JOEL ROSE, HOST:
If you or someone you love has given birth lately, you probably know about doulas - nonmedical professionals who provide comfort, encouragement and advocacy during birth. There is now a movement of doulas for the end of life as well - death doulas - and their numbers are growing. NPR's Fio Geiran has our story.
UNIDENTIFIED PERSON: I know. Amazing.
(CROSSTALK)
FIO GEIRAN, BYLINE: At a recent DC Death Collective gathering, death doulas and supporters greet each other.
DARNELL LAMONT WALKER: Death is not always dark and somber. When we get together, there's so much laughter and light.
GEIRAN: That's death doula Darnell Lamont Walker. He bonds with the group, talking about the heavier parts of their work and cracking a couple jokes he's learned in the death worker business.
WALKER: The guy walks in. He's like, good to see you. He's like, better seen than viewed.
(LAUGHTER)
GEIRAN: It was Walker's grandmother who taught him not to shy away from death. She did the work of a death doula, though she never used that phrase.
WALKER: She took care of people. She believed that no one should go through hard things alone.
GEIRAN: Walker is the author of "Never Can Say Goodbye: The Life Of A Death Doula And The Art Of A Peaceful End." The modern death doula movement started taking shape in the early 2000s, following the introduction of palliative care in the 20th century.
ASHLEY JOHNSON: It is the work of Cicely Saunders that really put in perspective the modern end-of-life movement.
GEIRAN: That's Ashley Johnson, president of the National End-of-Life Doula Alliance, or NEDA. Saunders, the person she had mentioned, founded the first modern hospice and helped establish the field of palliative care. As the death doula movement expanded, it also pulled from birth doula practices.
LESLIE TOLF: So just like there are birth doulas, it makes sense to have death doulas.
GEIRAN: That's death doula Leslie Tolf. She's a cochair at The DC Death Collective. She says the dying need an advocate, someone to help them through their transition, especially since private equity companies have been buying up hospices and stripping back services.
TOLF: More and more people are warehoused in assisted living homes. And so the companioning, the human part of the dying process, has been left on the side.
GEIRAN: Death doulas are also there for other kinds of conversations.
SAM STEBBINS: One lady I was working with who was getting close to dying and the one thing she wanted to do was get her fridge replaced.
GEIRAN: That's Sam Stebbins. He's a death doula and a minister.
STEBBINS: And I kept trying to nudge her, saying, don't you want to think about, like, the important things in life? And she was like, no, I want to get my fridge replaced - 'cause for her, her spiritual thing was she didn't want to leave her apartment, you know, as a mess for the next person.
GEIRAN: But why are more people becoming death doulas in recent years? Johnson, the head of NEDA, says the COVID-19 pandemic accelerated the awareness of death doulas. Tolf, the cochair of The DC Death Collective, also suspects other reasons.
TOLF: Frankly, I think it's because the baby boomers are such a large demographic of our population right now, and just like they wanted to manage their midlife, they want to manage their end of life.
GEIRAN: Death doulas have also gone mainstream, with a character in HBO Max's "The Pitt."
(SOUNDBITE OF TV SHOW, "THE PITT")
LESLEY BOONE: (As Lena) I'm Roxie's death doula.
UNIDENTIFIED ACTOR: (As character) Her what?
GEIRAN: And celebrities have spoken about training to become death doulas, like director Chloe Zhao and actor Nicole Kidman.
TOLF: The ability for her voice to resonate, you know, across people who won't have conversations with their parents - I am in love with Nicole Kidman now.
GEIRAN: However, Tolf says with increased awareness comes potential complications.
TOLF: As we grow, of course, people who might not be certified come into the mix and say, oh, I'm a death doula, having not taken the training. So I think that that is something we have to watch for.
GEIRAN: Another complication is creating uniform standards. Being a doula is a nonmedical title. So this work can be difficult to define, and people have different needs towards the end of life. Here's Johnson.
JOHNSON: So we provide a proficiency assessment that is designed to evaluate that the doula demonstrates knowledge and skills aligned with the nationally developed standards.
GEIRAN: But if you are looking for support, Johnson says there are ways to approach it.
JOHNSON: The questions that you should ask are - do you follow a code of ethics? What services do you offer? How long have you been practicing? What trainings have you completed? Are you comfortable with supporting my family's culture or spiritual beliefs?
GEIRAN: Darnell Lamont Walker says you don't need to wait for a serious diagnosis to have these early conversations about death. In addition to being a death doula, Walker also works as a children's television writer.
WALKER: My goal is to create content that will help a kid not become the adult that I'm working with who's so afraid of death and can't talk to others and can't be in community about it.
GEIRAN: He hopes his writing guides kids through complicated topics, the way his grandma guided him.
WALKER: One day, you're going to die. But until then, there's still so much life you can get to. Like, what becomes important?
GEIRAN: He says when we acknowledge death as a part of life, we give ourselves permission to live more fully. Fio Geiran, NPR News.
(SOUNDBITE OF ARCADE FIRE AND OWEN PALLETT'S "PHOTOGRAPH") Transcript provided by NPR, Copyright NPR.
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