Throughout history, humans have supported one another during death. The idea of a death doula as a profession is newer.
The Global Doula Project lists death doulas, or end-of-life doulas, as a service that emerged in the early 2000s. According to the International End-of-Life Doula Association, end-of-life doulas provide nonmedical support to individuals and loved ones as they navigate confronting mortality, death, and grief.
Dying is something we will all face, but grief, death, and dying are not always discussed. Some professionals and creatives are trying to change that.
Shoshana Ungerleider, MD, an internal medicine physician and a host and producer of Before We Go and the TED Health Podcasts, founded EndWell, which holds an annual conference bringing together a variety of professionals to explore end of life, caregiving, and grief.
Shows like Dying for Sex, a series about a woman with stage 4 breast cancer who goes on a journey to explore her sexual pleasure before she dies, offer more accurate depictions of hospice and dying. It’s based on the true story of Molly Kochan, who died from metastatic breast cancer in March 2019.
Even Nicole Kidman shared that she’s training to become a death doula after losing her mother in 2024.
Alua Arthur, founder of Going With Grace, a death doula training and end-of-life planning organization, and a New York Times bestselling author, spoke with Everyday Health about what death doulas do, how to find one, and why thinking about and planning for dying helps us live better.
Editor’s note: This interview has been edited for length and clarity.
Everyday Health: Who can death doulas help, and how?
Alua Arthur: People seek out death doulas at various stages in life. Some people come to a doula to do comprehensive end-of-life planning when they start to think about their mortality or when they want to start getting prepared. Sometimes it’s because they’re taking care of elderly parents, or they’re starting to see the mess that could be left behind and they want to avoid that for their own family members.
People also seek out a death doula to support them with any fears they have about dying or to help them work through their relationship with mortality overall.
EH: How does someone go about finding a death doula?
AA: A great place to start is with any death cafes or any death-focused organizations or spaces in your community. The internet is a spectacular place, too.
I run an organization called Going With Grace that trains death doulas, and we have a directory on our website. Anybody looking for a doula can pop onto the site, search by their location, and see if there’s a doula available for them.
EH: What criteria should people look for when choosing a death doula?
AA: First and foremost, you have to try to be clear about what you might want a death doula for. It’s fine to say, “Hey, my mom is dying, and we just need some additional support through the process,” because the doula should be able to ask significant questions to figure out the nature of the request.
You don’t have to come in with everything already figured out. You can just say, “We’re drowning here, and we need somebody to help us.”
From there, look for somebody who has the skill set for the things you’re looking for. Consider physical proximity if you want someone who’s going to be physically present with you while the dying is occurring, though this work can also happen virtually. And probably most important, look for somebody you jive with — somebody you would feel comfortable inviting into some of the most intimate moments in your life and in your person’s life — because they’re going to get up in it with you. So skills, proximity, vibe.
EH: It sounds similar to hiring a birth doula.
AA: It’s the same thing, just on the other side. When we’re talking about birth, people often think of it as a joyous occasion, something to celebrate, while people want to shun or hide away from the fact that dying is occurring. But it’s really the same thing.
EH: Are there certifications or credentials people should look for?
AA: The National End-of-Life Doula Alliance is an organization that supports death doulas. They have a directory, and they also have a micro-credential — a badge that doulas can earn that says they are competent in the key areas of practice. So if somebody is thinking about certification or curious about what that means, they can find doulas on the National End-of-Life Doula Alliance website who have that micro-credential.
Overall, though, there is no certifying body that currently exists to certify us. I’m grateful for that right now. It allows a little more flexibility in our work.
People have been doing this work since always. As long as people have been living, people have been dying, and people have been supporting them through it. Requiring certification would somehow circumvent the folks that learned in the community, from their grandmother, or from a person in the community, and they hold different knowledge than somebody who’s taking a training course like the one we offer at Going With Grace.
EH: Any red flags that a death doula may not be the right fit?
AA: Anybody who has very strong ideas about what happens after we die — if they’re clear about what happens and they’re trying to tell you — that’s probably not the right person, particularly if it does not align with what you believe.
Anybody who is giving a lot of approximations about time left, like how long somebody has to live, I’d say that’s also probably a red flag. Anybody who claims to know the things that we cannot know as humans, watch out for that.
EH: What are some common misconceptions about death and dying?
AA: There are a lot. One of the big ones is that nobody wants to talk about death. People often assume that people don’t want to talk about it, but that’s not my experience. When I share about my work, people immediately start talking about it. To me, that’s an indication that people just need permission to have the conversations that are most on their hearts and minds.
Dying is a commonality that we all share. Why do we make it seem so taboo or strange to want to talk about it?
There’s another big misconception about how the dying process actually occurs and what it looks like, largely because of what we’ve seen through the media. If people understood a little more about what it looks like, they wouldn’t be so surprised or confused by it when they actually encounter it.
Another misconception is that dying is a medical event, that it’s something to fear or something to fix, or that it needs doctors to intervene. Dying is not a medical event. Whether or not doctors intervene, the dying will occur.
Doctors of medicine can be useful for things like pain management and control, but the rest of it is really up to the community members and their constellations of care to provide the social, familial, and communal softening that is helpful to hold dying.
EH: For someone who has never really thought about death and dying before, how do you suggest they start?
AA: I’d venture a guess that they probably have thought about it, and it’s a question that probably makes them afraid. So a conversation with a trusted family member, confidante, or friend is useful for getting the conversation going.
I often suggest that people think about their own bodies and how their bodies will meet their end as an entryway; to see where there may be any fear or discomfort when thinking about our own. Thinking about the deaths of people in your life or your community is also a great way to start bringing your attention and awareness to your mortality.
EH: What are the most important things to have in place before dying becomes imminent?
AA: Here’s a generalized checklist. I’d start by considering who you want to make your decisions for you, as well as your healthcare directive and your desires around life support — those fall in the advance directive bucket.
I’d also suggest that people think about any comfort or care they want to receive when seriously ill or dying, things like ambience in the room and how they want to be held.
Consider your body disposition: What you want done with your body when you can no longer use it; whether you want to be buried or cremated, green burial, or aquamation. There are a number of choices.
Consider the services you want. Do you want your life celebrated or honored, in what manner, and who should be responsible for it?
Consider your dependent children, disabled adults, and pets and their care. Consider your possessions — what to do with all of your stuff.
People often think first that they should get a will, and a will is important, yes, but the items I just mentioned are the things that ultimately cause a lot of grief at the time of death. So wrap your possessions and your will together with planning for those other pieces.
Also, collect any important information and documents. Gather them, put them in one place, and make sure they’re accessible and people know where they are, so they’re not looking under your mattress for a Social Security card after you die. You’d be surprised how many documents I’ve found in a fridge, in the container for sugar, or someplace where you would never expect documents to be.
EH: You talk about helping people map out their future death. What does that look like?
AA: The first thing I’d want to come to is: What is the most ideal death for this person?
We often think of the idea of “the good death.” I use air quotes around that because it often implies some conditions that perhaps aren’t in place. So thinking about where you are right now, what would be the most ideal death for yourself?
Then get really deep in detail about what that looks like. In my idea, I thought about where I want to be, how the senses are engaged, which senses are engaged, who’s around me, what state my affairs are in, how much medical care I’m receiving, whether I have some awareness that dying is occurring. Think very holistically, in as much detail as possible, about what death will be. That helps to map it out.
EH: What does dying teach us about living?
AA: Mostly, I think dying teaches us what a gift living is. When I am thinking about my death, my entire life comes into very, very clear focus, and it allows me to be present with my life as it is today, in recognition that one day this life as I know it will end. It really nails down the preciousness of this ride, and it makes it all the more miraculous.
EH: Do you have advice for people who want to be more intentional with their living, knowing that we are all going to have an end?
AA: I’m going to say this flippantly, and I don’t mean it flippantly, because it’s quite a practice: When you’re caught up in the minutia — when you’re sitting in traffic, when you’re doing the 8,000th dish for the day — just remember you’re going to die. It’ll probably make the process a little bit more smooth.
I say it flippantly, but it’s a big practice to undertake, this consistent meditation on and reminder about mortality. It has a way of snapping us into the present and making the fact that we can touch dishes, feel water on our skin, or eat food so much more sharp and salient. Remember that you’re going to die.
EH: People often think of being intentional as accomplishing something grand. You’re describing something much smaller.
AA: That’s what it’s all about, really. Very few people are known for their accomplishments and the big things they did alone. In two generations, most people, we don’t remember their names anymore. But we remember the bits of who they were. Who we are shows up in the minutia. It shows up in our day-to-day lives. Accomplishments are so far down the list for me.
I know some people really like to lead with, “Go out there and do everything you want to do and put your mark on this world.” But the mark on this world could also be that you smile at the person on the street when you go get your coffee every morning. It doesn’t have to be creating the thing that revolutionizes whatever indicator.
A lot of times, our desire to do the big thing is based on an egoic sense of contribution. Whereas if I smile — regardless of what happens with that smile — if I’m just having a human moment of connection with somebody else. That has very little to do with my capacity to impact them or their day. It’s just something that felt good about me being human in that moment.
EH: For someone brand new to the concept of a death doula or planning for their death, what do you wish they knew?
AA: It might not be as scary as you think. And what you find when you’re in the process might be a key to unlocking something that your life definitely needs.
EH: You describe yourself as a recovering attorney. After years of doing this work, what have been the most meaningful takeaways for you?
AA: Not to take it too seriously, meaning life overall; not to get so mired in my life having to have some big meaning or some big purpose. I think many of us use that as a weapon against ourselves in an effort to try to be all the things.
When I get deeply mired in my life having some big purpose, I miss the gift of presence and of mortality.
I was doing that for a long time. I was searching for the thing, and it looks like I found the thing based on the work. But I’d like to keep that soft and pliable and gentle, and see what I actually create. I’m not tied to this work forever. We’ll see what meaning it brings me in the big picture.
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