Caritas Pathways
Where the Heart of Caring Science Supports Compassionate Connection, Mindful Presence, and True Dignity
Being with the Dying: What an End-of-Life Doula Really Does
At the end of life, the person who is dying remains the truest center of care. Their body, mind, and spirit carry a lifetime of experiences—and their final days are still their own. Hospice nurses, aides, social workers, chaplains, doulas, and loved ones all form a team of support, yet everything begins with the individual and what matters most to them.
Hospice nurses work with extraordinary skill to manage symptoms, coordinate medications, and communicate with physicians. These medical needs require careful attention and often fill much of a nurse’s time. A doula complements this care by focusing on the human presence that clinical tasks can sometimes crowd out—offering education, companionship, and the steady comfort of simply sitting nearby. Grounded in Jean Watson’s Caritas philosophy of human caring, a doula’s work honors the basic needs we all share: to be heard, to be comforted, and to be treated with dignity.
Listening to the Person, Not Just the Illness
Every person carries a unique story. As life nears its close, many feel an inner pull to reflect, to speak, or to rest in silence. A doula creates a safe, unhurried space for those expressions to unfold naturally. Gentle questions—What feels important to you today? Do you sense any changes in your body? Is there anything you still hope to say or do?—invite the dying person to share their own experience of this threshold, without pressure or expectation.
Some may wish to talk openly about their sense of time, about feeling close to death, or about things left undone. Others may simply want someone to notice the rise and fall of their chest and match their breathing in quiet companionship. Whether through words or silence, the focus remains on what they need in the moment.
Honoring Wishes, Large and Small
Comfort often lives in details that reflect personal choice. Together we explore:
Do they prefer quiet or the sound of gentle music?
Should the room feel warm and cozy or cool and airy?
Would they like frequent touch, or do they find touch overwhelming?
Are there particular scents, prayers, or objects that bring peace?
These questions are not about controlling death—they are about preserving agency and personhood, even as the body grows weaker. By listening deeply and collaborating with the hospice team, a doula helps ensure that each wish, from lighting a favorite candle to arranging a final visit, is honored whenever possible.
Care as a Circle
Families and loved ones are part of this circle, offering love and continuity. Hospice professionals bring medical expertise. The doula weaves in presence and gentle coordination, helping everyone stay centered on the patient’s needs and values. Together, we create a tapestry of support where comfort, dignity, and peace are not afterthoughts but guiding principles.
A Sacred Time
Dying is both a profoundly personal and profoundly shared experience. When care begins with the person at the center, every breath, memory, and connection takes on meaning. Whether through a quiet conversation, a deep breath matched in rhythm, or the simple act of bearing witness, no one has to travel this path unseen or unheard.
Written by Victoria Fanning, Founder, A Sacred Journey, LLC