A Decade of Doula Impact: Transforming End-of-Life Care
by Douglas Simpson
The first step to taming grief ghosts is noticing when they appear.
Grief is no stranger to those of us working as end-of-life doulas. We walk alongside individuals and families as they traverse one of life’s most vulnerable and intimate journeys— death. But as we offer presence and support, our own grief, both past and present, may quietly stir within us. These inner grief ghosts can be subtle, arising unexpectedly, or persistent, making it difficult to fully focus on our clients. If left unaddressed, they can affect our ability to hold space effectively.
In this reflection, we’ll explore how these “inner grief ghosts” appear, why taming them is essential, and how we can navigate this emotional landscape with compassion for ourselves.
In just a decade we have trained doulas in every U.S. state along with Washington, D.C., Guam, Virgin Islands, and Puerto Rico, and 46 countries.
As we reflect on ten remarkable years, the International End-of-Life Doula Association (INELDA) stands proud of our journey, growth, and impact on end-of-life care. What began as an earnest vision has blossomed into a transformative movement that has touched tens of thousands of lives, perhaps more.
Earnest Beginnings: Planting Seeds for a New Field of Practice
Ten years ago, we set out with a simple yet powerful mission: to transform the way the dying and their families experience the last months, weeks, and days of life and to provide education that allowed them to better support the dying and their loved ones. Our founders and builders believed that, with this knowledge, we could bring deeper meaning and greater comfort to the dying process. Today our mission has grown and shifted to include encouraging the presence of end-of-life doulas throughout the continuum of care, providing additional education offerings while seeking partnerships and change makers to open up spaces for doulas.
A Decade of Doulas: By the Numbers
Over the past decade, our growth has been nothing short of extraordinary. Since our inception, we have:
- Trained over 8,000 end-of-life doulas across the United States and internationally
- Conducted more than 215 comprehensive end-of-life doula training programs
- Awarded $300,000 in scholarship funds to individuals from diverse backgrounds beginning in 2021
- Trained doulas in every U.S. state along with Washington, D.C., Guam, Virgin Islands, and Puerto Rico, and 46 countries
The individuals and organizations that INELDA has trained have gone on to lead doula organizations, establish community doula networks serving regionally and statewide, and create a profound impact on the care facilities that they support.
The Evolution of Our Doula Approach
Our approach has continuously adapted to meet emerging needs and to provide a framework for all communities. What started as primarily a doula program created on a birth doula model with three phases has been reshaped and re-envisioned. In 2024, after many months of collaboration, revisiting learner feedback, understanding the asks and challenges of practicing doulas, and developing our internal collective voices, we put forth The INELDA Doula Approach.
Our current approach is a reiterative process of three doula principles of self-awareness, the autonomy of the dying, and the dying process, based on the foundation of full-self listening. This approach aims to empower individuals to become self-aware stewards of deathcare who foster autonomous choice-making at the end of life. We invite doulas to participate in the movements for transformative justice, working first to normalize death and dying within themselves and then educating others.
Certification: Building Confidence in the Doula Field by Developing a Standard of Competencies
Our new certification program is a community-based model with panel mentorship with peer-to-peer learning. The one-year-long cohort honors the many pathways to practice as a doula. Participants are required to partake in 95 hours of synchronous and asynchronous learning, working within their communities, and providing direct care.
It’s not just about completing more training, but about establishing a set of competencies rooted in the INELDA Doula Approach to end-of-life care that can be relied upon across all practice settings. Through our certification program, doulas will learn to reflect and be accountable to the care that they are providing through the lens of our core competencies.
Voices of Impact: Doula Testimonials
A few of the voices from individuals within our community share the impact INELDA has had on their life’s work and the ways in which the organization supports death awareness and the doula approach as doulas support others.
Doula and Veteran Bob Hamilton: I just want to let you know that the effects of your training continue today. Several of us continue to work with fellow vets in the latter stages of their lives, including the last hours. Our efforts are making a difference, one vet at a time. Your training has had more impact than just that of working with vets at the end of life, as everyone that attended is more comfortable talking about death and dying. And in our culture, that is no small accomplishment to be able to discuss something we were never taught.
Jessalyn Maguire, MSW: This course was transformative. I absolutely loved Wilka and Jason as educators—they brought such depth, compassion, and expertise to every session. The experience was challenging, enlightening, and energizing. By contemplating death in such a thoughtful and guided manner, I’ve discovered a renewed verve for life and feel profoundly called to action. I’m excited to be part of the death revolution, advocating for autonomous, meaningful, compassionate end-of-life care.
Educator Wilka Roig: I first happened upon INELDA in 2015 and was finally able to train in 2017. My first impression of INELDA was that it offered the most accessible, practical approach to support at end of life, but it has become so much more. What I learned in training became a daily gauge for how I was doing in my relationship to my own mortality and cultivating a lifestyle of death awareness, which has been most valuable. It gave me confidence to set out on what started as sitting bedside and community education and has become a path of community outreach and activism, which continues to prove most enriching. Today, as part of the INELDA team, I am continually inspired and proud of the meaningful contribution we are making to the evolution of our death culture.
Celebrate With Us!
We are excited to dive into the archive for a decade of webinars, newsletters, and teachings to share with you throughout 2025. Stay tuned to our social media to read and hear from some of the luminaries we have connected with over the past ten years.
Not connect to our online channels? Visit us on LinkedIn, Facebook, Instagram, and YouTube to get the latest posts, community shares, and online advocacy for accessible deathcare. If you have trained with us in the past and are still not a member of INELDA’s Facebook private group page, please send a request to join.
An Invitation to Join INELDA’s Mission
Whether you’re a private practitioner, community health worker, family caregiver, donor, health care professional, or someone passionate about transforming end-of-life experiences, there’s a place for you in the INELDA community.
As we turn the page to our next chapter, we remain committed to our core belief that every person deserves equitable deathcare. Join us in forging the next decade of doulas. Together, we will continue to expand the presence of end-of-life doulas and redefine how we consider, prepare for, and journey with others in our shared mortality.
Posted: February 11, 2025
AUTHOR BIO
Douglas Simpson is INELDA’s executive director. Prior to training with INELDA in 2018, joining as a full-time volunteer in January 2019, and moving into the executive director role in 2022, Doug spent more than 25 years in retail management. His time in retail taught him how to be an effective operator and focus on the “customer” and their journey into and around a brand. He is a board member of the American Clinicians Academy on Medical Aid in Dying.