How to Become a Death Doula by Barbara Karnes, RN

How to Become a Death Doula

 Examine why you want to be a Death Midwife. What is bringing you to this area? If it is because you want to share your religious beliefs with others then this is not the area for you. People as they approach the end of their life...

 

Dear Barbara, How do you start training in becoming a death midwife?

1. Examine why you want to be a Death Midwife. What is bringing you to this area? If it is because you want to share your religious beliefs with others then this is not the area for you. People as they approach the end of their life generally bring with them the beliefs they have spent a lifetime believing. If you have had a recent death of someone close to you, wait at least a year. Your personal wound is too fresh and each death you experience will stir your own pain. If you are frustrated with the current way end of life is being addressed--welcome. You will have found a place to help us grow.

2. Explore your personal belief system and your life challenges that have made you who you are. What do you think happens when death occurs? Do you believe in a life after death? Is death a failure, the enemy, or a natural part of living? What was your first experience with death? You bring your personal beliefs, true and false, to the bedside. Unless you understand your personal experiences and how they have affected who you are that part of your personality will taint and possibly affect your work with others.

3. Explore all religious beliefs. Get a basic understanding of world religions so you can support all beliefs as you guide a person and their family through their end of life experience. Read the Tibetan Book of the Dead to give yourself an esoteric prospective.

4. Educate yourself in as much information about the dying process as you can find. Explore what physically happens as death approaches, the signs of approaching death. What are the emotional aspects that surface as death nears? Learn about the natural way people die. You need to know how the body and mind unfolds as it approaches death from disease or old age. You need to understand the basics of pain and comfort management, nutrition, bowel/urine care and skin care.

5. More education, this time about communication skills, active listening, problem solving techniques, and people skills. Just because we can’t heal a physical body doesn’t mean that healing isn’t done. We have the opportunity to heal the emotional, mental, and spiritual parts of a person (using their spiritual beliefs, not ours).

6. Learn about your city and state laws and regulations regarding a death at home, funerals, cremation. Do you need to call a coroner? What are funeral home protocols? Learn about cremation procedures, burying in cemeteries, in the ground, in vaults, in mausoleums, home funerals? Families will use you as a resource for information they do not have.

7. You need to be a person who is comfortable improvising, thinking on your feet, making impromptu decisions, a quiet leader, a good listener, comfortable with silence, able to not have an answer, to be able to say “I don’t know”. You need to be invisible yet be the conductor that guides all the occupants of a room in a gentle rhythm. You need to have a life style that allows you to leave what you are doing at a moments notice (day or night), and to stay hours and hours. This is not a 9 to 5 job.

8. You need to create ways of taking care of yourself, to keep yourself balanced in work, play, sleep and eating. Find a ‘buddy”. Someone in this field who you can talk with at a moments notice. Someone who will help you debrief after a particularly hard experience. Create a closure ritual for yourself with each family and patient so you can move on to the next. Learn how to set limits.

These are a few of my thoughts on being a Death Midwife. There are several classes available for Death Midwives and End of Life Doulas. Just use our wonderful Google to search for and explore classes and what each offers.


Something More about How to Become a Death Doula: My work with end of life has been about education. All of my materials are aimed at showing the normal, natural way death comes to us all and how to live through that experience for ourselves or with someone else. I recently added You Need Care Too because we, professional caregivers face different challenges than many who work in the healthcare arena.

12 comments

Barbara

Hi Vivian, in response to your asking about end of life doula certification and more information: there are groups that offer training and their own certifications. Google would be the best bet to find them. Do your research as to which one best meets your needs. I have worked with Deanna Cochran of Quality of Life Care. https://www.qualityoflifecare.com. Check her out. She also collaborates with the National Hospice and Palliative Care Organization for her program. A good recommendation. My blessings are with you as you pursue this new service. Barbara

Hi Vivian, in response to your asking about end of life doula certification and more information: there are groups that offer training and their own certifications. Google would be the best bet to find them. Do your research as to which one best meets your needs. I have worked with Deanna Cochran of Quality of Life Care. https://www.qualityoflifecare.com. Check her out. She also collaborates with the National Hospice and Palliative Care Organization for her program. A good recommendation. My blessings are with you as you pursue this new service. Barbara

Vivian Luong

I recently retired after 29 yrs working as social wofker (bilingual English and vietnamese) . I like helping families during the time of passing. I am wondering if there is a certificate program or what the requirements would be to be able to offer this type of care. Thanks

I recently retired after 29 yrs working as social wofker (bilingual English and vietnamese) . I like helping families during the time of passing. I am wondering if there is a certificate program or what the requirements would be to be able to offer this type of care. Thanks

Barbara Karnes

Claudia, I’m afraid I have to disagree with you. Here is why: Dying is not a medical event. It is a social, communal event. We need people trained in end of life skills, not necessarily medical skills. In our academia, which is where all those with letters after their name come from, there is NOT extensive end of life skills taught. Someone training to be an End of Life Doula or EOL Midwife is specifically studying end of life—-not just the medical aspects of dying but all components. Working independently they have the time window to “be there” where RN’s working on the clock do not.

Claudia, I’m afraid I have to disagree with you. Here is why: Dying is not a medical event. It is a social, communal event. We need people trained in end of life skills, not necessarily medical skills. In our academia, which is where all those with letters after their name come from, there is NOT extensive end of life skills taught. Someone training to be an End of Life Doula or EOL Midwife is specifically studying end of life—-not just the medical aspects of dying but all components. Working independently they have the time window to “be there” where RN’s working on the clock do not.

Claudia

In my opinion I don’t see the need for yet another health care professional to be added to the arena. I would encourage any RN to get further education in this area since they have a license & can care for the dying within their scope of practice. Assignment to a Palliative Care unit, Hospice place, or Hospice at home would be a match that would be paid.
The public is I think, confused enough, with AD, BSN, MSN, ND, DNP, PhD, EdD, DNS, DSN that an RN might have without confusing them more. The term ‘midwife’ is known for ages & now includes advanced practice registered nurses (APRN). They also use the word ‘doula’.
I recommend business cards for ALL nurses, & information on checks since we are one of the most trusted professions there are. Lets keep that opinion by informing the public in the best way possible.

In my opinion I don’t see the need for yet another health care professional to be added to the arena. I would encourage any RN to get further education in this area since they have a license & can care for the dying within their scope of practice. Assignment to a Palliative Care unit, Hospice place, or Hospice at home would be a match that would be paid.
The public is I think, confused enough, with AD, BSN, MSN, ND, DNP, PhD, EdD, DNS, DSN that an RN might have without confusing them more. The term ‘midwife’ is known for ages & now includes advanced practice registered nurses (APRN). They also use the word ‘doula’.
I recommend business cards for ALL nurses, & information on checks since we are one of the most trusted professions there are. Lets keep that opinion by informing the public in the best way possible.

Pastor Betty Czubay, ELCA (my Lutheran denomination)

I recently retired after working as a nursing home chaplain for 20
years, and 8 years as a parish pastor. When I heard the term “death
doula”, I thought, “Why didn’t I think of that?” I have always looked
at death as the birth to eternal life, and every bit as joyful as our
human birth. Thank you for your wonderful material. I, my staff,
and families of residents have benefited greatly from them.

Best wishes to all death doulas.

I recently retired after working as a nursing home chaplain for 20
years, and 8 years as a parish pastor. When I heard the term “death
doula”, I thought, “Why didn’t I think of that?” I have always looked
at death as the birth to eternal life, and every bit as joyful as our
human birth. Thank you for your wonderful material. I, my staff,
and families of residents have benefited greatly from them.

Best wishes to all death doulas.

Barbara Karnes

Hi Joni, Deanna Cochran is an End of Life doula who offers training in that area. She would be able to answer your questions about how to make a career out of being an EOL doula.

Like a lot of areas in health care there is a need but no reimbursement avenues other than private pay. Hospices that have Eleventh Hour and Transition programs offer the opportunity although their training is not as comprehensive as I would like to see. There are residential care homes that are admitting only patient’s that are approaching the end of their life. EOL doulas would be a great addition to their staff.
Deanna Cochran http://www.qualityoflifecare.com/founder.html

Hi Joni, Deanna Cochran is an End of Life doula who offers training in that area. She would be able to answer your questions about how to make a career out of being an EOL doula.

Like a lot of areas in health care there is a need but no reimbursement avenues other than private pay. Hospices that have Eleventh Hour and Transition programs offer the opportunity although their training is not as comprehensive as I would like to see. There are residential care homes that are admitting only patient’s that are approaching the end of their life. EOL doulas would be a great addition to their staff.
Deanna Cochran http://www.qualityoflifecare.com/founder.html

Deb Peters

Dear Barbara, as a recently retired RN with a wide variety of experiences in our profession, and as wonderful as the freedom that retiring has afforded me , I find that I do miss ministering to my patients, families and staff. I have worked as a bedside nurse in hospitals, a triage nurse in ambulatory medicine, floor nurse in Surgery and Urology , a Director/Nurse in Hospice and lastly, retired as a DNS in SNFs where I had spent nearly 20 years.
Your topic this month immediately attracted and commanded my attention. The words you wrote really spoke to me, Barbara. I am not being vane, but I know that I was very successful in each of my positions and that I made a positive impact on the lives of the people that were recipients of my guidance and care. I believe that in the role of a Death Doula, I could contribute significantly to assist the dying person as well as their families and loved ones through the death experience.
I just want to thank you for addressing this extremely important topic that is an inevitable part of living for all of us.
Sincerely, Deb Peters, RN

Dear Barbara, as a recently retired RN with a wide variety of experiences in our profession, and as wonderful as the freedom that retiring has afforded me , I find that I do miss ministering to my patients, families and staff. I have worked as a bedside nurse in hospitals, a triage nurse in ambulatory medicine, floor nurse in Surgery and Urology , a Director/Nurse in Hospice and lastly, retired as a DNS in SNFs where I had spent nearly 20 years.
Your topic this month immediately attracted and commanded my attention. The words you wrote really spoke to me, Barbara. I am not being vane, but I know that I was very successful in each of my positions and that I made a positive impact on the lives of the people that were recipients of my guidance and care. I believe that in the role of a Death Doula, I could contribute significantly to assist the dying person as well as their families and loved ones through the death experience.
I just want to thank you for addressing this extremely important topic that is an inevitable part of living for all of us.
Sincerely, Deb Peters, RN

Cassandra Yonder

Check out BEyond Yonder Virtual School for Community Deathcaring in Canada www.deathcaring.ca

Various Midwifery Acts in Canada prohibit the use of the title and terminology around midwifery since it is a licensed profession and several Canadians who have called themselves “death midwives” have been asked to cease and desist by the colleges.

We are a grassroots movement with “community deathcare practitioners” who facilitate the cultural reclamation of community centered deathcaring in a multitude of ways as both volunteers and paid service providers.

Without any governing bodies, we are unregulated. The mission is to remember that we are all capable to take a more participatory role in caring for our dying, dead and bereaved.

Check out BEyond Yonder Virtual School for Community Deathcaring in Canada www.deathcaring.ca

Various Midwifery Acts in Canada prohibit the use of the title and terminology around midwifery since it is a licensed profession and several Canadians who have called themselves “death midwives” have been asked to cease and desist by the colleges.

We are a grassroots movement with “community deathcare practitioners” who facilitate the cultural reclamation of community centered deathcaring in a multitude of ways as both volunteers and paid service providers.

Without any governing bodies, we are unregulated. The mission is to remember that we are all capable to take a more participatory role in caring for our dying, dead and bereaved.

Annette

I’m not a nurse, I have no college degree, but have been providing full hands on in home care and especially Hospice care since 2004. Hospice has always been where my heart is. Ive begun considering honing my focus to be solely on Hospice care and especially as a doula for the dying. I’m wondering if there is a certificate program, or what the requirements would be to be able to offer this type of care.

I’m not a nurse, I have no college degree, but have been providing full hands on in home care and especially Hospice care since 2004. Hospice has always been where my heart is. Ive begun considering honing my focus to be solely on Hospice care and especially as a doula for the dying. I’m wondering if there is a certificate program, or what the requirements would be to be able to offer this type of care.

Melinda Rodriguez

I’m a hospice worker an I like helping families during the time of passing

I’m a hospice worker an I like helping families during the time of passing

Meg Baer

Dear Barbara: This was one of the best questions and replies in my experience with you. I wasn’t aware of the terms “Death Midwife” or Doula. I’ve been doing hospice care since 1988 with limited resources until I became familiar with your work. All I had to go on was my nursing background and my own experience and research. Thanks .

Dear Barbara: This was one of the best questions and replies in my experience with you. I wasn’t aware of the terms “Death Midwife” or Doula. I’ve been doing hospice care since 1988 with limited resources until I became familiar with your work. All I had to go on was my nursing background and my own experience and research. Thanks .

Joni Martin

Thanks for posting. I am an RN and I have been considering certification through End of Life Doulas and am wondering if this is still mostly voluntary or if people are able to create a career out of it.

Thanks for posting. I am an RN and I have been considering certification through End of Life Doulas and am wondering if this is still mostly voluntary or if people are able to create a career out of it.

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