Death Doulas and Hospice - What’s the Difference?
Death doulas and hospice providers both share a common interest - helping individuals and their loved ones through a vulnerable time of life, the end. While death doulas and hospice providers work well together, they play different roles and support their clients with different approaches.
What is hospice?
Hospice is a medical service with the focus on providing holistic care to individuals at the end of life. They are concerned about pain management and primarily focus on the client. Because it is a medical service, hospice care has certain criteria an individual must meet to be eligible, but can be paid for by insurance.
What is a death doula?
Death doulas have a wider view - they look at the surroundings of the client, the religion they follow, and their final wishes. We advocate for the client when they cannot ensure their values and preferences are respected.
How they differ
Family Support
Death doulas also have a strong focus on supporting the family. When needed, they mediate conversations between family members to help educate and support all members. It is very common for family members to feel a range of emotions like anger and frustration, even with each other. Sometimes this can lead to irrevocable things being said which could have lifelong, negative impacts on relationships. While some hospice agencies do offer social workers and education for families, death doulas can take a more hands-on approach.
Personal Care
Hospice providers and death doulas differ in how they provide hands-on care. Hospice is concerned with medication and pain relief, however, hospice aids are usually only there for an hour or so. Some agencies may have volunteers, however this can be inconsistent. Death doulas can spend as little or as much time as the client wants. Death doulas can be a nice complement to hospice services, and expand on the support given by the hospice agency.
When do they get involved?
While hospice providers are called when a person has less than six months to live, death doulas can work with anyone, at any time. Death doulas often support individuals who want to do advanced planning, whether they were recently diagnosed with a terminal illness, or simply want to ensure they are prepared for end of life. Many death doulas have connections with other agencies that can help through the end of life such as estate planners, home care providers, funeral homes, and religious leaders in the area. Death doulas can help you prepare for these conversations so you can feel confident and empowered to make your wishes known.
Additionally, death doulas can support individuals in leaving a legacy for their loved ones and planning for their final resting place. They can help to coordinate a burial or cremation, or even more unique final resting places, such as tree burials. Legacy projects can be valuable leave-behinds for families. A legacy project is a project that a dying person can create with the help of a death doula. These can look and be like recordings of sayings of your loved ones, making memory boards for your children to remember you by.
How they work together
Death doulas and hospice agencies can be utilized together. A death doula may be involved in initial conversations around end-of-life care, and even help to choose a hospice provider. A death doula can advocate to a hospice agency and help coordinate. Individuals in need of hospice care may also need home care or a community care setting. Death doulas can help navigate, research, and coordinate services.
Many people don't think about death and dying until it is too late - understandable, death and dying are uncomfortable topics that are often avoided in our society. However, with the help of a death doula, you can plan, have more control, and feel more comfortable in the final stages.
A hospice philosophy is “to have a good death”- meaning one that is pain-free, and with dignity. As a death doula I like to think of a saying “To have a good death, and what would you like to leave behind.” Whether you’re planning, or actively navigating end-of-life care, a death doula is a valuable addition to your support team.