How End-of-Life Doulas support the new Support at Home program
Australia’s aged care system is changing in a big way. From 1 November 2025, the new Support at Home program will replace the Home Care Packages Program and the Short-Term Restorative Care Program, bringing them together under a single, simpler model. It’s designed to give older people more choice, flexibility and help to stay in their own homes for as long as possible.
For those of us working as End-of-Life Doulas (EOLDs), this shift opens an important door. It’s a chance to bring our work into the national aged-care framework and make sure emotional, social and spiritual care are recognised as just as important as medical support at the end of life.
Understanding the Support at Home program
Support at Home’s design focuses on flexibility, simplicity and genuine choice for older people and their families. Services will be arranged under eight care classifications that reflect individual levels of need, from minimal to complex support.
Within this structure sits a new End-of-Life Pathway. This pathway provides targeted, short-term assistance for older Australians who have a life expectancy of around three months or less and who wish to remain at home during that time. It offers up to $25,000 in funding over a 12-week period (extendable to 16 weeks) to cover home-based supports such as personal care, emotional and social assistance, minor modifications, or coordination of services. Assessments are fast-tracked, with a medical practitioner or nurse practitioner able to initiate the referral.
This model represents a meaningful shift in focus. It acknowledges that dying at home, when desired and supported appropriately, can be both achievable and deeply valued.
How End-of-Life Doulas fit within the framework
End-of-Life Doulas already complement the work of clinical and allied-health teams by offering non-medical, relational care. Our focus on presence, listening, legacy work and emotional support aligns naturally with the aims of Support at Home – to enable people to live, age and die with autonomy, comfort and connection.
Within the End-of-Life Pathway, an EOLD can play a key role in bridging gaps between clinical services and the human experience of dying. By working alongside providers, nurses and family members, Doulas help ensure that the person’s values and wishes guide every aspect of their care. We can assist with advance care planning, facilitate family discussions, help prepare the home environment, and offer vigil support or respite for carers in the final days.
Our contribution also extends beyond the moment of death. Many Doulas help with funeral and memorial planning, and provide bereavement and follow-up support, helping families process grief and transition after loss – services that align with the Pathway’s broader emphasis on holistic wellbeing and continuity of care.
Working together: collaboration and integration
To realise the full potential of this model, collaboration will be vital. Providers can engage EOLDs as part of multidisciplinary teams delivering Support at Home services. Clear agreements outlining role boundaries, communication processes and measurable outcomes will ensure EOLD work integrates smoothly with provider obligations under the program.
Importantly, EOLDs can also work within the Support at Home Service List, under areas such as social and emotional support, respite, companionship and end-of-life planning. This creates a practical pathway for providers to include Doulas in care plans while remaining fully compliant with program requirements. It also positions EOLDs as legitimate contributors alongside other non-clinical and allied professionals, helping providers deliver on the program’s broader goal of flexible, person-centred care at home.
Evidence collection will also be key. Showing how EOLD support improves family experience, eases pressure on carers and helps people stay where they want to die will make a strong case for including Doulas in funded services. As HELD Australia and others continue to progress national professional standards, these frameworks will give providers and funders confidence in the quality and accountability of EOLD practice.
Challenges and opportunities ahead
Like any large reform, the transition to Support at Home brings complexity. Providers are preparing for new assessment processes, service classifications and funding rules. The End-of-Life Pathway is time-limited and focused on those with a prognosis of three months or less, so timely referral and coordination will be essential.
There is also a need to build understanding among providers about the EOLD role, ensuring our services are seen not as “extras” but as integral to high-quality, compassionate care. Culturally safe practice, inclusion of diverse communities and clarity of scope will remain essential.
A call to action for providers, Doulas and policy makers
For aged care and home-care providers, this is a moment to broaden what care at home can truly mean. Embedding End-of-Life Doulas within the Support at Home framework through the Service List and End-of-Life Pathway enhances service offerings and ensures that older people are supported not only physically but also emotionally and spiritually.
For Doulas, now is the time to align service models with the new framework, build partnerships with providers and gather evidence that demonstrates the value of this work within the Support at Home system.
For policy makers and funders, formally recognising EOLDs as essential contributors to end-of-life care and within the Support at Home Service List will help realise the program’s vision, ensuring every Australian has access to compassionate, person-centred support in their own home at the end of life.
Towards a more compassionate Aged Care future
The Support at Home program represents more than a policy change. It signals a shift toward genuine person-centred care that respects choice and dignity through to life’s end. The inclusion of the End-of-Life Pathway acknowledges that dying is a natural part of ageing, and that meaningful support at this time matters.
As End-of-Life Doulas, we are ready to meet this moment. By integrating our work into this national framework, we can ensure that older Australians are not only cared for but truly accompanied and supported to live fully and die peacefully, surrounded by compassion, connection and choice.
About the author
Shannon Beresford is the Director of Your Path Guide Pty Ltd, an Adelaide-based practice dedicated to helping people live and die with comfort, meaning and connection. His work brings together End-of-Life Doula care, sound therapy and compassionate travel experiences that honour each person’s story and choices.
As Chair of HELD Australia Ltd, the national peak body for holistic end-of-life and death-care practitioners, Shannon advocates for stronger recognition of the End-of-Life Doula role across Australia’s health and aged care systems. He also holds a Certificate IV in End-of-Life Doula Services, the only nationally accredited qualification in this field, and volunteers with the Central Adelaide Palliative Care Service (CAPCS), providing practical and emotional support to individuals and families in their final months of life.
References
- Australian Government Department of Health and Aged Care. Support at Home Program overview. health.gov.au/our-work/support-at-home
- Australian Government Department of Health and Aged Care. Features of the new Support at Home Program. health.gov.au/our-work/support-at-home/features-of-the-new-support-at-home-program
- Australian Government Department of Health and Aged Care. Support at Home Program – End-of-Life Pathway Factsheet (June 2025). health.gov.au/sites/default/files/2025-06/support-at-home-program-end-of-life-pathway.pdf
- LifeTec Australia. End-of-Life Pathway under the Support at Home Program. lifetec.org.au/services/support-at-home-program/end-of-life-pathway
- Aged Care Decisions. Support at Home Levels Explained. agedcaredecisions.com.au/support-at-home-levels
- Aged Care Made Easy. Understanding the End-of-Life Pathway. agedcaremadeeasy.com.au/understanding-end-of-life-pathway
- Palliative Care Australia. Position on the Support at Home End-of-Life Pathway. palliativecare.org.au/statement/support-at-home-end-of-life-pathway
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