When someone is nearing the end of life, the quality of support they receive shapes not only their final days, but the memories their family will carry.
In Australia, palliative care teams provide exceptional medical expertise – managing symptoms, coordinating treatment and guiding families through complex decisions. Yet there are human needs at the end of life that fall outside the clinical scope: the quiet hours of listening, the conversations about meaning, the gentle presence through the night and the practical guidance that brings comfort and clarity.
This is where End of Life Doulas (EOLDs) step in. We are not here to replace or compete with healthcare professionals. We walk alongside them, filling the gaps they cannot and in doing so, create a fuller circle of care.
Holding Space for Emotional and Spiritual Needs
End of life is as much a human experience as it is a medical one. In busy clinical settings, time is precious and emotional presence can be a rare luxury. Doulas offer that time, whether it’s sitting quietly in vigil, creating space for rituals or helping someone explore the meaning of their life.
As one UK Doula put it:
“Even if we can’t change what’s happening … we can help someone find meaning in their life. That can make a huge difference.” – End of Life Doula UK, Ashgate Hospice
This isn’t about delivering medical treatment. It’s about seeing the person as more than their illness and being a steady presence when emotions are raw.
Continuity from Diagnosis to Bereavement
EOLDs often join a family’s journey earlier than clinical teams can, sometimes at the time of diagnosis. We provide education, emotional preparation and practical planning long before the final days. And when death has occurred, we remain, helping families navigate what comes next and connecting them with grief support.
This continuity prevents the gaps that can appear when medical care ends abruptly.
In the words of Hunter-based Doula Kylie Gangemi:
“I assist families with practical care … but I can also provide them with spiritual support and grief education. I’ve got that suitcase with all the options for people, so they have an end-of-life experience that’s meaningful and authentic to who they are.” – ABC News
Advocacy That Respects Clinical Care
One of the most valuable ways doulas support both clients and clinical teams is through advocacy. We help people express their preferences clearly and navigate the systems around them, reducing unwanted interventions, easing stress for healthcare workers and aligning care with the person’s values.
From the recent NHS Leeds Doula pilot:
“Almost all (94 %) of those supported by a doula were able to avoid unplanned admission to hospital in their last 3 months of life, and 75 % achieved their preferred place of death.” – EoLDUK Leeds NHS Project Report
As one UK physician noted during the pilot:
“Once we realised the doula wasn’t here to ‘do our job,’ it became clear just how much they could help. The family was calmer, more informed and more engaged with the care plan.” – Medscape UK
Practical Guidance in the Real World
Doulas also handle the practical details that can overwhelm families – answering questions about what to expect physically, explaining processes after death or helping with funeral arrangements.
Queensland Doula Leanne Jones puts it simply:
“A birth midwife helps people birth, while a death midwife* helps people to die.”
Her work includes explaining what actively dying looks like, preparing families for each stage, and helping them navigate the legal and logistical steps. – Courier Mail
* An End of Life Doula is also commonly known as a Death Doula or Death Midwife.
Complementing, Not Competing
The Australian palliative care sector is beginning to formally acknowledge the role Doulas can play. Palliative Care Australia has produced resources to guide safe, effective collaboration between Doulas and health services – PCA Factsheet. Since 2022, the Certificate IV in End-of-Life Doula Services has provided a national accreditation pathway, making Australia the first country in the world to formally recognise End of Life Doula training.
As Heart to Heart Hospice puts it:
“End of Life Doulas are not medical professionals – their purpose is to complement hospice services and fill gaps that families or clinical staff can’t always cover.” – Heart to Heart Hospice
A Fuller Circle of Care
EOLDs bring something to end-of-life care that can’t be charted in medical notes:
- Time and presence when the clinical team can’t stay.
- Continuity before, during and after death.
- Advocacy that protects a person’s wishes.
- Practical guidance that reduces fear and confusion.
- Community connection that keeps dying human.
For clinicians, this means more supported families, less crisis-driven decision-making and care that aligns with what matters most to the person at the centre.
When we work together – medical teams and Doulas – the result is a richer, more humane end-of-life experience. Not just a good death, but a supported one.
If you work in palliative or aged care and would like to explore how an End of Life Doula can support your clients and team, please get in touch. Together, we can offer truly whole-person care.
Visit my website www.yourpathguide.com.au or email me at info@yourpathguide.com.au
About the Author
Shannon Beresford is an End of Life Doula, Sound Therapy Practitioner and founder of Your Path Guide, a practice based in Adelaide, South Australia. He provides calm, ongoing support to clients and families through all stages of end-of-life care. Shannon holds the Certificate IV in End-of-Life Doula Services and is the Chair of HELD Australia Ltd, the peak body for holistic end-of-life and death care. He also volunteers in the Central Adelaide Palliative Care Service (CAPCS).
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