A piece by Erin Reidy from End Of Life Doula UK

Death isn't something we often talk about, but it’s a journey we all eventually face and not one you have to take alone. An end of life doula has the privilege of ‘walking alongside’ individuals and their families during one of the most tender and profound experiences of life. We hope to be a presence that makes that inevitable journey a little less daunting. 

In its modern imagining, the concept of end of life doulas is relatively new. One of the first formal movements was started in New York City in the early 2000s and has spread across the globe. Here in the UK, End of Life Doula UK is proud to have over 350 members, and is growing every year.  

We humans have been holding the hands of others as they die since the very beginning of civilization. Compared to centuries before, the dying process is more removed from our daily lives than ever before. It’s become something that happens more in hospitals or care homes, not a process experienced by friends, family, and community. As end of life doulas, we are the bridge between those worlds, giving you and those important to you the knowledge and freedom to experience death and dying on your own terms.  

To put simply, we are there to provide non-medical support, ensuring that the dying process is as peaceful and meaningful as possible. It’s important to remember that just as every person is unique, every death is individual. The services an end of life doula offers will be adjusted to meet the needs of everyone involved, keeping that unique spark at the centre of it all. Think of a doula as a companion, advocate, and guide. In this article, you'll learn the basics of how a doula can help before, during, and after death, supporting not only the dying but also the loved ones left behind. 
 

Before the Final Days: Preparing with Compassion 

Some may think it a gift, others a curse, but we humans carry the knowledge of our mortality. End of life doulas help you hold that knowledge and work with it to better prepare for the end. Our role begins long before the final days arrive. Together, we’ll take the time to explore what's important to you and how you envision your final moments. This isn't just about logistics – it's about creating a space that feels safe, comforting, and true to who you are. 

Practical preparation  

Since many people don’t like thinking about death and dying, they aren’t fully aware of all the options they have available to them. Doulas can assist in the creation of your Advance Plans, including advance decisions, and other forms that clarify how you want to be cared for. It can be overwhelming to think about, but having these decisions made in advance can relieve stress and provide peace of mind for everyone involved. 

Emotional preparation 

One of the first things you might do is work on legacy projects. This could mean writing letters to loved ones, creating memory books, or even recording messages. These tangible expressions of love can be incredibly healing for you and your family. A doula can also help facilitate important conversations you may have been avoiding, giving you the chance to say what needs to be said. 

Or we can simply serve as a compassionate ear if you just want to talk. Maybe you’ve always felt like the rock of the family and don’t feel comfortable speaking with those closest. Or perhaps you’re comfortable discussing it, but your family members seem to shut down and change the topic whenever you try. In any case, an end of life doula is perfectly positioned to give you all the time and space you need.  

Preparing a peaceful environment  

What would make your space feel more comforting? Whether it's arranging photos, choosing music, or bringing in soft lighting, you and your doula will work together to craft an environment that reflects your values and personality. It's about making sure your surroundings align with the life you've lived and the people you love. 

Preparing the family 

Families often feel unsure of what to expect or how to best support their loved one. A doula offers educational sessions to help explain the physical and emotional changes that might occur. This can help reduce fear and foster more open, heartfelt interactions during the final days. 

During the Active Dying Process: Holding Space 

As the final days approach, an end of life doula's role shifts to one of steady, calm presence. We are there to support the dying, the person’s family/friends, and maintain the sanctity of the space. If still appropriate, the plans we’ve put together are now in place and everyone is clear on what to expect. The more we know, the easier it is to be in the moment and simply experience this natural, albeit emotional, moment in life. 

Guiding families  

For families, witnessing the dying process can feel overwhelming. A doula helps explain what is happening in simple, compassionate, non-medical terms. Changes in breathing, skin colour, or consciousness are natural parts of the process, but they can be alarming if you're unprepared. The doula will offer gentle suggestions on how to provide comfort, whether that means holding a hand, offering words of love, or playing a favourite song. 

Advocacy 

If medical staff are involved, a doula helps ensure your wishes are always communicated and respected, taking that responsibility and strain off your family members. Sometimes, families struggle to balance medical decisions with emotional needs. The doula can act as a bridge, making sure that the environment remains as peaceful and aligned with your desires as possible. This is also why the pre-planning stage is so important. We want to make sure your voice is always heard, even when you’re not able to speak for yourself.  

Being present 

Sometimes, the most important thing we can do is simply be there. A doula may sit quietly by the bedside, holding hands, offering gentle reassurance, or reading aloud if that feels appropriate. Each person is different, and the doula's goal is to tune into their needs and respond with sensitivity. Sitting vigil also provides an opportunity for the family to rest, as the active dying process can take days.  

Rituals and meaningful moments 

Even in the final hours, there is room for beauty and connection. You and your doula might have worked together to create simple rituals – lighting candles, saying prayers, or reading poetry – that honour your life and provide solace to your loved ones. These can happen during the dying process and following death. 
 

After Death: Supporting the Transition 

Death may mark the end of physical life, but the experience of grief and love continues long after. After your death, the doula remains available to help your family navigate the early days of loss. Our knowledge of local or national resources can make this phase easier, as we can signpost to organisations that are available to help. 

Care for the body 

A doula can guide the family through caring for the body. These rituals are typically planned beforehand, and can include bathing, anointing the skin with oils and perfumes, dressing, and shrouding. But even an act as simple as hair brushing can be an intimate act of love that helps to say goodbye to the physical body. 

Emotional support 

In the moments and hours immediately following death, emotions often run high. A doula holds space for families to express their grief, offering a listening ear and words of comfort. Sometimes, this is a quiet presence; other times, it involves guiding families through next steps. 

Burial and ceremonial events 

One of the most meaningful aspects of honouring a life well lived is deciding on the type of burial or ceremony following a death. A doula can help you explore various options, from traditional funerals to alternative and eco-friendly choices like green burials. For those seeking a celebration of life, the doula can assist in planning ceremonies that focus on joy, storytelling, and the positive memories shared with the departed. Options might include tree planting, scattering ashes in meaningful places, or crafting personalised memorial services. 

Logistics and planning 

Practical details like funeral arrangements, obituaries, death certificates, and notifying loved ones can feel overwhelming. An end of life doula will help guide you through these logistical tasks, easing the burden on the family so they can focus on being present with their emotions. 

Legacy projects 

If there are unfinished letters, recordings, or keepsakes, doulas can even assist families in completing these projects. Sometimes life limiting diagnoses move faster than anticipated and we don’t have time to finish everything we want to. There are some amazing organisations, even for niche hobbies, that are happy to lend a hand. This can be a beautiful way to continue feeling connected to the person who has passed. 

Long-term grief support 

Grief doesn't have a timeline and it pops up even when you’re least expecting it to. Whilst some doulas may also be trained grief counselors, not all can offer appropriate services. However, a doula can provide resources and referrals to grief counselors or support groups, ensuring that families have ongoing support as they navigate life without their person. 

And don’t underestimate the power of talking over a hot drink. After some time has passed, it can also be good for the family to get together with the doula to just walk through the events, sharing moments that stand out, sad and funny and everything in between. Processing in this way helps families build and share a narrative around the loss, an incredibly valuable aspect of grief work.  
 

In the end 

When approached with intention, care, and compassion, death can be a beautiful, connected experience. An end of life doula believes that every person deserves to die with dignity, surrounded by love and peace. We are here to help you experience the best death possible, and assist those most important to you in celebrating the unique life you lived. If this resonates with you, consider reaching out to End of Life Doula UK to learn more about how an end of life doula can support your family now and in the future. 

About the author -  

Erin Reidy is an end of life doula and member of End of Life Doula UK. She is also the founder of The Good Mourning Society, a community for people who will die… eventually. You can usually find her in the cinema or under a few cats.  

About End Of Life Doula UK -

End of Life Doula UK is the membership association and community of practice for end of life doulas in the UK. You can find out more here: https://eol-doula.uk



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