Thoughts on How Doulas Can Provide Dignity

When Private Life Becomes Public

By Michelle Thornhill, DEIJ Committee Chair 

 Through a DEIJB lens, Diversity, Equity, Inclusion, Justice, and Belonging, we recognize that dignity is not automatically preserved in institutional systems.

Ten Powerful Ways we can protect our clients when care transitions from home into hospital or facility settings. 

1. Protect Cultural Identity 

Ask about rituals, foods, touch, music, modesty, and spiritual practices. 

Advocate for cultural accommodations. 

Protection begins with honoring that culture is not an accessory to care; it is central to it. 

2. Safeguard Language Access 

Ensure professional interpreters are used (not just family members). 

Slow down conversations so informed consent is truly informed. 

Confirm understanding gently and respectfully. 

3. Advocate for Equitable Pain Management 

Research consistently shows disparities in pain treatment across racial and marginalized groups. 

Help clients articulate their pain experience. 

Encourage consistent reassessment. 

Support documentation and follow-up when pain concerns are dismissed. 

4. Protect Decision-Making Autonomy 

In medical settings, urgency can overshadow agency. 

Clarify the client’s values and goals ahead of meetings. 

Help families prepare questions. 

Pause conversations when they feel rushed.

5. Affirm LGBTQIA+ Identity and Chosen Family 

Hospitals may default to legal or biological definitions of family. 

Ensure chosen family is recognized. 

Advocate for correct names and pronouns. 

Intervene gently if identity is misrepresented. 

6. Preserve Spiritual and Religious Practices 

Coordinate clergy or spiritual leaders. 

Protect time and space for prayer, chanting, silence, or sacred objects. 

Spiritual care is not optional at the end of life; it is essential. 

7. Protect Privacy and Modesty 

Hospital routines can unintentionally strip away privacy. 

Ensure curtains are closed. 

Advocate for gender-congruent caregivers when possible. 

Support modesty preferences. 

8. Center Disability Justice 

Interrupt ableist narratives. 

Clarify that disability does not equal diminished worth. 

Support accessible communication and positioning. 

Justice means challenging harmful assumptions. 

9. Buffer Emotional Overload 

Hospitals can feel clinical and impersonal. 

Bring grounding practices into sterile spaces. 

Use soft voice, intentional touch (with consent), and breath. 

Help families process medical information emotionally. 

10. Create Micro-Spaces of Belonging 

Even in public systems, belonging can be cultivated. 

Bring familiar objects from home. 

Play meaningful music. 

Tell stories of the person’s life in front of staff. 

Remind everyone in the room: this is a whole human being. 

Belonging transforms rooms. 

The end-of-life doula becomes a bridge gently connecting personhood with policy, humanity with healthcare, and sacred experience with structured care. 

Respectfully excerpted from NEDA, Vol. 77, March 26