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Sally Gabriel, Ph.D. Certified End of Life Doula
Supporting Patients and Families through Life’s Final Chapter
As you contemplate the end of your life, how would it feel to have someone available to support and guide you and your family through the dying process, carrying out your wishes for an end of life with dignity and comfort?
As an End of Life Doula, I can be that someone.
What I Do
I provide non-medical support, companionship, counseling, advocacy, and education to patients and their loved ones through life’s final chapter. Most importantly, I teach that death is a natural part of life, not a medical event, and how to prepare for it.
Just as there are Birth Doulas who provide emotional and logistical support to pregnant women as they prepare for birth, End of Life Doulas provide similar support services to the dying as they prepare for death. We address a universal need and fill a gap in care at the end of life.
Far too many of us are unprepared for the experience of dying. In our largely death-phobic culture, having someone around you who is helpful, calm, and wholly present in the face of death is a huge relief. End of Life Doulas provide a peaceful presence at the bedside, spend the time to support the deep relationships patients and families need, and are trained to calmly address the complex situations that can occur at the end of life.
Why I Do This Work
My work as an End of Life Doula is a calling
Caring for people at the end of life requires:
a compassionate heart
a listening ear
I’m a caring, compassionate listener, trained in coaching, communication, grief support, aging, death, and dying.
I believe in your right to plan and orchestrate your own death journey and die feeling cared about and supported. I view the dying process as natural, sacred, and nothing to fear. I aim to help you and your loved ones create a peaceful, positive, and meaningful end of life experience.
I am based in Sarasota, Florida, and provide End of Life Doula services in Sarasota and Manatee counties and nationwide remotely.
Death is not the opposite of life but a part of it.
- Haruki Murakami
What exactly is an End of Life Doula?An End of Life Doula, also known as a death doula, dying companion, or death midwife, is a trained, non-medical professional who provides emotional, physical, informational, and spiritual support to individuals who are nearing the end of their lives and their families. Doulas offer guidance, education, and assistance before, during, and after death. An End of Life Doula operates like a life coach for patients and families at the end of life. She is there to help you determine what matters most during your life's final chapter and helps bring your wishes to fruition. What loose ends do you need help tying up? What broken or estranged relationships would you like to resolve? She can help you share your untold stories or help you hold a "pre-memorial so you can reminisce together with your friends and family. While most people cannot comfortably discuss death and the end of life, an End of Life Doula is trained to speak easily about these subjects and to treat dying as a natural process. She will help you and your loved ones experience the best outcome possible - death with dignity and physical, emotional, and spiritual comfort. We answer questions, ease anxieties, serve as guides, and advocate for autonomy and dignity. End of Life Doulas are not only for the imminently dying. We can assist people in all stages of life with advanced care planning, education, resolving death anxiety, and supporting grief. Please see the section under SERVICES for more specific information on what support I can provide.
Why would I need an End of Life Doula?When we let death “happen” without planning, it becomes a medical event rather than a normal part of a life cycle. We must remind ourselves that death is a natural part of life. Approximately 30% of people create end of life plans and share them with their loved ones. But what about the other 70%? We will all experience death at some point, so why not plan for it? The more you plan for your death, the better the experience will be for all involved. The greatest determining factor in whether or not an end of life journey is considered positive is the level of support experienced throughout the process. End of Life Doulas are Event Planners for the dying and help fill the gaps between all of your different service providers. We can work with you, your family members, and caregivers to help you develop an “End of Life Care Plan” so you have a say in the different aspects of your dying journey. End of Life Doulas are a calming and reassuring presence with knowledge of the death process. We serve as a compassionate resource for families who may be in shock, overwhelmed, and grieving at the impending death of a loved one. There are various services the End of Life Doula can offer in the dying process, and they are primarily a comforting, reliable, and knowledgeable presence during a difficult and emotional time. Why wouldn’t you need an End of Life Doula? Maybe that’s a better question.
When should I contact an End of Life Doula?End of LifeDoulas can be called in at any point during the end-of-life process (or earlier; see the next question). The best time to hire a death doula is at the point when a person first gets a terminal diagnosis. End of Life Doulas do not have the same admission criteria that hospice does and can begin important discussions at any time during one's illness. The sooner the End of Life Doula enters the process, the more time she has to get to know you and your family, prioritize end of life needs, and, with your input, create a high-quality End of Life Care Plan.
Do I have to be dying to work with an End of Life Doula?Absolutely not. You do not have to meet any particular criteria to work with an End of Life Doula. If you (or someone you love) receive a life-limiting or terminal diagnosis, even if the prognosis is years, I welcome you to contact me whenever you feel ready to start the conversations and planning around death. People without known diagnoses also work with End of Life Doulas to facilitate challenging conversations, create advance directives and manage death anxiety.
Do death doulas work with hospice?Yes. End of Life Doulas provide supplementary and complementary support. Anyone who has had a loved one in hospice knows that the number of hours of weekly hospice care is usually quite limited due to staffing, budgeting, and Medicare restrictions. Doulas work well alongside hospice staff and can provide more service hours than hospice workers.
Does hospice approve of End of Life Doulas?Yes. The National Hospice and Palliative Care Organization (NHPCO ) is the membership organization for all the hospices in the US. They have created 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.
How are End of Life Doulas different from what hospice offers?It is recommended that every individual and family facing a terminal illness call a local hospice as soon as possible. Usually, there is a medical referral to hospice, but that’s not necessary. Though End of Life Doula services do not replace the hospice's medical team of nursing, social work, and physician care, she easily complements the hospice team. Doulas offer more personalized attention, more continuity at the bedside, more advocacy for the patient’s wishes, and more time availability than what hospice can provide. The extensive end of life training a Doula receives exceeds what hospice volunteer programs provide. We are trained and practiced in being with intense and difficult emotions and listening fully. We can provide a consistent relationship with clients and families and full-time presence and companionship at the vigil and death. No other programs are currently providing that level of end of life care.
How are End of Life Doulas trained?Several qualified training programs educate and certify End of Life Doulas. Many Doulas have medical, social work, psychology, counseling, ministerial, or similar backgrounds before training as an End of Life Doula. When you choose an End of Life Doula, be sure to choose one who has earned certification.
Is there government licensure for End of Life Doulas?Not yet. The End of Life Doula profession is non-medical. Just like the establishment of birth doulas 40 years ago, a government license is not necessary to enter the profession.
Are any national organizations regulating the End of Life Doula Profession?Yes. The National End of Life Doula Alliance (NEDA) 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.
Does insurance cover the services of an End of Life Doula? How do Doulas charge for their services?No. End of Life Doulas are usually private pay. All “companion” services, such as home health aides, are private pay. Some hospices in the US include End of Life Doula services, but Medicare limits these individuals in how much time they can devote to each patient. End of Life Doulas charge for their services in various ways. Some create service packages for a set fee, while others charge by the hour.
Can an End of Life Doula give medication?No. An End of Life Doula does not give any prescription or over-the-counter medication. Only specific medical personnel and trained caregivers (including family members) can administer medication.
Can an End of Life Doula help make funeral arrangements and plan memorials?Yes. An End of Life Doula can help with all the necessary preparations before and after a person’s death.
What do ‘death-positive’ and the ‘death positivity movement’ refer to?The death-positive movement is about leaning into our natural human curiosity surrounding death to help mitigate our anxieties. (We all have anxieties). Death-positive people believe that speaking openly about death is not taboo or depressing. We view honest conversations about death and dying as part of a healthy mental state. The death positivity movement encourages us to be interested and curious about death, to talk about it openly, and to plan for its inevitability.
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