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Rise of end-of-life companions in the UK
For Rita Ball, few experiences compare to the intimacy of holding a dying person's hand. As a trained death doula in London, she has accompanied individuals and families through their final days, providing non-medical support that fills gaps left by traditional care systems.
What death doulas do
Death doulas, sometimes called soul midwives, offer emotional, practical, and spiritual assistance to those nearing the end of life. Unlike birth doulas, who support expectant mothers, these companions focus on easing the transition for the dying and their loved ones. Ball describes her role as helping families navigate uncertainty, from reassuring them it's acceptable to hold or kiss their loved one to playing music or speaking to them in their last hours.
Emma Clare, CEO of End of Life Doula UK, reports a surge in interest, with 114 new doulas joining her organization in 2025-far exceeding previous years. High-profile figures like Nicole Kidman, Ruby Wax, and Davina McCall have publicly announced plans to train as end-of-life doulas, further raising awareness.
Personal stories of support
Fanny Behrens of Devon credits death doula Sarah Parker with helping her and her husband during his terminal cancer battle. Parker provided a safe space for Behrens to grieve, encouraged difficult conversations about burial wishes and funeral plans, and guided the family through logistical tasks like contacting undertakers. Behrens recalls Parker's calm explanations of the physical dying process, which helped normalize the experience despite its pain.
"There's something about being with someone who's very familiar with the process, who is matter-of-fact and at home with it and compassionate-that really helps. Even though it doesn't take the pain away, it kind of normalizes it."
Fanny Behrens
Addressing fears and misconceptions
Clare notes that many people's understanding of death comes from dramatized portrayals in films or sudden tragedies. Doulas aim to demystify the process by explaining physical changes, such as shifts in breathing or body temperature, and preparing families for phenomena like the "death rattle"-a sound that can alarm those unfamiliar with it.
Krista Hughes, a soul midwife at cancer charity the Mulberry Centre, emphasizes the importance of tailoring support to the dying person's wishes. She once recreated an imaginary garden for a patient unable to die outdoors, using lavender oil, birdsong recordings, and vivid descriptions to evoke the setting they desired.
Beyond death: ongoing care
Doulas often extend their support after death, assisting with funeral arrangements, memorial services, or even visiting funeral homes on behalf of grieving families. Some, like Ball, also host "death cafes"-community gatherings where people discuss mortality over tea and cake to foster open conversations.
Challenges and debates
While demand for death doulas grows, the field remains unregulated in the UK, with no mandatory training or standardized pricing. Costs typically range from £25 to £45 per hour, though some doulas volunteer their services. Marian Krawczyk, a researcher at the University of Glasgow, highlights concerns about "opportunism around vulnerable people" but argues that doulas help address gaps in a healthcare system where end-of-life care is often a "postcode lottery."
Dr. Paul Perkins of palliative care charity Sue Ryder acknowledges the complexity of navigating the healthcare system during emotional distress. He advocates for ensuring the dying have the "best quality of life possible," allowing them to spend their final days with loved ones.
A shifting landscape
Krawczyk points to broader societal changes, including longer lifespans with chronic illnesses and rising expectations for personalized care. As death becomes less abrupt and more drawn-out, the role of death doulas may evolve to meet new needs-whether integrated into healthcare systems or remaining independent.
