Introduction
I am a Buddhist chaplain.
When people are facing death and dying, they often seek care and support. Two common roles in end-of-life care are chaplains and death doulas. However, there is often confusion between the two roles due to overlap.
Key differences between the disciplines are the scope of their role, training, approach, and institutional access in terms of employment.
In this blog, we will explore the differences between working with a death doula and a chaplain, helping you determine the right resource for your organization.
Scope
Chaplains offer their services in a broad range of scenarios, including critical care, grief counseling, end-of-life care and decision-making, among others. Their role is to support people who are experiencing existential crises, moral and ethical dilemmas, or moments of transition.
Chaplains do not work exclusively with dying individuals but are available to offer their support and guidance in any situation. They offer support to people of all ages and backgrounds, regardless of their health status. In hospitals, they provide comfort to patients facing various medical conditions, not just those nearing the end of life. In universities, chaplains support students through the ups and downs of their academic journeys, helping them navigate personal challenges and transitions. In companies, they offer confidential support to employees, lead workplace groups, provide grief and crisis support, and offer general spiritual guidance to those who seek it, regardless of their faith background. They offer space for all employees to reflect and discuss their personal and/or professional struggles.
Just as they stand by families during difficult times, chaplains are equally invested in witnessing and acknowledging life's moments of triumph and delight. This holistic approach to caring for the human experience underscores the profound impact chaplains can have on the lives of those they serve.
Death doulas’ focus and expertise are exclusively tied to death and end-of-life care. They compassionately support people facing a wide range of scenarios, including those with terminal illnesses, people who are aging and have a limited life expectancy, and those who are experiencing a decline in health due to chronic conditions.
Education and accreditation
Chaplains and death doulas bring unique skills to their practice, which are informed by their distinct methods of training.
Chaplains undergo rigorous formal education, typically requiring a Master's degree. They also participate in specialized, year-long training programs called Clinical Pastoral Education (CPE), which combines learning and practical experience in institutional settings.
Many chaplains are ordained clergy and may have denominational endorsement, which not only serves as a system of accountability, but allows them to attend to their own spiritual needs before supporting others. They have experience supporting individuals in various circumstances beyond just end-of-life situations, including prisons and social organizations. They also provide long-term support, such as ongoing groups, grief counseling, and memorial services.
Death doulas receive training through workshops, seminars, or online courses. While there is no standardized accreditation, many doulas acquire certifications from reputable organizations to enhance their skills. Their training focuses specifically on providing holistic grief support during end-of-life, addressing emotional, practical, and spiritual needs.
For specifics on how chaplains are trained, read this blog.
Supervision and support
Chaplains and death doulas benefit from ongoing supervision, which plays a crucial role in their growth and learning.
Chaplains are required to undergo structured supervision led by certified chaplain supervisors who provide continuous support, mentorship, and evaluation. This supervision is fully integrated into the institutions they serve, ensuring that chaplains can develop their skills for real-life, complex situations. They gain transferable skills by navigating institutional dynamics and weighing competing priorities, serving as liaisons between employees and patients. The comprehensive training from structured supervision makes chaplains well-equipped to support organizations in all contexts.
The supervision of death doulas varies. Some death doulas choose to work independently, which allows them to have complete autonomy in their practice. There are also those who seek supervision to enhance their skills and knowledge, providing valuable opportunities for growth and learning.
Mentorship for death doulas is an optional yet beneficial avenue for those wishing to expand their expertise in end-of-life care. Death doulas are considered “relatively new” by many institutions, but they have been around for centuries, perhaps even longer, despite colonization’s attempt to erase the history and practices. As with many traditional practices that are now being reclaimed, death doulas are not as widely accepted as the role of a chaplain. This means that there may be fewer resources available for death doulas, and fewer established standards for the kind of mentorship provided and received.
Over time, as the role of death doulas becomes more mainstream and accepted, it is likely that mentorship programs will become more comprehensive and thorough.
Working in institutions
While both chaplains and death doulas offer end-of-life care services, their integrations with institutions vary.
The professional training and recognition of chaplains allow them to be hired at institutions such as hospitals, hospices, universities, military bases, nursing homes, and correctional facilities. With their services integrated into institutional networks, chaplains can reach a broad spectrum of individuals from various backgrounds and belief systems. Furthermore, chaplains are able to meaningfully influence outcomes within these institutions by advocating for families in rooms where the families are not present.
Because of less standardized training and recognition, death doulas often work in community-based settings or with private clients and their families as opposed to in institutions. This allows for personalized service delivery that caters to individual needs and preferences, which may not always be possible in an institutional setting, but does not give the family the same level of advocacy within the institution itself.
Accessibility
The ability to work in institutions has a direct impact on accessibility. Chaplains are typically affiliated with institutional organizations and are therefore paid for by the institution as part of the overall package of care provided to clients. This means they are widely available and easily accessible to those who are seeking spiritual or emotional support during times of crisis, including end-of-life care.
On the other hand, death doulas are not affiliated with institutions and usually require an out-of-pocket cost for clients. They can be harder to locate and may not be as accessible to those without the financial means to hire them.
Preparing legal documents
Preparing legal documentation for end-of-life ensures that a person’s wishes are respected. The process can be emotional and challenging for grieving loved ones, which is why having a supportive professional can make all the difference.
Both death doulas and chaplains can assist in creating advanced directives, living wills, power of attorney, do not resuscitate (DNR) orders, physician’s orders for life-sustaining treatment (POLST) orders, funeral instructions, and burial arrangements. They can also assist in facilitating discussions and resolving disputes that may arise in end-of-life care. Furthermore, they can each provide support in helping individuals understand the legal process and the policies they need to follow.
Pros and cons
Here is a brief summary of the pros and cons of with a death doula or a chaplain to help you determine which discipline best fit your needs:
Chaplains
Pros
Extensive education and supervised training provide a solid foundation for their practice;
Expertise in addressing spiritual and emotional needs of diverse populations;
Recognized and integrated into institutional healthcare and support systems;
Ability to offer ongoing grief counseling and comprehensive support during end-of-life and bereavement;
Versatility in providing one-on-one pastoral visits and facilitating group support sessions;
Extensive training to offer crisis intervention and emotional support during times of distress;
Involvement in both challenging and joyful moments in life.
Cons
Some chaplains may have a stronger religious focus, which may not resonate with all individuals;
Formal education and training may require more time and resources for chaplains to achieve their qualifications.
Death Doulas
Pros
Take a holistic approach that encompasses emotional, practical, and spiritual aspects of end-of-life care;
Ability to offer ongoing grief counseling and comprehensive support during end-of-life and bereavement;
Actively reclaiming a culturally supressed practice;
Working independently allows death doulas to offer personalized care;
Training is more accessible in terms of finances and time, opening up the possibility for a wider range of practitioners from communities experiencing marginalization to practice.
Cons
1. Lack of institutional integration can limit their ability to collaborate with healthcare
professionals or provide services to individuals who are primarily receiving care within an
institution.
2. Varied levels of training and certification means that the expertise and qualifications of
death doulas can vary significantly, making it essential for individuals and families to conduct
thorough research before engaging their services.
3. Not available in many areas, making it difficult for people seeking end-of-life
support.
4. Services are not covered by insurance and must be paid out of pocket.
Conclusion
Although chaplains and death doulas offer essential, compassionate end-of-life care to those who are dying, chaplains function beyond the capacity of illness and death.
Chaplains can be a valuable resource—providing comfort, guidance, and support within organizations and corporations during any circumstance whether related to grief and loss or any experience tied to living.
Chaplains are equipped to deal with a range of issues that affect people within the workplace, such as transitions, fear of loss, stress, anxiety, grief, and interpersonal relationships. Their training in working with groups and individuals makes them versatile, and able to provide direct, 1:1 coaching and workshops on professional development.