As Vermont’s population ages, the need for end-of-life care continues to rise.

Vermont has the fourth oldest population in the country, with 1-in-4 Vermont residents being over the age of 60, according to a 2023 publication by the Vermont Department of Health. 

“When you say ‘Hi, I’m an end-of-life doula,’ not everyone knows what that means or has even heard of one before,” said Julie Raymond-Yakoubian, current team lead of UVM’s End-of-Life Doula Professional Certificate program. 

An end-of-life doula is a non-medical professional who supports dying individuals and their loved ones throughout the death and grieving process, filling in the gaps not covered by other end-of-life professionals, she said.  

This support is highly individualized, but can include recording stories and memories, helping to create memorial items, grief support for loved ones, assistance in end-of-life planning and coordinating visitors, Raymond-Yakoubian said. 

While birthing doulas have recently become more mainstream, end-of-life doulas tend to be less commonly known. Doula-like roles, however, have long been present in death and grieving throughout history and across cultures, she said. 

“We’ve gone by many different names over time,” said Raymond-Yakoubian. “We’ve always been here.”

Raymond-Yakoubian was first exposed to alternative death and dying practices while she was an anthropology Ph.D. student at the University of Alaska Fairbanks, where she was introduced to the concepts of death and dying across different cultures and communities. 

She began her career in end-of-life care by pursuing educational opportunities in funeral celebrancy and home funeral guidance, as well as several end-of-life doula programs, she said. 

Raymond-Yakoubian then pursued opening her own end-of-life doula practice in Alaska, where she resides, and took on the title of team lead for UVM’s End-of-Life Doula Professional Certificate program in July.

UVM’s End-of-Life Doula Certificate program is an online professional certificate program aimed at providing individuals with the skills to operate as end-of-life doulas. Topics of instruction for this program include the grief continuum, different belief systems surrounding death, the ethics of end-of-life work and more, Raymond-Yakoubian said.

UVM’s program is also unique, offering further certification opportunities in the end-of-life space. This includes a Companion Animal End-of-Life Doula Professional Certificate, Pediatric End-of-Life Doula Specialist Certificate and End-of-Life Doula Business Foundations Professional Certificate, she said. 

“It’s really focused on gaining skills to be a compassionate presence at end-of-life … and to give holistic support to individuals and their families who are going through this very profound transition,” she said. 

Emily Glassman, a registered nurse at UVM Medical Center who has worked in critical care and hospice, went through UVM’s End-of-Life Doula Professional Certificate program herself in 2021 after working alongside a pediatric end-of-life doula, she said.

“I was intrigued about the potential for another layer of comfort or aid that I could potentially give within my practice,” Glassman said. “It’s become part of my nursing toolkit.”

Glassman did not pursue the program with the intention of operating as a for-hire end-of-life doula, but instead hoped it would enrich her nursing practice, she said. 

Individuals are able to take UVM’s course for a variety of reasons outside of pursuing a career as a doula, such as to aid in volunteer work or simply to understand death more.

“I get a lot of people telling me, ‘That must be sad, I don’t know how you do it,’” Glassman said. “But it truly is some of the most rewarding work I’ve ever been a part of.” 

The addition of her end-of-life doula education has especially been helpful in reserving her mental energy while working as a registered nurse, and caring for individuals at end-of-life from a place of compassion, she said.

“I’m not there to fix it,” she said. “That might not be what this person needs right now. They might need me to be with them in this moment.”

UVM’s End-of-Life Doula Professional Certificate program was developed by Francesca Arnoldy, a doula, author, researcher and educator in end-of-life work. 

Arnoldy, a graduate of UVM’s Bachelor’s in human development and family sciences program, always had a profound interest in supporting individuals throughout the trajectory of their lives. After becoming a birthing doula and childbirth educator, Arnoldy experienced a series of losses in her life and found herself naturally shifting into a doula role at those times, she said. 

After this experience, Arnoldy felt pulled towards exploring end-of-life work more, becoming a hospice volunteer, end-of-life doula, educator and author of multiple books that explore death and grieving topics, she said.

In 2016 Arnoldy was approached by UVM to create a training program for end-of-life doulas, launching the program officially the following year, she said. 

“I felt really strongly while developing it that I wanted it to be very welcoming,” she said.

Arnoldy designed the program to cover a wide range of topics and be relevant for all students, no matter their reason for obtaining the certificate, she said. 

While many may find it difficult to talk about dying and try to avoid the topic altogether, conversations surrounding loss are necessary to provide community support and prevent isolation for those experiencing loss, Arnoldy said. 

Through end-of-life education, people can not only provide themselves with career opportunities, but also better prepare themselves to deal with loss and have difficult conversations with more understanding and confidence, she said. 

“We carry around these stories of loss and transition that want air and aren’t often invited into conversation,” Arnoldy said. “We don’t give ourselves enough credit for the courage that we actually have.”