Death Doula? End of Life Doula? Who Am I?

Is it just semantics? Or is it a clear distinction? It's something I've been thinking about for a couple of years now but in the last year the answer has revealed itself through the day to day of working as a doula: I am both.

Let's back up a bit.

Something death doulas run into from the start is how to refer to ourselves. It's a common discussion. "End-of-Life doula" is often used to soften the blow and to be more inclusive of potentially available services. "Death doula" is more striking and gets right to the point. It serves as a catchy title that engenders curiosity in media, as well, which is a double-edged sword. Each doula chooses how they'll refer to themselves, and that's where the discussion begins and ends, with their choice.

It comes down to optics and perspective, most of the time, that choice. Some doulas embrace the jolt and champion normalizing the word "death" as a talking point. Some doulas feel that calling themselves an "end-of-life" doula is softer and more approachable when talking with potential clients or educating about death and dying. Many doulas feel that "end-of-life" is a better description of the services they offer, especially if they work with elderly clients or clients with long lasting diseases. Caregiving at end-of-life is not necessarily about death, after all, even if that is the inevitable eventuality. Yet other doulas may feel that "death doula" is a thing to embrace, a lifestyle, and the whole point of the work is to start with death at the forefront of their work. A lot of the discourse winds up being about people's general discomfort with death, including the very word itself and its dark societal connotations. This branches into those who feel that embracing the word shines a light and washes away that darkness and those who feel that using "end-of-life" instead helps ease the way when the discussion starts - i.e. rather than beginning with death, we ease into it.

Add to these ideas the fact that there are so many approaches to this work, whether it's volunteering in deathspaces, educating on death & dying, engaging with death awareness and/or death education in our communities, sitting bedside (in private or organizational settings), working within the funeral industry, engaging with political discourse, caregiving, community outreach, death/legacy/memorial planning, organizational or financial death planning, MAiD and/or VSED facilitation - the list goes on and on. There are so many aspects to death & dying at end-of-life and there are doulas to help with all of them. Some doulas, like myself, offer comprehensive care & services. Others specialize in only one or two areas and refer out for other services. You can see why it becomes a highly individualized question: Am I a death doula or an end-of-life doula? You can also see why it becomes important to figure this out as we go out into the world to do this work - we need to present our services to potential clients et al in a concise way that shows who we are and makes it easier for those potential clients to choose the doula who best suits their needs.

And now?

Well, nine years along in my deathwork journey, three years after officially getting an obligatory (for my peace of mind) death doula certificate, and likely many years away from any kind of educational standardization within this emerging field, I tend to view it as a bit of a Wild West. Anything goes right now. I can't think too much about what other doulas define themselves as because there are too many variations. So, in the last couple of years, I've focused closely on my practice only. What can I offer? How do I define my work?

I've let my business develop organically, offering services which draw on my existing skill sets after 50+ years of life. I listened closely to what clients asked for and adjusted as I went along according to the services clients used most. I allowed for flexibility in my approach and focused on developing relationships with providers so I could create a working network. I did my damnedest for every client and stayed laser-focused on my ethical and professional standards, emphasising clarity and communication in my approach. At this point, I understand who I am as a doula and I have come to embrace the dualities of the work, as I see it.

I am both. If I am working with an elderly client who doesn't have a terminal diagnosis but who requires various kinds of care and support, I consider myself their end-of-life doula. If I am facilitating MAiD or VSED, I consider that deathwork and myself as their death doula. If I am doing some combination of caregiving and deathwork, I operate as both. The eventuality of death alongside the preservation of quality of life is an ongoing theme for a lot of us doulas. We also spend a lot of our time educating - sometimes on an individual level, face to face, answering direct questions from the curious - other times on a larger scale, speaking within community/public spaces - and that is part of deathwork.

I am both. I seek mentorship - both as a mentee, learning from older & wiser providers in deathcare - and as a mentor to new doulas needing guidance. I believe in this small community I've joined even though, nine years ago, I didn't realize I was joining it. I am excited as I watch the world have the discussions that are emerging as laws and proposed laws create societal dialogues about death & dying. Ongoing education & standardization seem like a part of the landscape for doulas, moving forward. We'll see.

For myself, in the future, I would be interested in working with lawmakers and policy makers, creating pathways with other deathcare fields for doulas to work within, and creating a robust doula community that supports itself. With growth comes evolution. I've ceased volunteering in death fields and now put in volunteer hours at the library instead, because it is life-affirming - but also because I've expanded my death practice to include community events such as death cafes and a three-times-weekly death walk offering - so I shifted my weekly volunteer hours to something non-death related as a form of self-care. It's a balancing act, always.

For now, I am in the field, both death doula & end-of-life doula, and it's been an incredible journey so far. ~m