The Role of Death Doulas in Hospitals and Nursing Homes

While 80% of Americans may want to die at home, unfortunately, many will die in hospitals and nursing homes, including skilled nursing and assisted living facilities. Many of the staff in these facilities, including doctors, nurses, health care aides, and administrators, do not know how to comfort or support dying people. That’s why they need end-of-life or death doulas. We better care for patients and clients during this inevitable part of life.

What is a Death Doula?

A death doula, also known as an end-of-life doula, provides emotional, spiritual, and practical support to dying individuals and their families. We support our clients with end-of-life planning, providing comfort and companionship, facilitating conversations about death, and assisting with legacy projects.

Death doulas know how to transform a cold and sterile room into a warm, comfortable space. We don’t pester a dying woman with food and water, we hold her hands instead. Doulas don’t poke and prod a dying man for unnecessary blood tests. Instead, we moisten his lips and rub lotion on his feet.

We know to dim the overhead lights and lower our voices. End-of-life doulas explain to anxious loved ones that Nana is “talking to the angels” and that this common phenomenon is a comfort to her.

We also help professionals in this space. Either by educating them about the end-of-life process so they can better care for folks or by caring for them ourselves, so uncomfortable staff members don’t have to.

A Lack of Compassion

Many doctors avoid discussions about death and prognosis, leaving patients and families unprepared for what happens next. As a result, my clients and their loved ones often feel confused and overwhelmed by the medical jargon. They are unable to fully understand their situation.

We can do better.

Doctors and administrative staff members often protect themselves with a strictly clinical and detached demeanor. This comes across as cold or unempathetic during sensitive times. My patients and families feel like “professionals” in this space lack the emotional sensitivity needed to comfort them during the dying process.

Why not hire death doulas to provide this essential patient-centered care and support?

Overemphasis on Treatment

Doctors and other healthcare workers are sometimes perceived as overly focused on pursuing aggressive treatments and interventions. Even when these are unlikely to benefit the patient. They purposely avoid discussing palliative care or hospice options.

This results in unnecessary suffering.

We’ve all heard stories or personally experienced feeling unsupported or misunderstood by doctors during serious or terminal illnesses. Nurses tend to be better in this realm, but overall, medical training emphasizes fighting and curing diseases with little thought to the quality of life.

They don’t discuss death until far too late. This leads to a lack of preparedness and a less-than-peaceful ending for far too many people.

Doulas Prioritize Differently

America’s healthcare system emphasizes efficiency and measurable outcomes. This discourages doctors and medical assistants from prioritizing comfort, emotional, or spiritual care.  

Let’s be fair, most healthcare workers got into this field to help people live. A famous hospice doctor once said that if someone wants to deny death, they’d do great in medical school.

So why are we relying on doctors for care they’re not trained or equipped to provide?

The same goes for elder care professionals. They build careers enriching older people’s lives, and many are quite uncomfortable discussing or facing death for themselves. To ask them to help others do this is expecting the impossible.

Even those hospitals and communities that may want to provide compassionate end-of-life care might find they are woefully understaffed.

As the U.S. population ages, the need for compassionate end-of-life care is increasing. Death doulas fill in gaps that include emotional support and continuity of care that medical or facility staff cannot provide due to time constraints.

Benefits to Patients and Families

While the numbers are thankfully decreasing, the number of people who die in U.S. hospitals is still too high. According to the CDC, over 700,000 deaths happen in hospitals per year. Many different studies suggest over 40% of deaths in America occur in nursing homes.

If you’re an administrator at such a facility, hiring qualified, professional death doulas will bring the kind of compassionate, end-of-life care that everyone deserves.

For hospitals, we significantly improve patients’ quality of life while reducing loved ones’ anxiety and stress. For nursing homes, we offer personalized care that respects your resident’s wishes and cultural practices. This enhances the dignity of the dying process.

Countless case studies show that the continued support we give families during the grieving process aids in healthier emotional recovery.

Benefits to Facilities

Hiring death doulas also benefits your hospital or nursing facility in the following ways:

  • Enhanced end-of-life care leads to higher patient and family satisfaction scores, often important metrics for healthcare facilities.
  • Doulas help ease the workload of medical staff by handling non-medical end-of-life tasks.
  • We allow more healthcare professionals to focus on clinical care.
  • Being known as a facility that provides comprehensive, compassionate end-of-life care enhances your hospital or facility’s reputation within the community.

Hospitals and Nursing Homes Need Death Doulas

Improved patient satisfaction and reduced staff burnout outweigh the costs of hiring death doulas. As full-time employees, part-time workers, or contracted professionals, we can be seamlessly integrated into the existing care team. Doulas complement rather than duplicate the roles of current staff. You can also ensure that death doulas are well-trained and certified. This provides a standard of care that meets your facility’s expectations.

Recently, I spoke at a consortium on longevity at Northwestern University. The audience was filled with scholars, doctors, professors, and other stakeholders. They asked me, “What is a short-term goal to ensure quality of life for everyone that we can focus on right now?”

I told them, “You have one of the largest hospitals and medical schools in the country. Hire death doulas. As soon as you can.”

By all means, let’s create a world where more people can live long happy lives and die peacefully at home. But in the meantime, while people continue to die in facilities, let’s hire death doulas and provide compassionate care when – and where – it’s needed most.

Death doulas enhance your hospital or nursing home’s end-of-life care. Contact me for information about starting a pilot program or arrange a meeting to discuss integration today.

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