End of Life Doulas and Bed Block: A Simple, Human Part of the Solution
Palliative Care Australia (PCA), the national peak body for palliative care, has recently highlighted growing pressure on Australia’s hospitals from bed block — where people remain in acute care beds not because they need acute medical treatment, but because they lack appropriate support in the community. In its 2026 Federal Budget Submission, PCA argues that stronger investment in palliative care, especially earlier and community-based care, could help ease pressure on hospitals while giving people the support they need at the end of life.
Palliative Care Australia’s call highlights what many families already know — that without enough support at home, the hospital too often becomes the default. That reality matters deeply to the person nearing the end of life and to their loved ones. It also matters to the health system.
You can read the full PCA release here: https://palliativecare.org.au/mediarelease/australia-can-relieve-hospital-bed-block-with-palliative-care-investment/
I support PCA’s direction wholeheartedly. Earlier access to palliative care, stronger home-based supports and clearer coordination across health and aged care are essential. At the same time, one important dimension is often missing from these discussions: the relational, practical support that sits alongside clinical care. This is where End of Life Doulas fit, and where I see real impact every day.
What End of Life Doulas Actually Do
End of Life Doulas are non-medical practitioners who support people and their families through the emotional, relational, spiritual and practical aspects of ageing and life-limiting illness. We do not replace clinicians or provide clinical care, but we fill crucial gaps that often contribute to avoidable hospital stays.
We help people make sense of what is happening, understand choices in plain language and begin conversations about what matters most. We support families and carers to navigate fear, uncertainty, fatigue and grief in ways that ease emotional strain and reduce the sense of crisis that often precedes an emergency hospital admission. We stay consistent when services rotate, helping people feel safe and understood even as clinical supports change around them.
That continuity and presence — the human, grounded accompaniment — makes a real difference. It reduces the fear of “what if” and helps people identify where they want to be, what they want to avoid and how to make that plan happen.
How Doulas Help Reduce Hospital Bed Block
Too often, people end up in hospital simply because they or their carers do not yet feel confident managing care at home. Sometimes carers are exhausted or overwhelmed. Sometimes plans have not been discussed early enough. Sometimes the system feels too fragmented to make sense of the next steps in the moment.
End of Life Doulas support advance care conversations early, helping people articulate their preferences and share them with family and health professionals. This doesn’t take the place of clinical planning, but it does make it more likely that a person’s wishes are understood and respected across settings. When people and carers have this clarity, the default response is less often “go to hospital”.
Carers play a central role in whether someone remains at home. When carers feel isolated or unsupported, hospital admission becomes the nearest form of respite, even when clinical support could be arranged. Doulas walk alongside carers as well as the person who is dying, offering reassurance, presence and simple practical guidance. That support helps carers cope longer and reduces the pressure to seek hospital care simply for a sense of safety.
Another contribution is consistency of presence. Health services are busy environments where staff change and rosters rotate. A doula can be the same familiar person throughout the whole journey. That continuity prevents small worries from escalating into crises that result in emergency department visits or longer hospital stays.
Importantly, doulas work in partnership with palliative care teams, general practitioners, nurses and aged care providers. Clinicians focus on symptoms, treatment and clinical decision-making. Doulas focus on relationships, daily life, communication and emotional wellbeing. Together, this creates a more complete model of care that supports people where they live, close to the people they love.
“End of Life Doulas work alongside clinical teams to provide the social, emotional and practical support that helps people remain safely at home and avoid unnecessary hospital stays.”
How This Complements National Priorities
Everything described above supports what PCA is advocating: care earlier in the illness trajectory, stronger community supports, clearer roles across hospitals and aged care, and fewer avoidable hospital admissions. End of Life Doulas are not an alternative to specialist palliative care. We are a complementary role that strengthens community-centred care.
The work we do helps people remain where they wish. This work helps reduce the fear that leads to crisis admissions and eases pressure on carers and the health system alike. It is quiet work, but practical and measurable. It benefits hospitals, but more importantly, it benefits people and families in the deepest moments of their lives.
A Simple Message
If Australia wants to reduce hospital bed block, support people to have the end-of-life experiences they prefer, and relieve pressure on health services, then we must value not only clinical expertise, but also the social and emotional support that surrounds it. End of Life Doulas are already offering this support in homes, aged care facilities and communities across this country.
We walk alongside people. We help make sense of the journey. We support carers. And we help ensure that hospital is used when it is truly needed, not simply when support feels absent.
A shared responsibility
Improving end-of-life care in Australia is not something any one group can do alone. It takes people, families, carers, clinicians, aged care providers, community services and policy leaders working together.
If you or someone you love is living with a life-limiting illness, you have a voice in this system. You can ask questions. You can start conversations. You can shape the care you receive.
I encourage you to speak with your GP, palliative care team, aged care provider, hospital team or home care provider about End of Life Doulas. Ask whether this kind of non-clinical, relational support could be part of your care. Ask how emotional, practical and family support is being addressed alongside medical treatment.
The more these conversations happen in homes, clinics, hospitals and aged care services, the more visible this work becomes. And the more likely it is that roles like End of Life Doulas will be understood, valued and included in future care models.
Better end-of-life care is not just about funding or hospital beds. It is about people feeling supported, understood and safe where they are.
That is what we all deserve.
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 weeks of life.
References
- Palliative Care Australia (2025), Australia can relieve hospital ‘bed block’ with palliative care investment.
https://palliativecare.org.au/mediarelease/australia-can-relieve-hospital-bed-block-with-palliative-care-investment/
Your Path Guide Pty Ltd 