The American way of death is going through some major changes. The COVID-19 pandemic coupled with the relatively unknown field of death doula may be leading the way to a more realistic and much more humane treatment of death.

Time magazine recently published an article about the rising number of death doulas —people who are trained to give practical and emotional support to terminally ill people as they approach their deaths. Since 2019, the number of end-of-life doula trainees has multiplied by as much as 500 percent, a dramatic rise attributed to the pandemic. 

Doulas do not administer or prescribe medications and so there is no licensing or governing body involved. Their fees range from $40 an hour to $100 an hour, and some work on a flat fee basis. People are attracted to the work not for a lot of money but for the chance to provide a real service to those who are having to confront and manage this universal experience, around which so much fear exists.

Doulas help their clients recall positive life experiences and bring them into present awareness. Near the end of life, awareness can come and go, and the doula can support these periods of awareness by helping people return to either positive memories or to focus on whatever supportive people might be with them in the present, thus easing their anxiety, resistance, and fear.

Sometimes, this process begets a spiritual opening or awakening, in which physical life is seen to be a part of a greater, encompassing spiritual life. Dying to physical, then, can be seen as a sort of awakening to a greater non-physical reality.

As of the end of January, 2022, COVID-19 deaths in the US have exceeded 900,000, and the U.S. is still seeing thousands of pandemic deaths every day. One doula training group reports that calls for service grew eight-fold, from one every couple of months in 2019 to three or four every month currently.

The growing demand for death doulas and their services might suggest a broader positive impact. Americans tend to ignore death, to avoid talking about or addressing it directly. Language usage is meaningful; instead of dying, people “pass on,” “cash it in,” “check out,” “get off the bus,” or “kick the bucket.” Seldom, in conversations that are personal, do we use the word “die”. And most people avoid facing the practicalities of death and as such, don’t have wills or advanced care directives to manage what is possible about their own deaths.

But with the new levels of interest in end-of-life doulas and their work, the reality of what we all ultimately face is becoming more open, more humane.