Extensive Advance Directive Training is a Win-Win-Win

As an end of life/death educator, I have learned first hand that our role starts “in the now” when it comes to advance care planning. Through my 25 years of death doulaship, I have seen that the doula skill set provides a perfect match to help others with end of life conversations and the questions that arise around mortality. This is because each doula operates in their own way of going about the work to make space, to create conversation, or to sit and be present. The death doula is especially effective because one of the best abilities is availability, as so often the traditional healthcare system provider might be overburdened and short on time when it comes to serious illness conversation and advance care planning. Further, being flexible and being ready for clients is one of the top reasons doulas are able to connect with their communities and help those people around them. But being ready and being flexible requires the doula to evolve themselves, skillset, and services. I have seen the most effective doulas help their clients and their communities by enhancing their skills and extending their innate ability to help others by engaging in extensive training and education.

I am not talking about a 4-hour training or 16-hour training but training that takes a deep dive into everything we should be assisting our clients with. More like a 40+ hour training when it comes to Advanced Planning. For as my friend Pam Carter says, it does not matter if you are 18 or 80 everyone needs an advanced plan. I firmly believe it is crucial to start planning ahead. My lived experience of working with thousands of clients ingrained in me the importance of having a well-rounded skill set to support individuals during challenging times. Participating in a comprehensive 40+ hour program that covers all aspects of client support not only benefits the doula’s growth and subsequent clients but also helps establish sustainable practices to offer long term services within the communities they serve. A well-educated doula in Advanced Planning will typically spend at least 8-10 hours working with a client to complete the initial Advanced Plan and then follow up every 6 months to a year to make updates to the plan.

Below are my thoughts on why extensive training is essential for end of life doulas to embark upon before they assist their communities and clients with advanced planning documents:

1. Understanding Legal and Procedural Requirements: Advanced planning documents such as living wills, healthcare proxies, and power of attorney forms have specific legal requirements that vary by jurisdiction. Training ensures doulas understand these requirements and can guide individuals through the correct processes to ensure their documents are legally valid. At its heart, advance care planning is an informational and educational document meant to empower people to help their healthcare provider understand and codify their end of life wishes and care.

2. Ensuring Accuracy and Completeness: These documents often involve complex decisions regarding medical care, end-of-life preferences, and financial matters. Proper training ensures doulas can help individuals articulate their wishes clearly and comprehensively, leaving no room for ambiguity or misunderstanding. This is crucial as people without these documents spend on average $10,000-$15,000 more at the end of life, which drains their well-earned nest egg.

3. Facilitating Informed Decision-Making: End of life planning involves making decisions about sensitive and deeply personal matters. Trained doulas can provide information about different options available, discuss potential scenarios, and help individuals make decisions that align with their values and beliefs. This extends to the person’s dedicated health care power of attorney, for having everyone aligned and understanding their roles and responsibilities helps bolster the end of life wishes and care. 

4. Navigating Emotional and Ethical Considerations: Completing advanced planning documents can bring up strong emotions and ethical dilemmas. Extensively trained doulas are equipped to support individuals and their families through these discussions sensitively and compassionately because they go through different scenarios with different types of people and different types of disease progressions.

5. Building Trust and Professionalism: By undergoing training, doulas demonstrate their commitment to professionalism and ethical standards in their practice. This builds trust with clients and ensures they receive reliable guidance during a vulnerable time. An example of this is a doula should never be the one to notarize forms for a client they are working with. A person who is not working with the client should be the one notarizing the forms. This eliminates any potential conflict of interest or just as importantly the appearance of a conflict of interest for the doula providing care and advanced directive assistance to their clients.

6. Knowledge of Resources and Support Networks: Training often includes education about local resources, support networks, and healthcare options available to individuals at the end of life. Doulas can connect clients with appropriate services based on their needs and preferences. Training programs often allow a plug-n-play model that helps the doula stand up their education and business.

7. Continuous Professional Development: The field of end of life care and planning is constantly evolving. Training helps doulas stay updated on best practices, legal changes, and new resources that may benefit their clients. Training programs are most effective if it is a living and breathing thing and those programs are continually making updates and the instructors are active working doulas in the field. They are able to not only share past experiences but also relevant and recent experiences. 

Ultimately, training for end of life doulas is crucial because it equips them with the knowledge, skills, and sensitivity needed to effectively support individuals and communities in completing advanced planning documents. This preparation ensures that clients receive informed guidance and compassionate care during a critical and often challenging time in their lives. I founded the International Doula Life Movement to offer extensive training, community support and free continuing education for doulas. What we have built is one of the most comprehensive training programs for doulas, who graduate with firm education and understanding of how to form a doula business and make an impact in their communities.

International Doula Life Movement and I are thrilled with our collaboration with Thanacare. We have worked together for over a year to train and educate our doula students on advance care planning and integrating Thanacare’s advance care planning app into their doula practices, ensuring proper training and support for doulas as they assist others with advance care planning.

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