End of Life Doula

March 13, 2024 at 8:32 p.m.
Kathy Bates is an End of Life Doula in the Seattle area
Kathy Bates is an End of Life Doula in the Seattle area

...by Michelle Roedell, Editor, Northwest Prime Time

Tuesday early afternoon found a group of curious older adults gathered at the Wallingford Community Senior Center (WCSC) to learn how an "End of Life Doula" can support the dying and their families. Kathy Bates, a Seattle-based End of Life Doula, was there to talk about her work and to answer questions.

The seniors had a lot of questions.

Amanda Kruger, WCSC program manager, said, "It was great to have Kathy present at WCSC to talk about being an end of life doula. People were very interested in learning about what an end of life doula does, the history, and how this service differs from other forms of end of life care. Kathy was engaging and had great stories and insights about some of her on-the-job experiences."

Kathy told the senior center group that finding someone you trust who can listen deeply to your questions and concerns about death can help you accept and work through the intensely personal process of dying. This service is not only for the person who is dying, but also for their loved ones.

While death isn't easily discussed in our society, every living being must go through the dying process. Those who work with people who are dying and their family members believe that the dying process can be a sacred and transformative experience.

An End-of-Life Doula, also known as a Death Doula, can provide non-medical support and guidance during that final transition. Death doulas are trained professionals who offer emotional, practical, and spiritual support to people who are dying and their loved ones.

Some people may ask the question of why an End-of-Life Doula is necessary if Hospice is provided. A Death Doula is an adjunct or complement to the Hospice team. The Hospice doctor and nurse manage only the medical aspects of an individual's care and they must work within insurance reimbursement guidelines, which limit their time. The Doula collaborates with Hospice professionals and is not limited by insurance restrictions.

End of Life Doulas can help with tasks such as:

  • Providing a caring presence, offering a safe and sacred space for you and your family to express fears, hopes and wants.
  • Act as advocates to navigate the healthcare system so you can understand your best options for end-of-life.
  • Offer supportive companionship so an individual doesn’t feel isolated and afraid, and instead holds sacred space for meaningful conversation, memories and reflections.
  • Help create an end-of-life plan by facilitating conversations about healthcare choices, legacy wishes and spiritual beliefs to have a dignified and heartfelt experience.
  • Find resources and support in your community.

Kathy tells us that bringing on a death doula helps the individual and their family ensure that this last rite of passage is a sacred and meaningful one. The process may begin when a person receives a life threatening or terminal diagnosis. Planning ahead helps not only the person with the illness but also helps families honor the wishes of their loved ones.

Kathy began her journey to that Tuesday afternoon talk at the Wallingford Senior Center six years ago when she saw an ad about End of Life Doula training in the Spirituality and Health magazine. Kathy, a Social Worker and Geriatric Mental Health Specialist, had worked for 30 years in skilled nursing communities. She was no stranger to helping individuals and their loved ones have difficult conversations as they were moving towards the end of life.

After seeing that ad, she recalls a sudden knowing. "I am meant to be doing this work," she shared with her husband, Greg. She retired from her role as a social worker and began her training.

"Being a gentle guide providing emotional, spiritual and psychological support, and helping diminish fear of the unknown, is at the core of my heart work," said Kathy. "Each End of Life journey is unique and sacred," she added. "Honoring the wishes of the dying person and their family is so important."

Kathy reflected on some of her experiences as an End of Life Doula. "There are so many stories to share, but some of the most touching ones include being a Doula for a woman who initially wished to see me just once a month. It was a time devoted to life review, reflection, getting her affairs in order, and preparing for the end of her life. Of interest, she did not want to involve her family in her planning, sitting vigil at her bedside, or to be notified of her death." The woman dismissed Kathy when the planning was done, but then, in her last four days, she contacted Kathy through her Durable Power of Attorney that she wanted Kathy at her bedside. "It was a a sacred honor and privilege to provide vigiling during the last days of her life. The gift was to be able to honor her wishes and to provide sacred space for her to let go of life."

Kathy recalls a time during the height of COVID being contacted by a son and daughter when their mother was discharged from the hospital to her home in an assisted living community. The woman was already unresponsive. Because of COVID protocols, Hospice could not make visits. Kathy was able to provide information, education, support, and gentle guidance to the family in how to care for and support their mother in her last days.

"Often, I have a special joy of being an End of Life Doula for three generations: the client, spouse, children, and grandchildren... As a Doula, I found that the grandchildren often were more at ease being present and caring for their grandparent. Providing gentle support, encouraging and empowering a person to listen to their intuition to follow their end of life wishes is at the core of my heart work."

Kathy is one of the founders of the Gentle Passage Doula Collective (
http://gentlepassagedoulacollective.com/). The Collective provides End of Life Doula training and educational webinars. The Collective also organizes Death Cafes to provide an opportunity to discuss death and dying. The cafes have no agenda other than in providing a safe haven to talk and share.

Kathy Bates has been in the healthcare field for over 40 years. In addition to her work as an End of Life Doula and social worker, she and her husband owned the Northwest Center for Adult Children, a private counseling practice. For more information about Kathy and her work, visit 
compassionatedoula.com. She can be reached at Kathy@compassionatedoula.com or by calling 206-948-3713.
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