Time and roles. The hospice nurse is the medical manager of the terminal patient with limited time at the bedside. The Doula is a non-medical professional who is the eyes and ears of the case with no time limitations. The Doula alerts the hospice team to any changes in the patient's presentation so that the hospice nurse can assess and update the care plan for maximum daily comfort of the patient (the goal of hospice).
Again, time and roles. 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. The Doula can spend as much time with a patient or family as they choose. The Doula can do everything EXCEPT give medication or do any form of medical treatment or wound care. The hospice volunteer needs to follow Medicare regulations that prohibit any form of moving, feeding, bathing, toileting etc.
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 may or may not be part of this service. If not, then families can feel this as another loss. End-of-life Doula’s services are available before, during, and anytime after death, even years later.
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. An End-of-life Doula can be there for as long as needed, as negotiated with the terminal patient and/or the family.
Absolutely! The National Hospice and Palliative Care Organization (NHPCO) is the membership organization for all the hospices in the US. They started The End-of-life Doula Council to be able to share with hospices and families how an End-of-life Doula can assist and complete the hospice team to “bridge the gaps in care” and allow for the best end of life experience for both the patient and their loved ones.
No, End-of-life Doulas are non-medical professionals. Just like the establishment of Birth Doulas over 40 years ago, this profession is not regulated by a government license, but there is a certification process and microcredentials that can be earned. Everyone interested in hiring an End of Life Doula is encouraged to do their own research to find someone who they trust. Doulagivers End of Life Doulas and Doulagiver Specialists go through extensive rigorous training and testing. All End-of-life Doulas should be able to provide a current Certificate of Education and Certificate of Liability Insurance as well.
End-of-life Doula services are not covered under insurance. Services are private pay, similar to other companion/caregiver type services, like Comfort Keepers, Home Instead or Visiting Angels. Fees are very affordable and can be purchased hourly or by packages. Please contact me today to schedule a free 30 minute consultation.
Yes, an 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 recovery of life after loss
YES! As a TELE DOULA! With The New "Tele Doula" option, I am now able to support patients and families using technology and staying safe in a time of COVID and when you I may not be able to be at the bedside.
This content is provided by Doulagivers Institute. For more information visit www.doulagivers.com
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