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End-of-life doulas on rise as people seek greater emotional support amid grief, death and dying

Reprint from ABC

After losing her son to suicide six years ago, Kate Slatter thought she knew how to handle the most complex grief.

But it was after the sudden death of another close family member that she found herself overwhelmed.

"In a way, I thought I would know what to do," she said.

"But every experience is different, and I was surprised to find that I didn't really know what to do as well as I thought I did."

How death doulas are making end of life care more accessible(NewcastleCast)

To help Ms Slatter cope, a relative suggested she employ an end-of-life doula to help plan the memorial.

But the doula ended up playing a much bigger role in supporting the whole family.

"They met with all of us on different days, stayed as long as we needed her to and was really empathetic and kind and warm," she said. 

"I hadn't really thought about the emotional support you could get from a doula.

"I think that's something a lot of people might not think of."

What is an end-of-life doula?

Similar to birth doulas who help women as they prepare to have a baby, an end-of-life doula offers non-medical support to a person and their loved ones before and after death.

Doula Kylie Gangemi said she covers a spectrum of services that spans emotional support and companionship to advocacy and even celebrant duties.

Kylie Gangemi has been working as an end-of-life doula in the Hunter region since 2022.(ABC Newcastle: Laurise Dickson)

"I assist families with practical care, like organising services, but I can also provide them with spiritual support and grief education," she said.

"I've got that suitcase with all the options for people, so they have an end-of-life experience that's meaningful and authentic to who they are."

Ms Gangemi was the first recipient of a Certificate IV in End of Life Doula Services, which is currently the only government accredited course for end-of-life doulas in Australia.

The qualification is provided by Preparing the Way, a training organisation which established the course in 2022.

Catherine Hutton is the co-director of Preparing the Way, an organisation that provides end-of-life doula accreditation.(Supplied)

Eight students signed up in the first year of the course and 36 trainee doulas commenced the course in 2024.

Catherine Hutton is the co-director of Preparing the Way, an organisation that provides end-of-life doula accreditation.(Supplied)

"While the end-of-life doula role is non-medical, what this accreditation does is establish an industry benchmark," Preparing the Way co-director Catherine Hutton said.

"It gives doulas that recognition in the medical world."

Ms Hutton believes doulas can play a vital role as part of a multi-disciplinary health team for clients and families, especially in regional and rural communities.

"It's important that we work alongside palliative care and medical teams, particularly as the population ages," she said. 

"We also need to network with other doulas to fill that gap." 

Demand for end-of-life doulas 

Conversations around death and dying are shifting in Australia, with voluntary assisted dying now legal in all states, and palliative-care providers like BaptistCare trialling end-of-life care at home in the Hunter region.

Ms Gangemi has seen enough demand for her own services that she has launched a business which employs a team of end-of-life doulas from the Hunter and Central Coast regions. 

She said there was a need for alternative end-of-life services in the community, like home-based death care and sustainable green funerals, in addition to end-of-life doulas.

"More families want to have a say and take back control of death, and that's where holistic funeral directing is different," Ms Gangemi said.

"We encourage the family to lead and we're just in the background supporting them to explore their options and their choices."

Changing the way we think about death

For Ms Slatter, working with a doula has opened her eyes to the alternative options for end-of-life care.

"They allowed us the space for grief, which I didn't have in my previous experiences with funeral homes and structured services," she said.

"It was a really kind way to honour our person that I honestly didn't think was possible, and I certainly wouldn't have been able to do it alone." 

Kate Slatter says using an end-of-life doula has helped her process the grief of her loved one. (ABC Newcastle: Laurise Dickson)

Ms Slatter believes this experience has also helped her and her family process the death of their loved one.

"Our doula managed to wrangle a family with many different personalities and put something together that I didn't think was possible."

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Great article that answers many questions about end-of-life doulas. Great service.

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