When someone in our life is dying, many of us feel unprepared, overwhelmed, or unsure of how to help. We want to be present, to provide comfort, to make the experience meaningful, but we may lack the knowledge, confidence, or emotional support to navigate this profound transition.
This is where an end-of-life doula steps in, offering presence, guidance, and compassionate support to individuals nearing the end of their lives, as well as to everyone who loves them — family, chosen family, friends, and even beloved companion animals.
An end-of-life doula provides non-medical, holistic care that complements clinical services, helping to make dying a more personal, connected, and meaningful experience. We offer practical guidance, emotional support, and the gift of unhurried presence during one of life’s most significant passages.
This need for supportive care is particularly urgent now. Australia’s population is ageing rapidly, with more people living longer and often with complex needs. Our aged care and palliative care systems are under increasing strain, with insufficient support spaces and workers to meet the growing demand.
This is the context in which the modern end-of-life doula movement is emerging — helping people and their support networks reconnect with dying as a meaningful part of life, and offering time, presence, and care that our institutions often cannot.
A brief history of the doula role
For most of history, birth and death have been intimately part of community life. Since prehistoric times, women have midwifed both beginnings and endings: birthing babies, caring for the sick, and preparing the dead. People were born at home, cared for at home when sick, and died at home. Tending to these profound transitions — birth, illness, dying — was primarily women’s work: mothers, daughters, sisters, neighbours, and close friends. This labour was embodied, intimate, and woven into daily life. Death was not hidden; it was part of the cycle of life in which families, chosen families, friends, and communities participated fully.
Over the past two centuries, however, industrialisation and medicalisation transformed both birth and death. Birth was moved from the hands of women and midwives to the male-dominated domain of hospitals. Death too was moved from the bedroom to the hospital ward, from the kitchen table to the funeral parlour. What was once women’s knowledge — caring for bodies in labour, tending the dying, washing the dead — became increasingly clinical, institutional, and managed by new professional industries, often disconnected from families, chosen families, friends, and communities. This shift has left many people today feeling unsure, afraid, or unprepared for death.
This shift represents more than improving hygiene or public health; it’s a story of cultural disconnection and control. The medicalisation of birth and death positioned them as clinical events overseen by professionals (predominantly men at first), rather than experiences held by families, chosen families, friends, and communities. We became disconnected from death and from the practices that once helped us attend to it with familiarity and meaning.
The birth doula movement emerged in the United States in the 1960s as a response to this shift: a reclaiming of women’s wisdom and presence around childbirth, recognising that birth was more than a medical procedure — it is an emotional, spiritual, and deeply personal event. The word “doula” is commonly translated as “a woman who serves,” but it derives from the Ancient Greek word meaning an enslaved woman. Medical anthropologist Dana Raphael coined the word “doula” to describe childbirth attendants, and it stuck.
The end-of-life doula movement follows a similar trajectory. Many of us see this work as part of the same reclamation, acknowledging that death, too, is more than a medical or logistical problem to be solved. Death is a natural transition deserving of care that attends not only to bodies, but to emotions, relationships, stories, and spirit.
Importantly, this is not about rejecting medicine, but recognising that dying is more than a medical process. The end-of-life doula role is to provide support that complements clinical care, tending to emotional, practical, and spiritual needs, and helping create space for connection and meaning.
While this work was traditionally carried out by women, today the field is diverse, with people of all genders engaging in this care, bringing their unique gifts, compassion, and presence to the role.
What does an end-of-life doula do?
At its heart, an end-of-life doula offers presence, continuity, and holistic support, tending to emotional, practical, relational, and, where appropriate, spiritual needs as someone approaches death.
This care can unfold over weeks or months, not just in the final hours, and can benefit both the person who is dying and their loved ones, whether family members, partners, chosen family, close friends, or carers. The bonds we form with companion animals are also recognised and honoured as part of this holistic approach.
Some of the ways an end-of-life doula might support individuals, families, or organisations include:
Emotional support
A doula offers a calm, compassionate presence during what can be an overwhelming time. We listen without judgment, holding space for people to express their fears, sadness, anger, joy, regret, and love — whatever emerges.
Sometimes people want to reflect on the meaning of their lives; at other times, they want to discuss their daily life, memories, or the people and companion animals they love. The presence of someone who is not rushing, not distressed, and not part of the immediate support network can help bring calm and a sense of grounding.
Education and information
Doulas help people understand what the dying process looks and feels like. For many, this is a time of great uncertainty. We can explain what physical changes may occur, what signs may signal the body nearing death, and what families can expect in the final days and hours, all in plain, accessible language. This can reduce fear and help everyone feel better prepared and less helpless.
Advance planning and communication
An end-of-life doula can assist individuals to explore their values and wishes and help articulate them clearly, whether about medical care, funeral preferences, memorial ceremonies, or what kind of atmosphere they want in their final days. This includes conversations about beloved pets and their care arrangements, as well as how friends might want to be involved in the process.
Many people feel overwhelmed by advance care directives and paperwork, and a doula can offer gentle support in navigating these decisions and communicating them with loved ones, chosen family, and close friends.
Legacy and life review work
Legacy work is about helping people reflect on and share what has been important in their lives. This could include recording stories, writing letters to friends and family, creating memory boxes, gathering photographs of meaningful relationships and beloved pets, or other personal projects. This work can be deeply meaningful for both the dying person and their support network, offering a sense of continuity, expression, and love.
Practical planning and guidance
End-of-life doulas do not provide legal or financial advice. However, a doula can guide people towards resources they may need and help organise what is within their control: preparing the environment for comfort, creating a vigil plan, arranging care for companion animals, or assisting with home vigils and after-death care.
Vigil support
Many support networks want to keep vigil as death approaches, but they may feel anxious or unsure of what to do. An end-of-life doula can help create an environment that feels peaceful, sacred, and supportive, whether that involves candles, music, prayer, quiet companionship, or simply being present.
We can also help coordinate shifts among family members, friends, and chosen family, ensuring everyone can participate meaningfully while also taking breaks and caring for themselves. This includes helping arrange temporary care for pets during intensive vigil periods and supporting the inclusion of beloved animals in farewell rituals when appropriate.
After-death care and rituals
After death, some people want to spend time with the body or provide gentle care before the funeral director arrives. An end-of-life doula can support these wishes, helping loved ones wash, dress, and prepare the body if desired, and offer guidance on the time they may have before the body is collected. This can be a profoundly healing experience, allowing family, friends, and chosen family to participate in meaningful acts of farewell.
We can also support rituals that honour the person’s relationship with beloved pets, whether that involves allowing pets to say goodbye or creating memorial practices that acknowledge these important bonds. Friends who may not be considered immediate family can also be supported in creating their own meaningful farewell rituals.
Bereavement support
The doula’s role can continue after death, offering listening, presence, and connection during early bereavement. While an end-of-life doula does not replace formal grief counselling, many people appreciate having someone familiar available for informal support in the days and weeks following a death.
This support recognises that grief affects everyone differently — partners, family members, friends, chosen family, and even beloved pets who may be struggling with the loss of their human companion. The grief experienced by close friends, who may not have formal recognition in funeral processes, is particularly important to acknowledge and support.
Support for carers and families
The needs of caregivers, family members, friends, and chosen family members are sometimes overlooked in busy healthcare systems. Doulas provide reassurance, education, resources, and space for everyone in the support network to express their emotions and concerns, and encourage them to care for themselves as they accompany their loved one. This includes recognising that close friends often provide significant care and emotional support, and their needs deserve equal attention and respect.
Support for aged care facilities and organisations
End-of-life doulas can also provide non-medical, compassionate care within aged care settings, supporting staff, residents, and their support networks during dying and death. An end-of-life doula can help residents prepare for death, offer presence and comfort when family or friends may not be available, and support facility staff who are often overextended.
Community education and outreach
Beyond individual support, many doulas also contribute to community education about death and dying. We run death cafes, facilitate Dying to Know Day events, deliver community talks, and appear at events such as Ageing Well expos and conferences. This broader educational role helps normalise conversations about death and empowers communities with knowledge and resources.
This broad range of care speaks to why individuals, families, chosen families, friends, and organisations might engage a doula:
- For reassurance when facing the unknown
- To reduce fear and confusion
- To provide presence and calm when professional care teams are stretched
- To offer emotional and practical support that helps everyone feel more prepared, connected, and cared for
To make dying a more personal, relational, and meaningful experience, not something that happens only in clinical settings, but something that families, communities, and individuals can approach with greater confidence and compassion
When might someone hire an end-of-life doula?
People seek end-of-life doula support for many different reasons and at various stages of living and the dying process. Understanding when this support might be most helpful can guide individuals, families, and organisations in making informed decisions about care.
At the time of terminal diagnosis
Many people engage an end-of-life doula soon after receiving a terminal diagnosis. This early connection allows time to build trust, explore values and wishes, and begin meaningful conversations about end-of-life preferences. Working with a doula from this stage can help reduce anxiety and provide a sense of agency and preparation.
Early engagement also allows time for advance care planning, legacy work, and relationship building between the doula and the broader support network, including family, chosen family, close friends, and beloved companion animals.
When planning ahead while healthy
End-of-life doulas can also support people who are not currently facing a life-limiting illness but who want to plan ahead with intention and care. A healthy person might engage a doula to help explore and document their preferences around future care, dying, death, and memorialisation — for example, through advance care planning, values clarification, life legacy work, and funeral wishes.
This proactive approach enables individuals to express their desires clearly to loved ones, thereby reducing confusion and stress in the future. It can also serve as an opportunity for reflection and legacy work, allowing individuals to think deeply about what matters most while they are well.
When facing uncertainty about the dying process
For many people, death remains a mystery. They may feel overwhelmed by questions: What will it feel like? How long might it take? What should we expect? How can we help? An end-of-life doula can provide education, reassurance, and practical guidance that helps everyone feel more prepared and less anxious.
This support is particularly valuable for families who haven’t experienced death before, or those who feel disconnected from cultural or religious traditions that once provided guidance around dying.
When family dynamics are complex
Not all families are close, and not all support networks are straightforward. Sometimes there are tensions, geographical distances, or complicated relationships that make dying more challenging. An end-of-life doula can provide neutral, compassionate support that helps navigate these complexities.
This includes situations where close friends play a significant caring role but may not be recognised in formal healthcare settings, or where chosen family structures need additional support and advocacy.
When caregivers are overwhelmed
Caring for someone who is dying can be physically, emotionally, and mentally exhausting. Family members, partners, and friends may feel stretched beyond their capacity, unsure of how to provide the right kind of support, or worried about making mistakes.
A doula can offer respite, guidance, and reassurance, helping caregivers feel more confident and supported. This is especially important when professional care services are limited or when people want to die at home but feel unprepared for what that involves.
When someone wants to die at home
While many people express a preference for dying at home, this can feel daunting without proper support. An end-of-life doula can help families understand what home dying involves, how to create a comfortable environment, and how to coordinate care with medical professionals.
This support extends to practical considerations, such as vigil planning, after-death care, and ensuring that beloved pets are cared for during intensive periods of caregiving.
When spiritual or emotional support is needed
Dying often brings up profound questions about meaning, purpose, regret, and legacy. Not everyone has access to chaplains, counsellors, or spiritual advisors, and some people prefer non-religious support for these deep conversations.
An end-of-life doula can provide a space for reflection, life review, and meaning-making that complements, but doesn’t replace, formal spiritual or psychological care.
When there’s limited family support
Some people face death with minimal family support, either due to family breakdown, geographical distance, or having outlived their generation. In these circumstances, an end-of-life doula can provide crucial companionship, advocacy, and practical support.
This is particularly relevant in aged care settings, where residents may have limited visitors or where family members live far away and cannot provide a consistent presence.
When professional services are stretched
Australia’s healthcare system is under increasing pressure, with palliative care services often overextended. While doulas don’t replace medical care, they can provide the time, presence, and personalised attention that busy healthcare teams may not be able to offer.
This complementary support can help people feel more cared for and less alone during a vulnerable time.
When someone wants a more personalised approach
Some people want their dying experience to reflect their values, preferences, and personality rather than being managed entirely by institutional processes. An end-of-life doula can help create a more personalised approach to dying that honours individual wishes while working within medical and legal requirements.
This might include supporting particular cultural practices, honouring relationships with companion animals, or creating meaningful rituals and ceremonies.
For organisations seeking to enhance care
Aged care facilities, hospitals, and community organisations increasingly recognise the value of holistic end-of-life support. Engaging doulas can help these organisations provide more compassionate, person-centred care while supporting staff who may feel overwhelmed by the emotional demands of their work.
The importance of timing
While end-of-life doulas can provide valuable support at any stage, earlier engagement often allows for more comprehensive care. However, it’s never too late to seek support. Even in the final days or hours, a doula can provide meaningful presence and guidance.
The key is recognising that death is a process, not just an event, and that support during this process can make a profound difference to everyone involved: the person who is dying, their support network, and even their beloved companion animals who may be struggling with the changes in their human’s condition.
Whether someone is facing their own mortality, supporting a loved one, or working within an organisation that cares for dying people, an end-of-life doula can offer the presence, knowledge, and compassion that makes this universal human experience more manageable, meaningful, and connected.
What an end-of-life doula does not do
It’s important to be clear about what an end-of-life doula is not.
We do not provide:
- Medical care or advice: We work alongside healthcare professionals, but we don’t administer medications or make medical decisions.
- Legal or financial advice: We can point people to the right resources, but we do not act as legal representatives or financial planners.
- Replacement for family or community: Our role is to accompany, to supplement, not replace, the natural networks of care where they exist.
This boundary is vital: doulas complement clinical and professional services, but we do not replace them.
The doula landscape in Australia
In Australia, the end-of-life doula movement is still relatively new, but it is growing rapidly and emerging at a critical time. With demographic shifts creating unprecedented demand for end-of-life care, our healthcare institutions are struggling to provide the support that many people need during their final months and weeks. End-of-life doulas can help fill some of these gaps by providing time, presence, and personalised care that complements, but does not replace, medical and institutional services.
I trained with Preparing the Way, Australia’s leading end-of-life doula training organisation. Preparing the Way is at the forefront of building and shaping what many of us affectionately call the ‘doulaverse’, the developing professional landscape of this work. Preparing the Way is unique in offering accredited training, including Australia’s only nationally accredited Certificate IV in End of Life Doula Services.
Preparing the Way’s founder, along with its partners and graduates, established Holistic End of Life and Death Care Australia (HELD), an emerging peak body dedicated to supporting and promoting professional holistic end-of-life and death care practice. HELD advocates for quality standards, ongoing review, education, ethics, and support for all holistic end-of-life and deathcare practitioners.
Currently, most end-of-life doulas operate in private practice. We are generally engaged directly by individuals or their support networks seeking non-medical support. While doulas are not yet commonly employed by hospitals or aged care facilities in Australia, some organisations have begun engaging doulas, and a few progressive funeral homes have also partnered with doulas to offer more holistic care to families and their support networks.
At the same time, we’re seeing an increasing level of advocacy and interest in the media, government, and broader healthcare sectors. As awareness grows, end-of-life doulas are beginning to be recognised as valuable contributors to a more compassionate, holistic, and person-centred approach to death and dying.
While this work has deep historical roots in women’s care, the Australian doula community is diverse today. People of all sexes and genders bring their compassion, presence, and skills to this field, reflecting the universal importance of care at the end of life.
What to look for in an end-of-life doula
Because this work is unregulated in Australia, doulas differ widely in training, experience, nd approach. It is worth taking the time to find someone who is the right fit for you.
Here are some questions to consider:
Training and experience: Where did they receive their training? How long have they been practising? Do they engage in ongoing professional development?
Approach and philosophy: Does their style resonate with your needs and values? Some doulas focus on planning and education; others on vigil work, bereavement support, or after-death care. Not all doulas do all things.
Specialisation: What areas do they focus on? For example, some doulas may prefer not to offer hands-on body care, while others are very comfortable providing that support. Some may have experience supporting people with diverse family structures or companion animals.
Boundaries and ethics: Are they clear about their role and limitations? Do they work collaboratively and respectfully alongside other professionals?
Insurance: Do they carry professional indemnity and public liability insurance? This can reflect a commitment to professional standards and may provide additional peace of mind.
Memberships and affiliations: Are they connected to any organisations? This can reflect a commitment to ethical standards and community of practice.
Presence and empathy: How do you feel in their presence? Can you imagine yourself, your support network, or your organisation feeling supported by them?
References or testimonials: If you’re unsure, ask for testimonials from previous clients or organisations they have supported.
Cultural sensitivity: Do they demonstrate understanding and respect for diverse family structures, cultural backgrounds, definitions of family, and the full spectrum of meaningful relationships, including close friendships and bonds with companion animals?
Ultimately, the most important thing is the relationship. A doula’s skill and experience matter, but so does trust, rapport, and the sense that this is the right person to accompany you and your support network.
Want to know more?
If you are curious about what an end-of-life doula can you, someone close to you, or your organisation, I would be honoured to have a conversation.
Whether you need someone to sit quietly and hold space, help navigate advance care planning, or be a companion in the final days, I am here to help.
Learn more about my End-of-Life Doula Services in Melbourne and online, and how I can support you through life’s most tender transitions.