Death Doulas and Healthcare: How We Can Work Together for Better End-of-Life Care
At a Glance
Healthcare professionals spend years learning how to diagnose illness, provide treatment, and save lives. They carry an incredible responsibility, and most do so with deep compassion and dedication. Yet many receive little to no education or guidance about how to talk with patients and families about dying, even though it is such an important part of care. Death doulas can help fill some of those gaps, without replacing doctors, nurses, social workers, chaplains, hospice, or palliative care. When death doulas and healthcare professionals work together, families can receive more time, education, preparation, and emotional support as they navigate serious illness and the end of life.
• Death doulas can complement the care healthcare professionals already provide.
• Honest conversations about prognosis can give families valuable time to prepare.
• Quality of life deserves a place alongside discussions about treatment and longevity.
• Earlier collaboration can help families understand their options before a crisis.
A Doctor Who Knew How to Save Lives, But Not How to Talk About Death
I once met a resident physician who told me something I have heard from many healthcare professionals: He knew how to save lives and how to diagnose and treat disease. But when it came to talking with patients and families about death, he felt unprepared. He cared deeply about his patients but had not been given enough education or experience to feel comfortable having those conversations. This is one of the major gaps I see in end-of-life care.
Healthcare professionals do extraordinary work. They diagnose disease, manage symptoms, perform procedures, and help people live longer. But death is also part of healthcare, and preparing patients and families for it deserves our attention.
Why Is Death So Difficult to Talk About in Healthcare?
Healthcare is largely built around treating illness and extending life. That makes sense. We want our doctors and nurses to help us get better when they can. But there comes a point when the questions need to change. Instead of only asking, "What else can we do?" We may also need to ask: What is this treatment likely to accomplish? What will recovery look like? How might this affect quality of life? What matters most to this person now? What happens if we choose not to pursue another treatment?
Those conversations require time. Yet many healthcare professionals are working with large caseloads, documentation requirements, limited appointment times, and constant demands for their attention. Death doulas can help provide some of the time and support that the healthcare system may struggle to provide.
When More Treatment May Not Mean Better Care
I once worked with a man in his late 60s who had been on dialysis for years. His quality of life had declined significantly. His doctor told the family they could try another procedure that might give him another month or two. But there was another question worth asking: What would those extra months look like? Would he be comfortable? Would he be able to spend meaningful time with his family? Would the treatment require more hospital visits, procedures, pain, or recovery?
Some people will want every possible treatment available. Others may decide that being comfortable and spending time at home is more important. What matters is that patients and families understand their options clearly enough to make decisions that reflect what they value most.
What Families Lose When We Avoid Talking About Death
When we avoid talking honestly about dying, families can lose something they cannot get back: time. If a family understands that someone may have weeks rather than months, they can make different choices. They may call a sibling who lives across the country or may ask questions they have been putting off. They may make funeral arrangements or simply just sit together. Honest information does not remove grief. It gives people an opportunity to prepare for what is happening.
Where Death Doulas Can Help
Death doulas provide non-medical support to people who are dying and to their families. That support can look different for every family. It may include helping someone think through end-of-life wishes, explaining what families might see during the dying process, sitting vigil, providing emotional support, helping with practical planning, or simply being present when everyone feels overwhelmed.
A death doula may also have something healthcare professionals often do not have enough of: time. A physician may have another patient waiting. A nurse may be responsible for several people. A social worker may have a large caseload. A death doula can often sit with a family longer, answer questions, listen to fears, and help them process information they have already received from the medical team.
Death Doulas Should Complement Healthcare, Not Replace It
Death doulas are not doctors. We are not nurses, social workers, chaplains, hospice providers, or therapists. We should not try to replace them. The opportunity is collaboration. A social worker brings expertise a death doula may not have. A chaplain provides spiritual care. Nurses and physicians provide medical care. Hospice brings an interdisciplinary team and specialized end-of-life support. Death doulas can add another layer of support around that existing care. The goal should be to recognize what each professional does well and make it easier for families to receive the right support at the right time.
What Could Working Together Look Like?
Better collaboration does not have to mean adding death doulas to hospital staff. A physician, nurse, social worker, or hospice professional could tell a family, "You may also want to consider working with a death doula." Death doulas can develop relationships with healthcare professionals in their communities so providers understand what they do and when a referral might help. Ideally, that introduction happens before someone is actively dying. Waiting until the final days limits what families can do with the support available to them. Earlier conversations allow more time for planning, questions, decision-making, and emotional preparation.
Questions You Can Ask When Someone You Love Is Seriously Ill
You do not have to wait for a healthcare professional to begin difficult conversations. If someone you love is facing serious illness or declining health, consider asking:
• What is the goal of this treatment?
• What could happen if we decide not to pursue it?
• What might quality of life look like with and without treatment?
• What changes should we expect as the illness progresses?
• Is it time to discuss palliative care or hospice?
• What non-medical support is available for the patient and family?
• Is there anything we should be preparing for now?
You deserve clear information. Asking questions is one way to get it.
Better End-of-Life Care Requires More Than One Profession
That resident doctor I met is a reminder that doctors and nurses should not have to carry every part of dying and death. Neither should social workers, chaplains, hospice professionals, caregivers, or death doulas. We each bring something different. When healthcare and death care professionals understand one another's roles and work together, families have access to more support. And when someone is approaching the end of life, that support can give them something important: more information, more choices, and more time to decide what matters to them.
Links/Resources
• Guest: Kacie Gikonyo, Death Doula Kacie - https://deathdoulakacie.com/
• LaborOut Conference - https://deathdoulakacie.com/laborout
• Laboring Out of Life by Kacie Gikonyo https://deathdoulakacie.com/
• Host: Traci Arieli, Comforting Closure - https://www.comfortingclosure.com
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