CareDoula® Values

1. Our role is non-medical accompaniment.
2. Our presence is that of love, compassion, and understanding.
3. We are loving awareness with a seasoned end-of-life attunement.
4. Our primary role is that of witness and companion.
5. Our primary intention is to help with what is happening in the moment, to bring peace or enhance the peacefulness of the situation and those present.
6. Our primary focus and advocacy is with the person who is dying, regardless of who may pay for our services. We let this be known at the first visit.
7. Our secondary focus is on the primary caregiver and the family and their needs. We state clearly if we are able to meet their needs at our first visit.
8. We understand and highly value palliative care prior to hospice service and do all we can to ensure the person we are serving is physically comfortable, and if not to help them find palliative services in their area. If no palliative services are available in their area, we will do the best we can to find alternative holistic services to replace it. 
9. We understand the value of holistic support and have a list of referral sources in our community to offer our family if needed.
10. Our role is that of guide to the family, to teach them how to care for their loved one as they die if they do not know how.
11. We assume that each person we are accompanying is whole and complete and fully capable of emotionally and spiritually ‘handling’ what is happening in the moment. 
12. We offer suggestions for resources when asked.
13. We pay attention to what the family wants and needs and focus on meeting those needs.
14. We respect the energy of death and acknowledge its presence, as well as the reality of death when it is near.
15. We do not collude in lying to the person who is dying if asked by anyone to do so.
16. We are silent observers, discerning when it is time to speak.
17. We are emotional and spiritual caretakers.
18. We offer practical support when we are able, and it is accepted.
19. If we are unable to serve a family, we do what we can to refer the person to someone who can help.
20. We may charge a fee for our service or volunteer it. 
21. We understand our presence is a powerful healing force and calming stabilizer. 
22. We value people of all races, economic status, religion, sexual orientation and culture. We do not participate in any form of discrimination as we acknowledge this is extremely hurtful. We do not condone this in others.
23. We understand the value of the home funeral and we share home funeral information with each family upon our first visit, so they know their options. (Please find out about your state/country’s laws re: home funerals.)
24. We believe that grief is a normal reaction to loss through death and respect that it shows up in various forms. We understand that many people have no idea how to engage with their grief and we will have a component to our service that supports a family after the death of a loved one. If we do not, we will have at least 3 referrals for our family.
25. We acknowledge the complexity of our role. We are more than spiritual support, more than practical support, more than caregiving support, more than emotional support, more than an end of life knowledgeable guide; our role is noble, kind, and respectful of all whom we serve.
26. We have a philanthropic component within our Practice that addresses those who cannot afford our services.
27. We are committed to each person in their experience and their whole circle of loved ones as we know that in so doing, we are helping to shift the consciousness of dying well in this culture, one person at a time.
28. We understand and agree that hospice is the leader of care when a family is on hospice service and we are an adjunct to that care and a member of the team. We should get permission from the family to speak to the hospice on their behalf if they want us to do so. We understand that the first person appropriate to contact in  any situation is the hospice nurse case manager. The hospice nurse case manager will get your information to the appropriate people. If after hours, you understand to call the hospice after hours phone number.   ​

CareDoula® Standards of Practice

Physical:

• We are non-medical. Unless we have a license to do so and are a physician or under the supervision of a physician,  we are not to offer medical care for the person who is dying. 
• We are not caregivers. Unless we are trained by the family, we are not to provide physical care which includes: transfers, toileting, bathing for cleanliness, eating, dressing, taking vital signs, giving medications, etc. The family MUST train you if you are going to provide this care.
• Unless we have a license to touch or a license to treat, and physician orders to do so, we may not provide massage or physical therapy or occupational therapy or any treatments unless we have authority and orders to do so. We may assist in daily tasks of strength maintenance or range of motion when the family trains us to do so if we wish to.
• We do not give medications unless the family trains us to do so and we accept full responsibility for our actions. We agree to consult with an attorney from our state to clearly define our legal boundaries if we would like to assist with medications. 
• All Certified CareDoulas® who also have another license or certification to physically care for people (Physician, Nurse, Occupational Therapists, Certified Nursing Assistants, etc.) must be clear to differentiate the doula role from their licensed role at the time of service. Reminder: A doula is a non-medical role that provides practical, emotional and spiritual support—as a companion.

Spiritual:

• Doulas are not licensed spiritual leaders (unless you have received that designation elsewhere). We may provide spiritual support in any way that the family requests that is within our education, training and comfort level. We must use the term "spiritual companion" if we are not a licensed or ordained Priest, Rabbi, Chaplain or other trained spiritual leader. We will use clear language if we do not have those credentials so as not to confuse the public. 
• We may provide options for spiritual support upon request, or if it appears the family would like this service and help them obtain it.
• If we are a licensed spiritual care leader we state clearly that this role is separate from the doula role so as not to confuse the public. This is a separate service. 

Emotional:

• Doulas are not licensed mental health care providers unless they have completed the requirements and have earned that designation. We may use the term 'emotional companion" or "provide emotional support" or "provide deep listening" or other similar phrasing. In order to not confuse the public; we use very clear language.
• We may offer deep listening, solace and comfort and similar emotional support through our words, gestures, eye contact, and presence.
•  We may offer mediation between family members if we are skilled to do so.
•  We may offer assistance in reconciliation, and forgiveness and closure if we are skilled to do so.
• We  offer companionship and witness. 
• If we are a licensed mental health care provider, we state clearly that this role is separate from the doula role so as not to confuse the public. This is a separate service. 

Energetic:

• Doulas are not "Energy Healers" unless you have had the training or received the special gift to do so and have earned that designation. If you have this designation, it is a separate service from the end-of-life doula role.
• We always ask permission to treat, pray, 'send energy' etc. before we do anything of this sort. We never assume it is wanted unless they tell us.
• We provide witness and presence and energetically embrace the family in loving intentional energy to be their own best healer and guide. We do not interfere, try to “save the day” or otherwise insert ourselves into their process without them asking us directly. 
• We are a compassionate and peaceful presence. We come to each visit with curiosity not a template and in the spirit of witness and helper when asked.

Practical:

•  We may offer advocacy—medical or other forms.
•  We may offer assistance, where our comfort level lies, with practical concerns such as housekeeping, cleaning, organizing, cooking, errand running, yard work, etc.
• We may offer assistance, within our comfort level, with advance directives, medical bills, legacy projects, funeral planning, memorial service planning, home funerals. We will refer to another professional that we have vetted if we cannot provide the service that is being requested. 
•  We may offer assistance with physical needs as long as the family trains you to do so and you wish to do so. 
• After death, you may assist in preparing the body only if the family is using funeral home services. You may not if you are assisting with a home funeral. You may only educate the family and guide them to the actions themselves. You may not accept payment for help in preparing the body of the deceased. We may accept payment for educating the family only in body preparation. 

Collaboration:

• We make referrals to outside practitioners and resources appropriate to the situation. We have a list of resources in our community.
• We are an adjunct to the hospice team. They are the lead in providing plan of care for any family on hospice services.
•  If we begin working with a person who is dying and they are not on hospice, we will begin discussions with them about optimal support during dying time, make sure they know of palliative care and suggest the support of hospice if we see that dying is imminent. 
•  Our primary allegiance is to the person who is dying and their family.
• We are a part of the whole system, operating within the system how the family dictates and our skill level allows. 

Ethics:

• We maintain confidentiality at all times.
• We maintain transparency of our intentions and motives with our main focus to serve the family according to their wishes, respecting the reality and truth of dying and the death process.
• We are honest about what we see and how we may be helpful. 
•  We never lie to the person who is dying at the request of anyone.
• We do not deny the reality of death as it is approaching for the comfort of anyone.
• We do not misrepresent ourselves and our abilities. 
• We do not offer services for which we are not qualified or licensed. 
•  We fulfill our obligations.
• When we make a mistake, we admit it and fix it.
• We maintain the highest level of professionalism, integrity, and honesty at all times.

 Practical Matters:

• We address all three aspects of the time periods: 
  •   during the months/weeks/days/hours prior to death.
  •   during death
  •   during the post death (within 3 months) time period.
  •   Additionally (post COVID-19), we will ensure to have referrals to appropriate bereavement services to share with any person severely impacted by COVID-19. 
•  We give each client information on advance directives (if they have not done them), as well as information on home funerals and green burials on our first visit. 
• We will be transparent on all pricing. We will NOT include charges later in our time with a family if we forgot to include it in the beginning. We will take that as a lesson for us to do better next time with proposal making and not surprise a client with a new bill. We must be extremely diligent in pricing issues. We must earn their trust.
• We must master the art of under promising and over delivering. Our words do not mean as much as our actions.
• We must vow to ALWAYS take full responsibility for all our decisions. “The buck must always stop HERE (with ourselves).”
• Have a terms and refund policy clearly stated if they should be unhappy with your services.
• Have a general good faith agreement that clearly spells out fees and expectations with every client.
•  Have a full system in place for self-protection: Professional Liability Insurance policy, disclaimers, bond, dba, good faith agreement with each family (contract), business structure for your practice that protects your present assets, and any other practice that will support your professional and personal safety. QLC gives you the options to consider but you must agree to do your own due diligence and get the proper advice from an attorney about your professional business setup.
• Be willing to support QLC by sharing CareDoula® news, free trainings, and events.