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Demand for end-of-life doulas on the rise as palliative care need increases

ABC NEWS logo ABC NEWS 1/08/2021
Anna Unterberger posing for the camera: Kate Sidebottom, 25, has been an end-of-life doula for a year. (ABC Goulburn Murray: Charmayne Allison) © Provided by ABC NEWS Kate Sidebottom, 25, has been an end-of-life doula for a year. (ABC Goulburn Murray: Charmayne Allison)

Kate Sidebottom was just eight when she witnessed her first death.

Her grandfather was dying, and rather than shelter their daughter, Ms Sidebottom's parents decided to expose her to his passing as a natural part of life.

She looks back on that moment as the catalyst for her "calling" – to care for others in their last days.

"I've just always had a passion for it, since I was little," she said.

In the years since, she's naturally slipped into palliative care roles for family and friends.

And last year, the 25-year-old from Shepparton in Victoria trained to be an end-of-life doula.

"I think it's a subject that's not talked about enough," she said.

"But death is inevitable.

"And while there's no such thing as a good and bad death, you can definitely die well."

End of life doula numbers on the rise

Ms Sidebottom is just one in a swiftly growing number of end-of-life doulas in Australia.

Australian Doula College director Renee Adair said they had seen a "massive increase" in enrolments for this area of study.

"We get more and more enquiries every week," she said.

More people are also seeking end-of-life services.

"A lot of people are needing gaps filled," Ms Adair said.

"There are gaps in all areas of the system, particularly in recent years, in end-of-life."

Ms Adair said doulas provided emotional and physical support and advocacy to the dying person and their families.

"Some people may just want to know more about end-of-life planning," she said.

"Or someone may have a life-limiting diagnosis or be at the end of their life and looking for someone to support them emotionally that's not family."

More palliative care needed as populations age

This increase in doulas comes as a concerning palliative care shortage begins to emerge Australia-wide.

According to the Australian Institute of Health and Welfare, this is because the nation's population is ageing fast, and rates of cancer and other chronic diseases are on the rise.

There are only 270 palliative care physicians registered in Australia – just 50 per cent of what the country needs.

And with Australia's ageing population tipped to reach 30 million people by 2030, this is only expected to get worse.

"We're concerned we haven't got sufficient funding invested for the future," Palliative Care Australia chief executive Camilla Rowland said.

The majority of residential aged care facilities don't have palliative care services employed – or even visiting.

Ms Rowland said funding from both state and federal governments – and more discussions around who was responsible – was needed to address this.

Meanwhile, in rural and remote regions, the bulk of support is provided by carers.

Under-served populations such as Aboriginal and Torres Strait Islander and culturally and linguistically diverse groups are also being left behind.

And with COVID-19 putting pressure on health services, Ms Rowland said the palliative care workforce was tighter than ever.

"There really needs to be some significant planning for the future – not just in residential aged care but also in-home palliative care," she said.

Hopes end-of-life doulas can step up

While end-of-life doulas can offer a vast range of support, they can't fill growing gaps in medical care.

But Ms Rowland acknowledged more people were turning to doulas as an additional aid.

"I believe this emergence of death doulas is not particularly regulated," she said.

"But that might be something that's been addressed through potential accreditation.

"It will be interesting to see how that goes forward."

But Ms Sidebottom and Ms Adair are among those hoping doulas will one day work alongside medical professionals in all palliative care settings.

"I think over the next couple of years there'll be even more interest in doula support," Ms Adair said.

"We have forgotten the sacredness of end-of-life. In our culture, it's not considered as much of a rite of passage as in others.

"But it's really important that people have a beautiful, calm end that they are choosing."

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