Time and roles. The hospice nurse is the medical manager of the terminal patient with limited time at the bedside. The Doulagiver is the non-medical professional that is the eyes and ears of the case with no time limitations. The Doulagiver alerts the hospice team to any changes in the patients presentation so that the hospice nurse can assess and update the care plan for maximum daily comfort of the patient (the goal of hospice.)

A Doulagiver/ End of Life Doula can do everything EXCEPT give a medication and do any form of medical treatment or wound care. The hospice volunteer needs to follow Medicare regulations that prohibit any form of touching, moving, feeding, bathing, toileting etc. The hospice volunteer in most US states is limited to a maximum weekly bedside visit of 4 hours. The average volunteer visit is 1-2 hours a week. This does not provide the adjunct support that patients and families so desperately need at this stressful time.

No. Doulagiver/End of Life Doulas are private pay. All “companion” services such as Home Instead, Visiting Angels, Comfort Keepers etc. are all private pay. Most End of Life Doulas have a sliding scale payment option.

No. A End of Life Doula never gives any medication whether prescription or over the counter.

Yes. A Doulagiver End of Life Doula has a ”scope of practice” that includes everything from the time of a terminal diagnosis to helping patients and families as the illness progresses, to the vigil, time of death, after death care, understanding and honoring grief and finally recover of life after loss.

Most hospice teams leave a case after the patient has died. Many times families are feeling this as another loss. Hospice does offer bereavement services for up to a year or 15 months in most states. This is usually initiated by a call from a volunteer and the living family member is told about monthly support groups that they may attend. The original hospice team that worked with the family is not part of this service.

Time. Most hospices provide HHA services up to a maximum of 2 hours a day 5 days a week. This is based on acuity of the patient and is only available if the hospice has an available aid.

No End of Life Doulas are a Non-Medical Profession. Just like the establishment of Birth Doulas 40 years ago. This is not regulated by a government license.

YES! ( NEDA ) The National End of Life Doula Alliance has set a national practicum with Core Competencies for the practice of professional End of Life Doulas. All End of Life Doulas that pass the assessment receive the NEDA National Credential and can become members of the national membership organization

YES. The National Hospice and Palliative Care Organization (NHPCO ) is the membership organization for all the hospices in the US. The have just put together The End of Life Doula Council to be able to share with Hospices and families how the Professional End of Life Doula can assist and complete the hospice team to fill in “the gaps in care” and allow for the best end of life experience for both the patient and their loved ones.