Living On: What Death Doulas Do and Why Their Role Matters

Traci Arieli
Sep 25
4 min read

Updated: Sep 26

I didn’t always understand how important it was to talk about death or the people we’ve lost. When my cousin Heather died by suicide, I was devastated. I had spoken to her just two nights before, and did not realize she was in pain. After she died, no one in our family spoke about her. It was as if it was too painful to let her live on, even metaphorically.

Years passed, and I saw that remembering Heather did not mean grasping onto the pain. I chose to include her in my life because she still mattered to me.

That sense of reassurance, that it was okay to still have a relationship with Heather even after she was gone, made me feel immensely more at peace. It helped me understand what so many people need at the end of life and in grief: permission, presence, and a way to stay connected. That realization is part of what led me to become a death doula.

What Is a Death Doula, Exactly? What Do Death Doulas Do?

You’ve probably heard of a birth doula; someone who offers support during a birth. A death doula offers something similar at the other end of the spectrum; compassionate, non-medical support for individuals and their loved ones as they approach the end of life.

Death doulas are there to walk alongside people, not to fix or cure, but to be present. We hold space for the emotional, spiritual, and practical needs that come with dying - things that often go beyond what medical professionals can provide.

Every death is different, just like every life. Some people want help navigating fear. Others want help planning a vigil, organizing their affairs, or simply making meaning of their final days. Families very often need reassurance, a calming presence, and someone to witness the experience with them. That’s where a death doula comes in.

What Are the Duties of a Death Doula?

The duties of a death doula depend on the needs of the individual and their loved ones. At the heart of it, we’re there to support the dying and those who care for them. Some of the practical tasks might include helping with advance care planning, creating legacy projects, or walking someone through what to expect in the final days. We might help coordinate a vigil, offer comfort during the active dying process, or simply sit in silence so no one feels alone.

Often, our work is deeply emotional and spiritual. A death doula might help someone talk through their fears, explore what brings them peace, or create rituals that feel meaningful to them. We help families hold space for grief as it unfolds, even before death occurs. Ultimately, our role is to meet people where they are, offering presence, not pressure. Sometimes that means listening to stories. Sometimes it means bearing witness to tears. And sometimes it means holding a hand through the night.

What Qualifications Do You Need to Be a Death Doula?

There’s no single path to becoming a death doula, and that’s part of what makes this work so personal. Most doulas go through some kind of training. Personally, I don’t know a single doula who hasn’t. Many of us also choose to become NEDA-proficient, a designation earned through the National End-of-Life Doula Alliance, which involves passing an assessment to demonstrate core knowledge and competency.

But no training program alone can prepare someone for this work. Every doula I know carries a story: a moment of loss or a transformative bedside experience. And the majority of us feel this is a calling that we couldn’t ignore. It’s that blend of education and experience that shapes a death doula into someone who can show up with calm, clarity, and compassion when it matters most.

Will Insurance Cover a Death Doula?

Since our role is non-medical, we are not covered by Medicare or private health insurance plans. We are paid directly by individuals or families, and fees vary depending on location, scope of services, and length of involvement. Many doulas also offer sliding scale options or are open to conversations around affordability. While it’s an out-of-pocket expense, families describe it as one of the most meaningful investments they made during a profoundly difficult time.

I became a death doula because I never want anyone to feel the silence my family did after Heather died. We didn’t know how to talk about our grief, so we didn’t, and in doing so, we lost her all over again. What I’ve learned since then is that remembering matters. Saying someone’s name matters. Being present, even when we don’t have answers, matters.

As a death doula, I offer the kind of support I wish we’d had. Gentle, honest, and rooted in the belief that every life deserves to be honored, in dying, and in remembering.