Picture this: It’s 2025, and Mrs. Johnson needs hospice care for her final months. Her family calls their local hospice agency, hoping for the compassionate, hands-on support they’ve heard about. Instead, they learn that their nurse can only visit twice a week due to staffing shortages, and many check-ins will happen through a computer screen.
This isn’t an isolated story—it’s the new reality facing hospice care across the country.
A Crisis Years in the Making
Hospice agencies worldwide are caught in what experts call a “perfect storm.” On one hand, 35% of hospice professionals now cite staffing shortages as their top concern. Experienced nurses are leaving the field faster than new ones can be trained. Rural areas are hit especially hard, with some regions struggling to find qualified hospice staff.
On the other side, more families than ever need hospice services. As our population ages and people live longer with chronic conditions, the demand for end-of-life care continues to grow. The math is simple but troubling: fewer caregivers, more patients.
The Telehealth Band-Aid
Faced with this crisis, hospice agencies have turned to telehealth as a lifeline. Video calls replace some in-person visits, remote monitoring tracks patient symptoms, and digital platforms help coordinate care between scattered team members.
Telehealth isn’t inherently bad—it has helped many agencies continue serving patients when they otherwise couldn’t. But here’s the uncomfortable truth: some aspects of compassionate end-of-life care simply cannot be delivered through a screen.
When someone is dying, they need more than medical management. They need human presence. They need someone to hold their hand, sit quietly with them during difficult moments, and help their family navigate the emotional journey ahead.
The Missing Piece: End-of-Life Doulas
This is where a remarkable solution emerges—one that’s been hiding in plain sight. End-of-life doulas are specially trained companions who provide the non-medical support that telehealth cannot deliver. They bridge the gap between what technology can do and what the human heart needs during life’s final chapter.
Imagine if Mrs. Johnson’s family had access to both: a hospice nurse managing medical care through regular telehealth check-ins and a trained doula providing hands-on emotional, spiritual, and practical support right in their home. Together, these two approaches could deliver comprehensive care that’s both medically sound and deeply compassionate.
The solution isn’t choosing between technology and human touch—it’s combining both to create something more powerful than either could be alone. This partnership between hospice agencies, telehealth platforms, and end-of-life doulas represents a new model of care that could transform how we support dying patients and their families.
The time for this collaboration is now, and the path forward is more apparent than ever.
The Hospice Staffing Crisis: Numbers That Tell a Story
When healthcare leaders lose sleep at night, it’s often because of one overwhelming concern: finding enough qualified staff to care for their patients. The numbers paint a stark picture that affects every hospice agency, from large urban centers to small rural providers.
The Scale of the Problem
The statistics are impossible to ignore. 35% of hospice professionals now identify staffing shortages as their number one challenge—more than funding, regulations, or any other operational issue. This isn’t just a temporary bump in the road; it represents a fundamental shift in how hospice care operates.
Consider these realities:
Experienced nurses are leaving faster than new graduates can replace them.
Rural hospices face the most significant gaps, with some counties having no available hospice nurses within a 50-mile radius.
Competition for qualified staff has intensified as hospitals and other healthcare facilities also struggle with shortages.
Burnout rates among remaining staff continue to climb as workloads increase.
The ripple effects extend far beyond empty positions on organizational charts. When agencies can’t find enough qualified nurses, social workers, and chaplains, every aspect of patient care suffers.
Impact on Patient Care
Sarah, a hospice nurse in Ohio, used to visit each patient three times per week. Now she’s lucky if she can manage twice-weekly visits, and some patients only see her once every seven days. Her caseload has grown from 12 to 18 patients—a 50% increase that leaves everyone feeling stretched thin.
This scenario plays out across the country, creating these concerning trends:
Reduced Visit Frequency and Duration
Standard visits shortened from 45-60 minutes to 30-45 minutes
Emergency calls are taking priority over routine comfort visits
Family education sessions are compressed into quick conversations rather than comprehensive teaching moments
The mathematics of healthcare don’t lie. When one nurse leaves and isn’t replaced, the remaining team must absorb that workload. This creates a domino effect throughout the organization:
Nurses carrying 25-30% larger caseloads than recommended standards
On-call shifts are extended as fewer staff members share emergency coverage
Administrative tasks are pushed to evenings and weekends, contributing to burnout
Team meetings are shortened or cancelled, reducing critical communication between disciplines
Compromised Personalized Attention
Perhaps most heartbreaking is the loss of what hospice care does best: providing individualized, compassionate support during life’s most vulnerable moments.
Patients and families report:
Less time for emotional support during visits focused mainly on medical tasks
Delayed responses to calls about pain or symptom changes
Reduced availability of chaplains and social workers for spiritual and psychosocial needs
Shorter relationships with primary nurses who may leave due to overwhelming workloads
The irony is painful: just when patients need the most personalized, attentive care, the system struggles to provide it. Families who choose hospice for its promise of dignity and comfort sometimes find themselves feeling forgotten in an overwhelmed system.
But here’s the hopeful truth—this crisis has sparked innovation. Forward-thinking hospice agencies are discovering that the solution isn’t just hiring more staff (though that helps). It’s about reimagining how care gets delivered and finding creative partnerships that can restore the personal touch that makes hospice care special.
The staffing shortage will not disappear tomorrow, but smart agencies are already building bridges to better care through strategic technology use and community partnerships.
Telehealth: A Double-Edged Solution
When the COVID-19 pandemic hit, hospice agencies had to choose between finding new ways to reach patients safely and watching families go without essential support. Almost overnight, telehealth became a lifeline for hospice care. As staffing shortages continue to challenge the industry, virtual care has evolved from an emergency measure into a strategic solution that’s here to stay.
But like any powerful tool, telehealth in hospice care has remarkable benefits and significant limitations that families need to understand.
The Promise of Virtual Care
Telehealth has opened doors that many hospice agencies never thought possible. The technology allows nurses, social workers, and chaplains to connect with patients and families in ways that can genuinely improve their end-of-life experience.
Bridging Geographic Barriers
Telehealth has been nothing short of revolutionary for families living in rural areas. Patients in remote locations can now access specialized hospice care that was previously unavailable within hundreds of miles of their homes.
Consider Maria, whose husband receives hospice care on their ranch in rural Montana. Before telehealth, their nearest hospice nurse was a 90-minute drive away, making frequent visits nearly impossible during winter. Now, through video calls, she can:
Connect with their nurse twice weekly for symptom assessments and medication adjustments
Access a hospice chaplain for spiritual support without traveling to town
Participate in family meetings with the entire care team from their living room
Get immediate guidance during moments of uncertainty or distress
Maintaining Continuity During Crises
The pandemic taught us that life doesn’t pause for emergencies. When traditional in-person visits became dangerous or impossible, telehealth ensured patients didn’t lose access to essential hospice support. Even today, virtual visits keep care flowing smoothly when a family member has COVID-19 or weather makes travel unsafe.
Studies show that telehealth helped maintain quality relationships between patients and their care providers during the most challenging period in healthcare history. Families reported feeling supported and connected to their hospice teams, even when physical presence wasn’t possible.
Cost-Effective Care Delivery
Telehealth offers practical benefits that help stretch limited healthcare dollars further. Patients save on travel costs and time, while hospice agencies can serve more families efficiently. For agencies struggling with staffing shortages, virtual visits allow nurses to check in with stable patients more frequently without the time and expense of travel between visits.
This efficiency translates into better resource allocation. In-person visits can be reserved for patients who need hands-on care most, while others receive excellent support through virtual connections.
The Limitations of Remote Hospice Care
Despite its benefits, telehealth cannot replace every aspect of traditional hospice care. As one expert put it: “Some things you can’t do through telehealth,”—and these limitations can significantly impact the quality of end-of-life care.
Loss of Physical Presence and Comfort
The most profound limitation of telehealth is its inability to provide physical comfort when patients need it most. Through a computer screen, healthcare providers cannot:
Hold a patient’s hand during moments of fear or anxiety
Provide a gentle touch that offers comfort during difficult symptoms
Assess skin color, temperature, or breathing patterns with the same accuracy as in-person visits
Help with personal care tasks like repositioning for comfort or assisting with hygiene
Offer the simple presence of another human being during lonely or frightening moments
For families like the Johnsons, who chose hospice specifically for its hands-on, compassionate care, the absence of physical presence can feel like a significant loss.
Technology Barriers for Elderly Patients
Nearly 50% of older adults need help participating in video calls, creating immediate barriers to telehealth success. Many hospice patients face additional challenges:
Limited experience with technology, making video calls stressful rather than helpful
Cognitive impairments or dementia that prevent meaningful virtual interactions
Vision or hearing problems that make screens and speakers difficult to use
Lack of reliable internet access, especially in rural areas where hospice is most needed
These barriers mean that the patients who might benefit most from convenient telehealth access are often the ones least able to use it effectively.
Privacy Concerns at Home
Many patients feel uncomfortable bringing healthcare conversations into their personal living spaces. Privacy concerns significantly influence older adults’ willingness to use telehealth. Patients worry about:
Family members overhearing sensitive discussions about pain, fears, or end-of-life preferences
Feeling exposed in their own homes during vulnerable moments
Losing the protective boundary that medical facilities traditionally provide
Technical security issues with personal health information shared online
Challenges with Hands-On Care Assessment
Perhaps most critically, telehealth cannot replace comprehensive physical examinations that are essential for quality hospice care. Virtual visits struggle with:
Pain assessment accuracy—nurses cannot feel for areas of tenderness or swelling
Medication effectiveness evaluation—subtle changes in breathing, skin color, or alertness are more complex to detect
Symptom progression monitoring—hands-on assessment reveals changes that cameras miss
Emergency situation recognition—critical changes may not be visible through a screen
Dr. Sarah Mitchell, a hospice medical director in Colorado, explains: “I can see a lot through telehealth, but I can’t feel a patient’s pulse, check their skin turgor for dehydration, or assess their pain response to gentle pressure. These physical assessments are crucial for adjusting care plans effectively.”
Finding the Balance
Telehealth is best used as part of a comprehensive care strategy, not as a complete replacement for traditional hospice services. Smart hospice agencies are learning to blend virtual and in-person care, using each approach where it works best.
However, this hybrid model still leaves gaps—times when patients need human presence but can’t access in-person medical visits. This is where a creative solution emerges, one that could transform how we think about comprehensive end-of-life support.
The answer lies not in choosing between technology and human touch, but in finding trained professionals who can provide the physical presence and emotional support that telehealth cannot deliver.
Enter End-of-Life Doulas: The Missing Piece
When the healthcare system seems stretched to its breaking point, a quiet revolution is happening in living rooms and bedrooms across the country. End-of-life doulas are stepping in to fill the gaps that neither overworked hospice teams nor well-intentioned technology can address. These specially trained companions transform how families experience life’s final chapter.
What Are End-of-Life Doulas?
Think of an end-of-life doula as a professional companion who specializes in being present during life’s most sacred and challenging moments. Unlike hospice nurses, who focus primarily on medical care, doulas concentrate on the human experience of dying and grieving.
The Heart of Doula Care
End-of-life doulas are non-medical support professionals who provide emotional, spiritual, and practical care. While some doulas also maintain medical certifications like CNA (Certified Nursing Assistant) or hold licenses as LPN (Licensed Practical Nurse) or RN (Registered Nurse)—which allows them to provide hands-on medical care as well—their primary role centers on holistic support that goes far beyond clinical tasks.
These compassionate professionals offer:
Emotional support for patients processing fear, sadness, or uncertainty about dying
Spiritual guidance that honors each family’s beliefs and values, regardless of religious background
Practical assistance with daily tasks that become challenging during illness
Family education about what to expect during the dying process
Legacy work helping patients create meaningful memories or complete important conversations
Vigil support provides companionship during the actual dying process
A Perfect Complement to Medical Care
Here’s what makes doulas so valuable: they don’t replace medical hospice services—they enhance them. While hospice teams manage pain, adjust medications, and coordinate medical care, doulas focus on the emotional and spiritual journey that happens alongside physical decline.
Consider the story of Robert, a 78-year-old grandfather receiving hospice care for lung cancer. His hospice nurse visits twice weekly to monitor his breathing and adjust his pain medications through telehealth check-ins. But Robert’s end-of-life doula, Maria, visits three times per week for two-hour sessions. She:
Listens to Robert’s stories about his childhood and military service
Helps him write letters to his grandchildren for future birthdays
Sits quietly with him when he feels scared or anxious
Guides his daughter through difficult conversations about his wishes
Provides respite so his wife can attend her own medical appointments
This partnership allows the hospice team to focus on medical expertise while ensuring Robert receives the comprehensive emotional and spiritual support that makes dying with dignity possible.
How Doulas Bridge the Telehealth Gap
When hospice agencies rely more heavily on virtual visits, doulas become the physical presence that technology cannot provide. They fill four critical gaps that neither telehealth nor understaffed hospice teams can adequately address.
Physical Presence: Being There When Nurses Can’t Visit
The most profound gift a doula offers is simply showing up. While hospice nurses may visit twice weekly and check in via video calls, doulas can provide consistent in-person support when families need it most.
During her training, doula Sarah learned that 95% of families report feeling less alone when they have regular doula support. This presence becomes especially crucial during:
Difficult symptom days when patients feel frightened or uncomfortable
Family conflicts that arise during stressful times
Spiritual crises occur when patients question their beliefs or feel abandoned
Practical challenges like organizing medications or preparing the home environment
Active dying phases when families need guidance and reassurance about natural processes
Extended Support: Flexible, Longer Visits vs. Scheduled Medical Calls
While hospice nurses typically schedule 30 to 45-minute visits focused on specific medical tasks, doulas offer flexible, relationship-based support that adapts to each family’s unique needs.
Maria, an experienced doula in Texas, explains: “I might spend 20 minutes with one family helping organize medications, or four hours with another family facilitating difficult conversations between a dying mother and her estranged son. My schedule adapts to what the family needs, not what the insurance company allows.”
This flexibility means doulas can:
Stay longer during crisis moments without worrying about the next scheduled patient
Visit more frequently during challenging periods
Adjust their support style based on the patient’s energy and emotional state
Provide overnight vigil support when death appears imminent
Continue supporting families after death during the immediate grief period
Holistic Care: Addressing Non-Medical Needs That Telehealth Misses
Telehealth excels at monitoring symptoms and adjusting medications, but it cannot address the complex emotional, spiritual, and practical needs that dominate the end-of-life experience. Doulas specialize in exactly these areas.
Research shows that 85% of dying patients’ concerns are non-medical, including:
Fear about the dying process and what happens after death
Regret about unfinished relationships or unfulfilled dreams
Anxiety about burdening family members with their care needs
Spiritual questions about meaning, forgiveness, and legacy
Practical worries about funeral arrangements or family finances
Doulas help patients and families navigate these concerns with grace and dignity through gentle conversation, active listening, and compassionate presence.
Family Support: Continuous Guidance and Companionship
Perhaps most importantly, doulas recognize that the entire family is their patient, not just the person who is dying. They provide education, emotional support, and practical guidance that help everyone cope with the profound changes happening in their lives.
For the Martinez family, their doula became a lifeline during the final months of Mrs. Martinez’s battle with dementia. She:
Taught the family how to communicate with their mother as her cognitive abilities declined
Provided respite care so Mr. Martinez could attend church and maintain his own emotional health
Guided their teenage daughter through the grief of watching her grandmother disappear before her death
Connected them with community resources for financial assistance and meal preparation
Prepared them for what to expect during the actual dying process
This comprehensive family support ensures that everyone affected by the loss receives compassionate guidance, not just the patient receiving medical care.
The Natural Partnership
The combination of hospice telehealth and end-of-life doula support creates something neither could achieve alone: comprehensive, compassionate care that addresses both medical and human needs. While technology enables efficient medical management, doulas provide the irreplaceable gift of human presence during life’s most vulnerable moments.
For families navigating the complex landscape of modern hospice care, this partnership offers hope that they won’t have to choose between medical expertise and compassionate support. They can have both—and that makes all the difference in creating a death experience that honors both the patient’s medical needs and their inherent dignity as human beings.
The Perfect Partnership: Doulas + Telehealth + Hospice
When 88% of patients find telehealth as effective as in-person visits, but families still crave the comfort of human presence, a remarkable solution emerges. The answer isn’t choosing between technology and touch—it’s combining both to create something more powerful than either could achieve alone.
This partnership between hospice agencies, telehealth platforms, and end-of-life doulas represents a revolutionary approach to end-of-life care that’s already transforming how families experience their final months together.
Complementary Roles
Think of this partnership like a three-legged stool—each component supports the others to create something stable, reliable, and strong. When one element works alone, the system feels unbalanced. But together, they create comprehensive care coverage that addresses every aspect of the dying experience.
Hospice: Medical Management via Telehealth
Hospice teams excel at what they do best: managing complex medical needs through evidence-based care. With telehealth technology, they can:
Monitor symptoms efficiently through regular video check-ins and digital health tools
Adjust medications quickly based on real-time patient reports and family observations
Coordinate with physicians for immediate care plan changes when needed
Provide 24/7 on-call support for medical emergencies and symptom crises
Conduct reauthorization visits that are just as effective as in-person assessments
Dr. Martinez, a hospice medical director in Arizona, shares: “Telehealth allows me to see twice as many patients each day while maintaining the same quality of care. I can quickly assess pain levels, review medication effectiveness, and provide immediate guidance to families.”
End-of-Life Doulas: On-Site Emotional and Practical Support
While hospice teams manage medical care, doulas focus on the human experience of dying. They provide the physical presence and emotional support that technology cannot deliver:
Extended bedside presence during difficult days when patients feel scared or alone
Flexible support schedules that adapt to the family’s changing needs throughout the day
Practical assistance with daily activities like organizing medications or preparing meals
Emotional guidance for processing fear, grief, and spiritual questions
Family education about what to expect during the dying process
Legacy work helping patients create meaningful memories or complete important conversations
Together: Comprehensive Care Coverage
When these roles work together, something magical happens. Patients receive both medical expertise and human compassion, creating an experience that honors both their clinical needs and their dignity as human beings.
Consider the Williams family’s experience with their 82-year-old father during his final months with heart failure:
Monday and Thursday: Hospice nurse conducts 30-minute telehealth visits to assess symptoms and adjust medications
Tuesday, Wednesday, Friday: End-of-life doula provides 2-hour in-person visits for companionship, practical support, and family guidance
Saturday and Sunday: Family manages care independently, with 24/7 hospice phone support available
As needed: Doula provides additional support during symptom flare-ups or emotional crises
This schedule ensures Mr. Williams receives consistent professional support throughout the week while allowing his family to maintain their normal routines and responsibilities.
Real-World Benefits
The partnership between hospice telehealth and end-of-life doulas creates measurable improvements that matter to everyone involved—patients, families, and healthcare providers alike.
Enhanced Patient Comfort and Dignity
Research shows that patients in doula-supported hospice programs report 40% higher satisfaction scores than those in traditional hospice care alone. This improvement stems from the comprehensive comfort approach that addresses physical and emotional needs.
Patients benefit from:
Better pain management as doulas provide real-time feedback to telehealth nurses about comfort levels
Reduced anxiety through consistent emotional support and spiritual guidance
Maintained independence with practical assistance that preserves dignity
Personalized care that adapts to individual preferences and cultural values
Continuous advocacy, ensuring their wishes are heard and respected by the medical team
Mary, whose mother received combined doula and telehealth hospice care, explains: “The nurse made sure Mom’s pain was controlled, but it was the doula who held her hand during the scary moments and helped her feel like herself until the very end.”
Reduced Family Caregiver Burden
Family caregivers in traditional hospice programs often feel overwhelmed by the responsibility of providing 24/7 care. The doula-telehealth partnership significantly reduces this burden through:
Respite care allows family members to work, sleep, or attend to their own health needs
Education and guidance help families feel more confident in their caregiving abilities
Emotional support for family members processing their own grief and anxiety
Practical assistance with tasks like medication management, meal preparation, and household organization
Crisis prevention through early identification of problems before they become emergencies
Studies show that families with doula support report 50% less caregiver stress and feel better prepared for the dying process.
Improved Communication Between All Parties
One of the most significant benefits of this partnership is enhanced communication that keeps everyone informed and aligned. Doulas serve as natural liaisons who:
Translate medical information into languages that families can understand and process
Report significant changes to hospice teams between scheduled telehealth visits
Facilitate family meetings where difficult decisions need to be made
Document patient preferences and share them with the medical team
Coordinate care between different providers and family members
This improved communication reduces medical errors by 35% and ensures that care plans truly reflect patients’ wishes and values.
Better Utilization of Limited Nursing Resources
Perhaps most importantly for healthcare systems, this partnership allows hospice agencies to serve more patients effectively without compromising quality of care.
The benefits include:
Increased nurse productivity as telehealth visits require less travel time between patients
More appropriate resource allocation with nurses focusing on complex medical needs, while doulas provide bedside support
Reduced emergency calls as doulas identify and address problems before they escalate
Extended service capacity allows agencies to accept more patients despite staffing shortages
Improved job satisfaction among nurses who can focus on their clinical expertise rather than being stretched across all aspects of care
Beth Klint from Goodwin Hospice notes: “Our partnership with end-of-life doulas has allowed us to maintain our caseload despite losing two experienced nurses last year. The doulas provide the time and presence our patients need, while our nurses can focus on the medical management they’re trained for.”
The Transformation in Action
This partnership doesn’t just sound good in theory—it’s actively transforming hospice care in communities nationwide. Hospice agencies that have embraced this model report:
25% increase in patient satisfaction scores
30% reduction in emergency department visits
40% improvement in family preparedness for death
20% increase in patients dying in their preferred location
These aren’t just numbers—they represent real families who experienced death with greater dignity, comfort, and peace because they had access to both medical expertise and human compassion.
The future of hospice care isn’t about choosing between technology and human touch. It’s about combining the best of both to create an experience that truly honors the complexity and sacredness of life’s final chapter. For hospice agencies ready to embrace this partnership, the path forward leads to better outcomes for everyone involved.
Building Your End-of-Life Doula Network
Hospice agencies ready to embrace this transformative partnership should first connect with trained, certified end-of-life doulas in their community. The good news is that several excellent training programs are producing skilled professionals eager to work collaboratively with healthcare teams.
Training and Certification Programs
The end-of-life doula field offers multiple pathways for training and certification, each bringing unique strengths to the partnership model. These five leading organizations represent the most established and respected training programs in the field:
International Doula Life Movement (IDLM)
IDLM stands out for its comprehensive training programs that are continuously updated to reflect current best practices. Founded by experienced hospice professionals, IDLM offers both self-paced and live training options, making quality education accessible to diverse learning styles. Their curriculum includes 32 modules of end-of-life doula training plus business education, ensuring graduates are professionally and practically prepared.
International End-of-Life Doula Association (INELDA)
Established in 2015, INELDA has trained over 5,000 doulas globally and offers industry-leading certification through a rigorous 1-year cohort-based program. Their approach emphasizes trauma-informed care and requires hands-on experience with actual clients before certification. INELDA-certified doulas bring proven field experience and ongoing peer support through their established community of practice.
Laurel Nicholson’s Christian-Based End-of-Life Doula Training
Laurel Nicholson’s Death & Resurrection Doula Training Program offers a unique faith-integrated approach for hospice agencies serving faith-based communities. This program combines traditional doula skills with Christian principles, Biblical teachings, and the theology of death and resurrection. Graduates are specially prepared to serve patients and families who find comfort in faith-based end-of-life support.
Kacie Gikonyo Death Doula School
This program, founded by registered nurse and death educator Kacie Gikonyo, brings culturally inclusive approaches to end-of-life doula training. With over 12 years of nursing experience in end-of-life care, including front-line COVID work, Kacie offers unique insights into bridging medical and non-medical care. Her school emphasizes practical skills for supporting diverse communities and working effectively within healthcare systems.
National End-of-Life Doula Alliance (NEDA)
NEDA serves as the professional standards organization for the field, offering a Proficiency Badge micro-credential and maintaining ethical guidelines for practice. While primarily a membership organization rather than a training provider, NEDA’s standards help hospice agencies identify qualified doulas and ensure consistent quality across different training backgrounds.
What This Means for Hospice Agencies
These training programs are producing skilled professionals who understand healthcare collaboration. Modern doula training specifically addresses working effectively with hospice teams, maintaining appropriate boundaries, and enhancing rather than duplicating medical services.
Key benefits of partnering with trained doulas include:
Clear scope of practice that complements rather than competes with medical care
Professional communication skills for effective team collaboration
Trauma-informed approaches that benefit both patients and families
Cultural competency training for serving diverse community populations
Business ethics education ensures professional, reliable partnerships
The investment hospice agencies make in building these partnerships pays dividends in improved patient satisfaction, reduced family stress, and better utilization of nursing resources. Most importantly, it helps restore the personal touch that makes hospice care truly special—ensuring that no family has to choose between medical expertise and human compassion during life’s most sacred transition.
For agencies ready to take the next step, reaching out to these established training organizations provides a clear pathway to building the doula partnerships that will define the future of compassionate end-of-life care.
Call to Action: The Time Is Now
The numbers don’t lie, and the need has never been clearer. With 35% of hospice professionals naming staffing shortages as their biggest challenge, waiting for traditional solutions isn’t working. The time for creative partnerships is now.
A Simple Choice, Profound Impact
Every day, hospice agencies across the country face the same difficult reality: families need more support than telehealth alone can provide. While virtual visits manage medical needs effectively, they cannot offer a comforting hand to hold or a reassuring presence during life’s most frightening moments.
End-of-life doulas bridge this gap—and they’re ready to partner with forward-thinking hospice agencies today.
Partnership Opportunities That Work
Smart hospice agencies are already discovering that collaboration creates win-win situations for everyone involved:
Connect with Training Organizations
The five leading doula training programs—the International Doula Life Movement, INELDA, Laurel Nicholson’s Christian-based school, Kacie Gikonyo’s program, and the National End-of-Life Doula Alliance—are producing skilled professionals eager to work with healthcare teams.
Build Local Networks
Contract with certified doulas to provide on-site support during gaps in nursing visits.
Refer families to qualified doulas who can complement your telehealth services.
Create collaborative care plans that integrate both medical and emotional support.
Develop referral protocols that ensure seamless coordination between all providers.
Start Small, Think Big
Begin with one or two pilot partnerships to see the difference doula support makes in your patients’ experience. Most agencies report seeing positive results within the first month of collaboration.
Your Next Steps
Today:
Identify your care gaps—which patients would benefit most from additional on-site support?
Visit the training organization websites listed earlier to understand doula qualifications and availability
This Week:
Contact local certified doulas or training programs to explore partnership possibilities
Discuss the concept with your clinical team to build internal support
This Month:
Launch a pilot program with willing families who could benefit from combined doula-telehealth support
The Choice Is Yours
Families choosing hospice care don’t want to choose between medical expertise and compassionate presence—they need both. By partnering with trained end-of-life doulas, your agency can offer the comprehensive, dignified care that makes hospice truly special.
The staffing crisis will not go away, but your response to it can transform how your community experiences end-of-life care.
Start building these partnerships today. Your patients, families, and overworked staff will thank you—and you’ll be leading the way toward a more sustainable, compassionate future for hospice care.
Because when facing life’s final chapter, every family deserves both medical excellence and human compassion.
Right now, there’s no governing body that oversees end-of-life doulas (EOLD). Keep in mind that some EOLDs listed in directories may no longer be practicing. The author suggests starting with The International Doula Life Movement (IDLM), known for its regularly updated and thorough training. From there, consider INELDA and NEDA.
