The Art of Setting Boundaries: Working With Families at the End of Life
by Marady Duran, LMSW, MATD
Throughout my years of practice as both an educator with INELDA and a clinician serving individuals and families at the end of life, one recurring question consistently arises: “How do you establish and maintain healthy boundaries with the families you serve?”
This is a profound question—one that speaks to the very heart of compassionate caregiving. Boundaries are not barriers; they are structures that allow both practitioner and family to engage authentically, safely, and sustainably. Over the years, I have reflected deeply on this topic and gathered lessons from both personal experience and the shared wisdom of colleagues and learners in this field.
Throughout my years of practice as both an educator with INELDA and a clinician serving individuals and families at the end of life, one recurring question consistently arises: “How do you establish and maintain healthy boundaries with the families you serve?”
This is a profound question—one that speaks to the very heart of compassionate caregiving. Boundaries are not barriers; they are structures that allow both practitioner and family to engage authentically, safely, and sustainably. Over the years, I have reflected deeply on this topic and gathered lessons from both personal experience and the shared wisdom of colleagues and learners in this field.
Understanding the Need for Boundaries
Each practitioner brings their own rhythm and capacity to this work. For some, structure—such as a consistent schedule or clear communication parameters—creates a sense of containment and safety. Others may prefer a more fluid, intuitive approach that adapts to the changing needs of clients and families. There is no single correct way; the essential task is to discern what is sustainable for you emotionally, physically, and spiritually.
In my own early years as a hospice volunteer, the word “no” rarely left my lips. When asked to take on another client, I said yes. When a family needed extra help—laundry, errands, emotional support—I said yes again. My desire to be helpful and to minimize others’ suffering gradually led me toward burnout. It wasn’t until I found myself emotionally depleted and spiritually drained that I realized how essential boundaries are to effective care.
Boundaries as an Act of Care
Through supervision and mentorship, I began to understand that boundaries are not acts of rejection—they are acts of respect. They create clarity, predictability, and emotional safety for both practitioner and client. Boundaries affirm the truth that while we may walk beside families during profound transitions, their journey is ultimately their own.
INELDA’s code of ethics and scope of practice provide important guidelines to prevent role confusion and compassion fatigue.
Practical Strategies for Setting Boundaries
- Establish and communicate clear availability. Define your schedule and stick to it as consistently as possible. If you are available only on certain days or during specific hours, communicate this up-front and assist families in identifying other supports for off-hours or emergencies. Collaboration within a doula collective or hospice team can distribute care and reduce overload.
- Clarify communication channels. Let families know how and when you can be reached—whether through calls, texts, or emails—and when you are offline. This transparency builds trust while reinforcing your right to rest and recharge.
- Stay within professional scope and ethical standards. Maintain awareness of your doula role. Avoid stepping into responsibilities that belong to medical staff, clergy, or family members. The goal is to support, not replace, other disciplines or systems of care.
- Engage in reflective practice. Routinely assess what is working in your practice and where you feel depleted. Reflective journaling, supervision, or consultation can illuminate areas for growth and self-care. Remember, your needs and boundaries may evolve as your professional and personal livesshift.
- Lean into your strengths. Identify where your skills create the greatest impact, whether that’s facilitating ritual, providing psychoeducation, or supporting grief work. When we work from our areas of strength, both we and the families we serve benefit from a more grounded and meaningful connection.
Sustaining Ourselves to Sustain Others
Boundary-setting is not a one-time decision but an evolving practice. It requires continual self-awareness, courage, and compassion—for others and for ourselves. As end-of-life professionals, we cannot pour from an empty vessel. By honoring our limits, we preserve the emotional and ethical integrity of our work.
As you reflect on your own practice, consider where you might strengthen your boundaries—what needs more structure, what deserves more spaciousness, and what changes could better sustain you in the year ahead. Healthy boundaries are not a sign of detachment—they are the foundation of enduring, authentic, and compassionate care.
Posted 11/11/2025