing the University of Vermont training, then joining NEDA. But I want to stress that you don't need *all* of these certifications. Aside from the fact that they all cost money and time, one is fine. I got my second as a refresher after taking a pause when COVID hit. Nothing beats real-life experience. You can take all the trainings in the world, but it's equally as important to get client experience. That leads me to the next step in becoming a doula.
Once you have completed your certification and training, you will need to gain experience in order to become a competent and confident death doula. One way to do this is to volunteer with organizations that provide end-of-life care, such as hospices or palliative care centers. This will give you the opportunity to work with clients and gain hands-on experience in the field--just make sure you're on the same page with the organization regarding your role. If there is no opportunity to work face-to-face with patients in a hospice setting, try getting experience on your own. Set up a website, spread the word, and and connect with other doulas and relevant organizations in your area. I advise against being a doula to friends and family because you can't be an objective third-party, which is a major part of the doula role. (Of course, experiencing the death of a family member or loved one feeds into your experience as a doula around witnessing the dying process and seeing the gaps in our healthcare system. Many people come to the field because of this.)
I have found that, sometimes, people who complete doula training are really excited about it, but then they volunteer with hospice and decide it's too much for them. That is OK. It's better to know it's not for you then to invest heavily upfront in building a website and printing business cards, etc., only to find that you've changed your mind.
In addition to gaining experience, it's important to continue your education and professional development as a death doula. There are many resources available, including conferences, workshops, podcasts, forums, and webinars, that can help you stay up-to-date on the latest developments in the field and improve your skills.
Overall, becoming a death doula can be a rewarding and fulfilling career. By getting training and gaining experience, you can provide valuable support to individuals and their families as they approach the end of life.
I want to leave you with a few thoughts about "becoming a doula":
1. Becoming a death doula is not like becoming a nurse or a social worker in that there is no official accreditation required by a formally governed institution. I expect that will change over the years as organizations such; the National Hospice and Palliative Care Organization (NHPCO) have begun recognizing the role of doulas and hospices start piloting the use of doulas. You can also now purchase death doula insurance. And frankly, as the healthcare system becomes more strained and baby boomers reach the end of their lives, we will be more needed than ever.
2. While the end-of-life doula movement--and the positive death movement as a whole--is gaining traction, the onus is on YOU to build your practice. The phone is not going to start ringing once you complete training. YOU will need to be proactive about building relationships with other doulas and death care professionals (from funeral directors to hospices to nurses). This looks like grassroots outreach efforts--asking for 1:1 meetings to explain what you do, offering free education workshops about death and dying at your local library or care home, writing an op-ed for your local paper, or attending an expo or conference where you can spread the word about death doulas. I can't tell you how many people find out what.a death doula is and say "I could have really used an end-of-life doula when {person} died."
3. You will never reach a point where you have "all" the experience. Humans are complex, relationships are complicated, and there are a million and one ways to die. Approach your practice as one of continuous learning. Don't expect to know all the answers or wait to get to a point where you will always know exactly what to do or what is likely to happen--you'll be waiting indefinitely. We are human, too, and I have yet to meet a seasoned hospice nurse who doesn't still have moments where they second guess themselves. It's about constant pursuit of knowledge and experience and doing the best you can with what you have. As Barbara Karnes once wrote to me, "you can't quarterback everything."
Best of luck on your journey!