Everybody dies, but it seems like most people don’t want to talk about it. And since many have never experienced the dying process, it can be tough to know how to plan or what to expect when you or a loved one gets closer to death. Fortunately, there is an entire professional community dedicated to death and dying whose members aim to open the conversation and ease the process.

What is a death doula?

Death doulas, also called end-of-life doulas or death midwives, are non-medical professionals who provide care before, during and after death, much like how birth doulas or birth midwives care for a person throughout the birthing process. This care can include physical, emotional, spiritual and practical support to individuals and their loved ones, which can span weeks, months or years.

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Death doulas guide a person in planning and carrying out personal needs, beliefs and desires, while empowering involved decision-making. They aim to demystify the dying process by teaching what signs to expect in the final days or by validating emotions. They can even become trusted companions in the end, holding a person’s hand at their bedside or providing relaxation techniques to ease distress.

Death doulas come from all different walks of life. Often, personal experiences with dying family members or loved ones can lead someone to the profession, as was the case for Jenafor Ryane.

"My wish for folks is that their death is just like an extension of their life and what mattered most for them."

– Jenafor Ryane

Becoming a death doula

Ryane began her death doula journey after her father died from a terminal illness in 2011. She had never witnessed the dying process before and did not know what to do or what to expect. By the end, the first-time caregiver hungered for a better experience. “I just knew it could have been more meaningful, more intimate and more connected,” she says.

Jenafor Ryane, photo courtesy of J. Ryane.

But during her grandmother’s death a few years later, a care professional was able to teach and guide Ryane’s family through the process, showing that death can indeed be accompanied by more positivity.

These familial experiences inspired her to turn death care into a passion and to do her part to improve the dying process for others, and so, she sought formal doula training. In 2018, she graduated from the Conscious Dying Institute’s Sacred Passage: End of Life Doula Certificate Program.

Since graduating, she has worked as a death doula and a trained yoga and mindfulness instructor in Victoria, using her knowledge to offer comfort and ease stress for her clients and their loved ones.

“My wish for folks is that their death is just like an extension of their life and what mattered most for them,” she says. “It is an amazing opportunity, but it takes courage and support.”

The top three ways death doulas can help

There are many ways death doulas can help in the end-of-life process. Though all doulas come with their own sets of skills and training, many share basic care objectives.

Here, Ryane offers the top ways death doulas like her can serve in the dying process:

1. Creating an advanced care plan

A death doula can help create and document an advanced care plan, which helps you consider your beliefs, values and wishes to shape your future medical care. Doulas can guide you through a precise timeline of the process to ensure you have everything in order.

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“[Creating an advanced care plan] might be even more important for someone who has had a diagnosis of dementia because we know that cognitive decline can be expected with that type of diagnosis,” says Ryane.

“It’s important to communicate what you want as soon as possible; the best time to make your plans is when you're healthy and the second best time is right now.”

Often, care plans include:

• Where you want to die.
• What you want to hear, smell, see or taste.
• Therapies you’d like to explore (massage, counseling, acupuncture, pet therapy, music therapy, art therapy, etc.).
• Who you would like with you.
• Your estate plans.
• Whether to have a funeral or memorial.
• Whether to be cremated or buried.

2. Providing end-of-life support

“If you are caregiving to someone who's dying, and you've never been with someone who's dying before, it can be really scary to not know what to expect,” Ryane says.

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A death doula can help guide you through the process, whether in the last months, weeks, days or hours of a person’s life.

Support can include:

• Acting as a liaison between your medical health-care team and helping to navigate the system.
• Advocating for you in getting the resources needed.
• Offering respite for loved ones and care partners by sitting at the bedside and spending time.
• Providing comfort care to reduce anxiety, fear or pain, such as yoga, mindfulness or meditation.
• Teaching what to expect during the active dying stages.
• Planning ceremonies or end-of-life rituals and helping to administer them after death, including washing, dressing or blessing the body.

3. Expanding education and conversation

Death doulas aim to provide a more meaningful and positive experience with death by normalizing and de-institutionalizing the process.

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“The topic of death has been relegated to the shadows, resulting in stigma and fear," Ryane says. "We've given it to others outside our families and communities to deal with. Death doulas seek to empower folks to reclaim death, to not miss out on this sacred part of life."

They do this by:

• Creating a space to talk freely about death and dying without judgment.
• Hosting events to share experiences, thoughts, fears and philosophies about death.
• Offering safety and comfort in the conversation.
• Teaching that there are many ways to cope with death.

“We can find meaning and depth at the end of life,” Ryane says. “There are often tears, but also belly laughs and moments of joy — and there can be so much love.”