"Death Bouncers" and "Spiritual Guides": How End-of-Life Doulas Provide, Frame, and Navigate Spirituality and Spiritual Care.

The medicalization of death has left gaps in the spiritual and psychosocial well-being of the dying. Factors like professional and caregiver burnout, lack of training, overburdened caseloads and rigid schedules, and other organizational constraints lead to holistic, humane care falling through the cracks. Consequently, the dying and their families are opting to rely on individuals who can bridge these gaps-end-of-life (EOL) doulas. EOL doulas employ a variety of non-medical practices from touch therapies to legacy projects to religious rites that provide support covering the emotional, spiritual, and practical aspects of dying. Utilizing qualitative interviews with 23 EOL doulas located and working in the United States, this research offers insights into doulas' provisions of spiritual care, how death doulas' understanding of the death transition inform spiritual care provisions, as well as how death doulas navigate differences in spiritual and religious belief systems between themselves and their clients. The study emphasizes the critical role of EOL doulas in bridging gaps in end-of-life care, providing personalized, compassionate support sometimes missing in institutional settings.