The Three Phase Doula Model

Below you will find a brief explanation of the INELDA three phase model, which informs my work as an end of life doula. It is worth noting that while there are three phases to this doula model, as many of us know, end of life is anything but neat and tidy. The three phase model is flexible and each phase can be practiced independent of one another.

Phase I: Summing Up, Life Review and Planning

Phase I focuses on conducting a life review with the dying person or their caretaker(s). This is called "summing up" and is meant to help the client understand the impact their life had. The doula engages in deep active listening (listening with curiosity and intention, with the client's need at the center), in order to get to know the client, their story, their beliefs, areas where they wish they could have made different choices in life, etc. One outcome of phase one is simply to hold space for the client as they come to terms both emotionally and spiritually with what is happening to them. Another aspect of this phase is to help the client with any plan making they may want to engage with: planning their vigil, creating a legacy or remembrance project, confronting regrets, unfinished business, grief or shame, or the more practical aspects of end of life like advanced care planning, health care directives or a living will.

Phase II: Conducting Vigil

Phase II focuses on executing the vigil plan that the client feels honors their idea of a “good death.” Holding vigil is not the same as a funeral or memorial service, but rather occurs during the active dying process, which could be anywhere from one hour to many hours. A doula can assist in conducting vigil in many ways, including being present to support caretakers and loved ones during the active dying process with practical or active tasks related to dying persons vigil plan, sitting with family and friends to provide emotional or spiritual support during the active dying process, and to conduct any rituals, if asked.

Phase III: Early Grief and Reprocessing

Phase III focuses on reprocessing the death of the loved one with any primary caretaker(s) or family members. This phase can look many different ways, and might include conducting a ritual, some deep active listening in order to hold space for the grieving, guided imagery/mindfulness work, or a general check in on basic needs (are the caretakers eating, sleeping, do they need grief support resources).