End-of-life doulas can offer additional avenues of support when it comes to communicating the value of hospice care to referral sources and the general public.

Doulas can help create proactive educational touchpoints about patients’ end-of-life care options across a range of diverse populations, said Beth Klint, executive director at Goodwin Hospice. Based in Alexandria, Virginia, the hospice is part of the nonprofit senior living and health care organization Goodwin Living.

Compared to hospice clinicians and social workers, doulas have more time to dedicate toward goals-of-care conversations with patients and families and also greater capacity to connect with other health care providers, Klint indicated. Integration of these professionals’ services can go a long way in forming strong community collaborations and referral relationships, she said.

“Doulas in particular offer nonmedical support that helps families navigate the end-of-life journey in a different way than hospices do,” Klint told Hospice News. “They are an untapped resource that’s been operating within communities for some time and available to people facing a terminal or serious illness diagnosis. Doulas are already helping people with advanced care planning, educating them about the resources available and debunking some of the rumors about the end of life. Having doulas involved further upstream when people are referred to palliative care can help patients enter the hospice space sooner when their needs aren’t as high or critical.”

Goodwin Hospice collaborates with the Virginia-based organization Present for You to provide end-of-life doula services. The organization helps families with nonmedical aspects of serious illness care such as legal, financial and practical challenges, as well as addressing social determinants of health and finding supportive, palliative or hospice care options.

Goodwin Hospice and Present for You in 2022 launched a supportive staffing model through which death doulas work alongside hospice social workers and spiritual care providers. The model is supported by the nonprofit hospice’s foundation and offered as a complimentary service at no charge to patients and their families.

The hospice provider has seen “more traction” of its doula services in the last five years, particularly in the palliative care space, Klint stated.

End-of-life doulas have been instrumental in improving understanding and patient access through greater integration of these services across the health care continuum, she said. Their support can help fill gaps of care and address unmet practical, psychosocial, emotional and spiritual needs.

Doulas are not bound to the same time constraints as hospice employees and are able to provide more bedside presence while also interacting in greater capacity with interdisciplinary care teams across different settings, according to Klint. They can help provide education to referring clinicians, various community organizations, spiritual leaders and underserved populations.

“People are not always supported in the middle of their diagnoses and so we don’t always prepare people further upstream,” she said. “But if you’re someone with cancer, heart failure or you’ve had multiple hospitalizations with palliative care it can be this very organic interaction. For someone who has questions, needs help or is just trying to understand [and] look at the big picture of the disease, I think that’s a role for end-of-life doulas in senior living and in palliative care to have those conversations. There is more room for them in these spaces, we just don’t utilize them.”

Doulas can improve public outreach and understanding, serving as community liaisons in some ways, Klint stated. These professionals come from different career backgrounds, cultures and spiritual beliefs and value systems that are representative of their communities. This can allow for more insightful and meaningful conversations about end-of-life care options, she added.

Doulas can serve as a trusted voice in the community that helps communicate a hospice’s unique services and bereavement support as well. These professionals can be a beacon for providers operating in rural regions with sparse resources seeking to boost awareness and access, according to Klint. Their community connections can offer invaluable understanding for hospices to better steer their public messaging efforts in more inclusive and diverse ways.

“Doulas are part of the communities they serve and that community level of supporting people and understanding what their needs are is significantly different for someone living in an area that is not saturated with caregivers,” Klint told Hospice News. “We’re really pushing to find a place for them and think outside of the box of traditional models of care to be a little more creative and try to support people through difficult times.”