live with heart

End of Life Questions

End of Life Questions & Answers about the differences you may have about this role, why you want to consider having an End of Life Doula or Transition Advocate.

  • Q: What is the difference between a hospice nurse and a Doulagiver/End of Life Doula?
  • A: 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 )
  • Q: What is the difference between a hospice volunteer and a Doulagiver/ End of Life Doula?
  • A: As 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.
  • Q: Does insurance cover the services of a Doulagiver/End of Life Doula?
  • A: No. Doulagivers/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. Payment comes from the family/friends who hire them.
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  • Q: Can a Doulagiver/ End of Life Doula give any medications? What about over the counter medications?
  • A: No. A End of Life Doula never gives any medication whether prescription or over the counter. 
  • Q: Can a Doulagiver/ End of Life Doula help make funeral arrangements for me?
  • A: 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.
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  • Q: What services and support will hospice provide for me after my loved one has died? What does the Doulagiver provide for grief support?
  • A: 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.
  • Q: What can a Doulagiver/ End of Life Doula do that a Hospice home health aide can’t do?
  • A. 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.
  • Q: Is there a government licensure for End-of-Life Doulas?
  • A: 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.
  • Q: Does Hospice approve of End-of-Life Doulas?
  • A: YES. The National Hospice and Palliative Care Organization (NHPCO) is the membership organization for all the hospices in the USA. They 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. 

Here is a list of other articles about being doula, here’s a bit of information about hiring Mari-Lyn as a Life Transition Advocate or Death Doula.  If you have more end of life questions or would like to speak to me, just book an appointment.

Thank you

Mari-Lyn