Core Competencies of an INELDA-Practicing Doula
INELDA’s core competencies are extrapolated from the INELDA Doula Approach, a process-based model for providing end-of-life doula care, based on each principle within the model and the subsequent elements that describe the foundations of practice held by each principle. The goal of these competencies is to create a scaffolding for doulas to practice with and further their development, awareness, artistry, and skill in the care they provide. These core competencies offer ways to hold INELDA-trained doulas accountable for the care they are providing. They include the qualities needed to meet the competencies or proficiency of skill under each principle of the INELDA Doula Approach.
These competencies include understanding of the field of deathcare and lean into the frameworks laid by INELDA’s scope of practice and INELDA’s code of ethics documents. This triad of documents seeks to define ways for end-of-life doulas trained and certified by INELDA to provide equitable, ethical, conscientious, and compassionate care.
INELDA’s core competencies are listed under each of the three fundamental principles of the INELDA Doula Approach:
Self-Awareness
Doulas practice through the cultivation of self-awareness, which invites ongoing reflection of their own beliefs, preferences, and biases toward the concepts of death and dying. When the doula can separate their own identity from that of those they support, they can show up with greater cultural sensitivity, understanding, and respect for the dying person and their circle of support.
- Discovery and awareness of:
- Unattended and ongoing grief
- Biases and internalized lenses of oppression
- Learned platitudes and automated assumptions and responses
- Lenses and projections from personal lived experiences
- Continued self-exploration to unlearn habitual lenses and taught biased patterns
- Nuanced development and cultivation of self-awareness:
- Honesty and integrity
- Definition and practice of presence
- Commitment to holding space for, honoring, and learning from the other’s unique journey toward end of life
- Self-reflection on lessons learned
- Prepares for time with the dying person and their circle of care
- Is resourced and responsive when meeting with dying person
- Practices full-self listening
- Able to honor their internal dialogue while still focusing on the person they are serving
- Practices self-care
- Attends to their own grief and needs after each session
- Processes afterward
- Has established ways to reprocess their own experiences
- Peer review and mentorship
- Participates in larger community of feedback and support
- Education and advocacy in and for the movement of conscious deathcare
- Deference to the role and scope of the doula and/or more restrictive codes as per organization
- Clarity of boundaries in the nonmedical, nonfamilial role
- Refrain from operating from dual roles, regardless of additional licenses
- Awareness of gaps in end-of-life care as they affect the community served
- Active engagement to address gaps in care
- Community-centered lens, encouraging and prioritizing the self-determination of the community and individuals therein
Autonomy of the Dying Person
A dying person has the ability to exercise self-determination and relational autonomy when considering their choices for end of life. The doula understands that the person they are accompanying and supporting at the end of life, or that person’s proxy, drives the agenda.
- Supports self-determination and relational autonomy of the dying person within their circle of care
- Agrees to center, and be guided by, the dying person in all processes of support
- Relinquishes attachment to outcome
- Operates from a lens of inclusivity and liberation where all people are respected in their desires at end of life
- Supports the dying person through any systemic oppression
- Understands the doula role as “being (with)” not “doing (for)”
- Practices full-self listening, deep inquiry, and thoughtful response
- Accompanies, sits with, and holds space for the dying in the agreed-upon setting with the dying person
- Notices the impulse to intervene in the other’s process, and returns to presence with their process
- Allows space for and trusts discomfort, and refrains from reconciling, fixing, “helping,” redirecting, and “silver-lining” someone else’s experience
- Recognizes challenges when harm can or has occurred, creating space for restoration of trust, and recusing role as doula when required
- Participates in the growth, research, and advancement of equitable and accessible care for all
The Dying Process
The dying person goes through both physiological changes and loss at the end-of-life. Each person’s dying process is unique and will inform the type of doula care that may be offered to the dying person and their circle of support.
- Awareness of the dying person or their circle of care to know what is within or outside of the doula’s scope of practice
- Conviction that dying is a natural, human experience and does not require intervention
- Commitment to understanding and appreciating the unique trajectory of dying and how it impacts the dying experience
- Practice of full-self listening and presence with attention to verbal and nonverbal cues throughout the process of physiological death
- Awareness of the advancements in the current field of deathcare
- Engagement in research, inquiry, and learning about the unique trajectory of dying and its possible disease process
- Compilation of supporting resources that address the holistic needs at end of life
- Discussion of resources with the dying person and circle of care
- Recognition of and action to refer people to additional professional support services as prompted
- Continued learning about global structures of oppression and intentional systemic discrimination and how they impact delivery of deathcare services, specifically at end of life
- Acknowledgment of and respect for the inherent losses in the dying process
- Commitment to support the individual grieving experience of the dying person and their circle of care