Time and Roles.
The hospice nurse serves as the medical manager for the terminal patient, focusing on clinical care during limited time at the bedside. Their role involves assessing medical needs, administering treatments, and coordinating with the broader healthcare team to ensure symptom management and patient comfort.
The death doula, while a non-medical professional, occupies a crucial complementary role. They act as the attentive eyes and ears for the case, often spending time with the patient and family that medical staff cannot always offer. The doula observes subtle changes in the patient’s condition and communicates these observations promptly to the hospice team.
This collaboration ensures that the hospice team can rapidly reassess and update the care plan, targeting maximum comfort tailored to the patient’s evolving needs. Together, the hospice nurse and death doula provide a balance of expert medical care and compassionate, consistent presence.

An End of Life Doula can do everything EXCEPT give a medication and do any form of medical treatment or wound care.
The hospice volunteer needs to follow Medicare regulations that prohibit any form of touching, moving, feeding, bathing, toileting etc. The hospice volunteer in most US states is limited to a maximum weekly bedside visit of 4 hours. The average volunteer visit is 1-2 hours a week. This does not provide the adjunct support that patients and families so desperately need at this stressful time.

Time.
Most hospices provide services up to a maximum of 2 hours a day, 5 days a week. This is based on acuity of the patient and is only available if the hospice has an available aid.

No.
A End of Life Doula never gives any medication whether prescription or over the counter.

Most hospice teams leave a case after the patient has died. Many times, families are feeling this as another loss. Hospice does offer bereavement services for up to a year or 15 months in most states. This is usually initiated by a call from a volunteer and the living family member is told about monthly support groups that they may attend. The original hospice team that worked with the family is not usually part of this service.

Yes!
An End of Life Doula has a “scope of practice” that includes everything from the time of a terminal diagnosis to helping patients and families as the illness progresses, to the vigil, time of death, after death care, understanding and honoring grief and finally recovery of life after loss.

Yes!
The National Hospice and Palliative Care Organization (NHPCO) is the membership organization for all the hospices in the US. They have just put together The End-of-Life Doula Council to be able to share with Hospices and families how the Professional End of Life Doula can assist and complete the hospice team to fill in “the gaps in care” and allow for the best end of life experience for both the patient and their loved ones.

No.
End of Life Doulas are private pay. All “companion” services such as Home Instead, Visiting Angels, Comfort Keepers etc. are all private pay. Schedule a free consultation to discuss your care and financial needs.

Generally speaking, in person services are available in the Los Angeles area. I am also pleased to offer virtual teledoula services via Zoom.

A: No.
End-of-Life Doulas are a Non-Medical Professionals. Just like the establishment of Birth Doulas 40 years ago. This is not regulated by a government license.

There are several excellent and comprehensive training programs that provide certification for End of Life Doulas.
Additionally, proficiency testing is conducted by the National End-of-Life Doula Association and other organizations.