End-of-Life Doulas and Insurance Coverage: What Does The Future Hold?
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by Jane Callahan Dornemann
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Money shouldn’t have to play a role in having a better death, but as in many aspects of life, it does. As my years of doula work march on and the cost of living rises, I find myself taking on more pro bono clients or “forgetting” to charge for an hour here and there. Increasingly, people just don’t have enough to fully meet their needs at the end of life. For those trying to make a living as end-of-life doulas, it pushes them toward primarily serving the haves versus the have-nots. We also need to buy groceries, support children, and pay rent, which limits the amount of free work we can do for those in need.
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Christine has been a death doula since 1998. She didn’t know that was the proper term, though, until she received her INELDA training! She has had the privilege of walking more than 60 hospice patients through the death process. Her 26 years volunteering with hospice continue—now with more ease, as she has reduced her corporate work by 75%. She lives in Mill Valley, California, where she holds a monthly Death Cafe and offers doula support.
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Q&A WITH CHRISTINE COMAFORD
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When and why did you decided to become and end-of-life doula?
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I have been around a lot of death in my life. When I was seven years old, my two closest friends died roughly six months apart—one from leukemia, the other was trapped in her burning home. So from an early age, death was something that clearly was part of life for me.
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March 18, 2025
Tuesday 12pm – 1pm ET
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Host: Marady Duran
Price: FREE Q&A – Open to All
Learn about INELDA’s end-of-life doula training and our approach to supporting the dying and their loved ones. This discovery call is an opportunity to hear about the topics covered during our training and how we facilitate a supportive and experiential learning environment.
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COMMUNITY MEETUP: SUPPORTING END-OF-LIFE PROJECTS
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March 20, 2025
Tuesday 3pm – 4pm ET
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Host: Janine Cuthbertson
Price: Open to All Members
Join us at this month’s member meetup focusing on end-of-life projects. Come share projects you may have helped foster and skills you have to offer individuals at end of life. Together we will discuss letter writing, quilting projects, art shows, short films, and other ways to honor the dying person and their circle of care. Learn some new tools and resources. *If you have already registered for a community meet-up in the past there is no need to register again.
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•EXTENDED• END-OF-LIFE DOULA TRAINING
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MARCH 31, 2025 to APRIL 16, 2025
Mon & Wed 6pm – 10pm ET
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Location: ZOOM
Educators: Nzinga Abdullah-Aziz, Kim Stravers & Omni Kitts Ferrara
Price: $895 (discounts for INELDA-trained doulas and members)
This six-session online doula training is intended for those who hope to support the dying and their circle of care. Learn INELDA’s doula approach and methods by exploring your own mortality, supporting the autonomy of the dying person, and understanding the signs and symptoms at the end of life.
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Black Grief and Healing:
Why We Need to Talk About Health, Inequity, Trauma and Loss
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Edited by Yansie Rolston and Patrick Vernon, OBE
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The stories and poems in this anthology illuminate the unique ways loss affects the Black community and the effects of the widespread lack of understanding of traditional rituals and beliefs. They show us how people’s experiences of collective loss during the pandemic, the aftermath of the Grenfell Tower fire, and ongoing systemic health inequalities are experienced not just as individuals but also as part of a global community. Contributors from a range of backgrounds, professions, and identities discuss the challenges of grieving under the shadow of continuing adversity, including threats of deportation. Sources of strength and healing are also explored, from personal and spiritual responses to community initiatives and activism.
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Everyone Dies: Our Commitment to DEI
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“Identifying what your group can do well, is passionate about, and is needed—that’s the sweet spot. That’s your mission. Your mission should be brief and clear, so that you can refer to it at moments of decision, at forks in your organizational road.”
―adrienne maree brown, Emergent Strategy: Shaping Change, Changing Worlds
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As companies, educational institutions, and nonprofits juggle the challenges of “flagged words” by our current administration, we at INELDA want to assure you that we are committed to our organization’s doctrines. We recognize our vision that “all individuals have accessible, equitable, and compassionate deathcare that holistically affirms one’s humanity and supports end-of-life choices” carries some of these flagged words. This is a moment when many of the structures we have trusted have flip-flopped in their commitments, and I can ensure that INELDA will not.
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OUR LATEST EDUCATIONAL OFFERINGS
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Pathways to Practice and Bridge End-of-Life Doula Training
Pathways to Practice: Being an end-of-life doula can mean many different things. Just as each person’s desires and preferences around the end of life are different, there are many pathways for doulas to offer support. Pathways to Practice is a six-week cohort-style course to help empower you with the skills to build your unique doula practice and model of care. We have intentionally shifted away from the language of “business development” because the spectrum of doula care is vast and incorporates many ways to provide service beyond just the traditional business model.
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DOULA SUPPORT FOR THE UNHOUSED IN PITTSBURGH
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INELDA is excited to share that we have opened our training to Pittsburgh residents who are supporting the unhoused. This training was developed with a generous grant from the McElhattan Foundation. We are excited to be back in the city in May delivering this training to the community of carers supporting the unhoused folks living in Pittsburgh. This training is for all individuals who serve people who experience homelessness. This includes medical providers, hospice volunteers, social workers, street outreach workers, medical students, and people of any other relevant discipline.
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INELDA VOLUNTEER IN-PERSON OPPORTUNITIES
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INELDA is seeking on-site volunteers to assist with facilitating our in-person training and community events through the remainder of 2025. All are welcome to volunteer. Whether you are interested in assisting with an in-person community event or training, this will be an opportunity to experience firsthand while helping the educators teach or host the curriculum to others in the deathcare community.
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DID YOU KNOW THAT INELDA IS A 501(C)(3) NONPROFIT ORGANIZATION?
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We rely on public support and program revenue to meet our annual budget and continue providing educational and community programs, scholarships, advocacy, and outreach to expand the presence of end-of-life doulas. Help INELDA meet its mission and transform end-of-life care with a monthly gift of $5, $10, or more.
CLICK HERE to become an INELDA Sustainer today!
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Phoenix magazine has published an article featuring INELDA educator Kim Stravers and features a quote from executive director Douglas Simpson about the role of end-of-life doulas and the support we offer.
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MAiD: A Personal Story of Family, Policy and Commitment to Care
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March 26 | WED 7 – 8:30pm ET
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Medical Aid in Dying (MAiD) is an end-of-life option where a physician prescribes medication to a competent adult with a terminal illness who wishes to end their life this way. As of January 2025, numerous countries and 11 states in the US have legalized MAiD, recognizing it as a humane way for people with terminal illness to end their lives. This March’s webinar MAiD: A Personal Story of Family, Policy and Commitment to Care will feature Thalia DeWolf, RN and INELDA’s membership coordinator, Janine Cuthbertson as they recount the inspiring story of Janine’s mother’s end-of-life journey with Medical Aid in Dying under Thalia’s supervision.
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From the decision to use MAiD, to Janine’s fearful realization that no medical professionals were allowed by hospice rules to be present, to their brave decision to connect with Thalia to seek help, we will set the stage for the great acts of courage and advocacy that followed. We will explore Thalia’s reasons for breaking hospice rules in order to remain with her patient, the reasons for them losing their hospice position because of those actions, and their subsequent appeal to an ethics board to challenge what they believed to be inhumane rules.
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This webinar will be a powerful look into the ways that MAiD helps people with terminal illness transition, the ways that fear complicates grief, how deathcare practitioners can be the best advocates for their patients and circles of care, and how rules that don’t protect the most vulnerable are meant to be challenged. Come learn how end-of-life doulas can practice this courageous care for our patients and their circles of care. This webinar will be hosted by INELDA Executive Director and board member of Academy of Aid in Dying Medicine Douglas Simpson.
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Cost: Free with INELDA Tier 2 & 3 Membership | Tier 1 and Non-members $15
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I work with a lot of clients to write their own obituaries, and the starting phrase I use for the conversation is “The end is not the story.” When we are in the thick of illness and grief and endings that are approaching too quickly, it is easy to get lost in what life is like now, to think that all they are is the disease and the treatment and “the fight.” I try to help people understand that they are so much more than what is happening to them in this moment. I’ve also had people “write a letter to a friend” about the things in their life they don’t want anyone to forget or the things they feel most proud of.
—Rebekah Jacob
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National Alliance to End Homelessness | Center for Learning
Caring for Older Adults Experiencing Homelessness: For Service Providers
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The National Alliance to End Homelessness is a nonpartisan, nonprofit organization whose sole purpose is to end homelessness in the United States. It uses research and data to find solutions to homelessness, works with federal and local partners to create a solid base of policy and resources that support those solutions, and then helps communities implement them.
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INELDA is excited to have recently partnered with NAEH’s Center for Learning. Center for Learning courses are built for staff working in homeless response and related fields, for funders and directors, and for anyone who would like to learn more about best practices in homeless response. Its latest class, Caring for Older Adults Experiencing Homelessness: For Service Providers, features INELDA’s director of education, Omni Kitts Ferrara.
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I am confused why some end-of-life doula programs are certified versus others that offer a certificate. Can you share the differences?
—Discovery call participant
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Director of education Omni Kitts Ferrara: Great question, and one that even gets confused in news articles too! There currently is no national certifying body for the work of end-of-life doulas, so every program has different approaches to what they call certified. In terms of INELDA, anyone who goes through our end-of-life doula training program with us receives a certificate of completion. This certificate validates the work you did in prework, live sessions, and postwork. At INELDA, certification is more than a certificate. We just relaunched our program as a yearlong cohort guided by INELDA educators to support you as you offer support to others. This program requires active participation in the certification program online portal, which includes supplementary materials, videos, short classes, forums, and more, as well as cohort review sessions and a continuing education series. READ MORE TIPS
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How do you practice self-care when things are crumbling around you? How do you manage to stay connected to your well-being and equilibrium when you are faced with an onslaught of crises, changes, heartbreaks, and tragedies in the world? How do you stay in your body when it feels like things are falling apart and the enormity of fear, sadness, grief, and anger are bearing down on you?
—Saruh Lacoff
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The World Needs More Palliative Care, Study Concludes
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The need for palliative care has grown by 74% in the past three decades across the world, according to research recently published in The Lancet. While the growth is global, the countries with the largest rise are low- and middle-income nations, which represent 80% of people who have conditions calling for palliative care.
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Are Robots the Next Care Partners?
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Japan leads the world in percentage of people ages 65 and over. It has also long been a leader in robotics. Today, these two distinctions are coming together in the emerging development of AI-driven robotic care for older people in Japan.
“Given our highly advanced aging society and declining births, we will be needing robots’ support for medical and elderly care, and in our daily lives,” Shigeki Sugano, a leading researcher in a humanoid robotics program known as AIREC, told Reuters.
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Takotsubo Syndrome: Death by Heartbreak
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Romantics have long referred to dying of a broken heart. But in the past few decades, scientists have found the literal truth behind the phenomenon of sudden cardiac death after a devastating event: the rare but powerful takotsubo syndrome.
Most commonly found in postmenopausal women, takotsubo syndrome is not yet fully understood. Using imaging technology, researchers have detected that the hearts of people with takotsubo syndrome often display a left ventricle that has ballooned out, making it difficult for the heart to deliver blood effectively to the body. Researchers have various hypotheses about why the ballooning happens: a surge of stress hormones, a temporary “stunning” effect on the heart, or reduced estrogen, given the population most likely to exhibit the syndrome.
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All the time they were praying
He watched the shadow of a tree
Flicker on the wall.
There is no need of prayer,
He said,
No need at all.
The kin-folk thought it strange
That he should ask them from a dying bed.
But they left all in a row
And it seemed to ease him
To see them go.
There were some who kept on praying
In a room across the hall
And some who listened to the breeze
That made the shadows waver
On the wall.
He tried his nerve
On a song he knew
And made an empty note
That might have come,
From a bird’s harsh throat.
And all the time it worried him
That they were in there praying
And all the time he wondered
What it was they could be saying.
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Support Accessible, Equitable, and Compassionate Deathcare
DONATE HERE
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© INELDA 2025 International End of Life Doula Association is a
501(c)(3) tax-exempt nonprofit organization that relies on public support to do it’s work.
Tax ID#: 47-3023741
Phone: 201-540-9049
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