Frequently Asked Questions

An End of Life Doula is someone who supports a person faced with an illness or terminal diagnosis. The End of Life Doula can educate, advocate for, and empower clients by starting the conversation about death and embracing the dying process early. By aligning the clients needs with their expectations and wishes, the End of Life Doula can significantly improve the quality and dignity of the end of life journey. Some of their tasks and skills may include:

• advocate for the best possible experience for the client
• understand the physiology of death and the complexity of emotions that go along with the diagnosis of a terminal illness
• assist clients in creating and carrying out their health care treatment decisions
• are knowledgeable about legalities, options, and tools in Canada
• provide emotional, physical comfort measures and an objective viewpoint
• providing information needed to make informed care decisions
• facilitate communication between client, family and other care providers
• protect the client’s dignity and the family’s memory during the death experience
• allow the family to participate at their own comfort level

In Canada, End of Life Doula work is not a regulated line of work so no certification is required. Although End of Life Doulas are not regulated, The End of Life Doula Association of Canada is committed to establishing a community of practice for End of Life Doulas. This is done through background and education checks, as well as criminal record checks every 5 years. We also follow directions from the local health authorities, hospice and palliative care associations and the Ministry of Health.

End of Life Doulas go into hospital or palliative care settings only when their clients are admitted into care and continue to want their doula’s support. The doula provides support to their client and client’s family, and does not form part of the recognized health care team under the current Ministry of Health guidelines. However, clients and their families may invite the doula in the room as they wish.

At this time, End of Life Doulas are not covered under medical or private insurance. It is a goal of the association to make End of Life Doulas available to everyone regardless of their ability to pay. Therefore one of our goals is to achieve funding so that everyone has equal access to quality end of life care.

End of Life Doulas are paid privately by the client or their family. Typically, payment is upfront, and the fees charged are subjective to the services, and estimated amount of time spent working with the family. This can range from $45 – $100 per hour, though prices depend on many factors, including location and duration of service. Many doulas offer flat rate service packages as well. Doulas are also encouraged to support persons who can not afford to pay either by offering services on a sliding scale or working pro bono. Newly trained registered member doulas are also required to obtain 40 hours of volunteer experience and at least three clients outside of their family before they can become members of our Association.

End of Life Doulas are complementary to, but do not seek to replace, support provided by hospice palliative care workers.
End of Life Doulas are neither trained nor able to administer medication and all medication must be administered by the trained and licensed nurse during the medical home care visit. The End of Life Doula/client relationship may begin at the point of diagnosis or as early in the journey following diagnosis, and continue throughout the progression of the illness.
The Doula may provide support through the vigiling time, and continue with the family for a period following the death – it really depends on the needs and wishes of the family and the types and level of support the individual End of Life Doula is able to provide.

We expect people who plan to open a business as an end of life doula to conduct their practice in an ethical way. Our Association has a Standard of Practice document we have adopted.

As important as what End of Life Doulas do, they do not;

• prepare the body following death – in BC, that is the role of the Funeral Director
• act as Social Workers – end of life doulas give support, not advice
• dispense medication of any kind
• make diagnoses
• take over and drive the process – they support the family’s needs
• make assumptions about what the client or their family/friends need

In some cases, we are called to vigil or be present at the time of death. We believe that educating individuals to act in the role of an End of Life Doula has impactful benefits on a clients end life. We believe End of Life Doulas will:

• increase autonomy
• educate individuals and families to manage their own health care decisions
• increase the use of advanced care planning
• reduce or help manage the family burden
• support access to palliative care programs and seamless continuity of care across health care settings and teams
• enhance the use of culturally and spiritually sensitive care
• increase communication through the end of life journey

We believe that End of Life Doulas can help bridge the needs of continuing and end-of-life care by providing continuity of care through the journey from diagnosis to end of life – for family and friends as well as the individual who has received the diagnosis. After the death has occurred our contract with the client ends. At this time, the family may decide to continue with a contract for grief support.

End of Life Doulas work closely with funeral directors to create the most memorable experience for the loved ones of our clients. It is not in the scope of practice to prepare or direct care of the deceased, however end of life doulas are aware of the legalities and requirements for care of a body, transportation and burial, or cremation. In some cases a doula will attend a ceremony or funeral, however it is not a requirement.

The End of Life Doula Association is not affiliated or connected with Medical Assistance in Dying (MAiD). Individual doulas may support clients who choose MAiD, however, our Association remains neutral about MAiD, recognizing it is an individual’s choice. A doula will provide the proper resources to clients who would like information about MAiD, but it is not an End of Life Doula’s scope to encourage or persuade a client to access MAiD.

Although End of Life Doulas are not regulated, The End of Life Doula Association of Canada is committed to ensuring all its members meet a minimum amount of mastery of prerequisite knowledge and skills that are fundamental to the Scope of Practice of an End of Life Doula. There is no requirement to practice under the EOLDAC, or another association or college. There are several programs that advertise themselves as offering end of life doula certification, however that certification is not recognized in Canada. That said, in an unregulated field, it can help lend credibility by aligning with an association like ours.

Although End of Life Doulas are not regulated, The End of Life Doula Association of Canada is committed to self-regulating all of its registered member doulas. This is done through background and education checks, practical experience requirements, continuing education requirements, as well as criminal record checks every 5 years. We also follow directions from the local health authorities, hospice and palliative care associations and the Ministry of Health.