The Doula’s Role in Facilitating Advance Care Planning Conversations
Talking about the end of life can feel overwhelming, even when we know how important it is to plan ahead. Advance care planning (ACP) ensures that a person’s medical and personal wishes are honored, yet so many people delay or avoid these conversations altogether. As an end-of-life doula, I often see families unsure where to start, individuals hesitant to make decisions, and loved ones struggling to navigate urgent healthcare decision making.
My role is to make these conversations easier. I provide a safe, supportive space for individuals and their families to explore what truly matters to them. I help them move beyond fear and uncertainty, guiding them through a process that feels personal, meaningful, and empowering.
Why Advance Care Planning Matters
Advance care planning is about more than just filling out paperwork—it’s about making sure that a person’s values, beliefs, and priorities shape their care when they can no longer speak for themselves. Without clear directives, families and healthcare providers often find themselves making difficult decisions without truly knowing what their loved one would have wanted.
ACP includes:
- Choosing a healthcare surrogate or medical power of attorney
- Defining treatment preferences, such as resuscitation, ventilator use, and palliative care options
- Discussing quality-of-life considerations
- Documenting final wishes in an advance directive
Despite its importance, many people put off ACP because it feels too soon, too complicated, or simply too uncomfortable. That’s why I do this work—to help people approach these conversations with confidence and clarity.
How I Support Advance Care Planning Conversations
1. Creating a Safe and Comfortable Space
One of the biggest barriers to ACP conversations is fear—fear of the unknown, of saying the wrong thing, or of facing mortality. My first priority is to hold space for these emotions. I create an environment where individuals and families feel heard, supported, and empowered to speak openly about their wishes.
Unlike a medical provider who may focus primarily on treatment options, I approach these discussions holistically. I ask thoughtful questions, encourage deep reflection, and help people articulate what a "good life" and a "good death" mean to them.
2. Bridging the Emotional and Practical Aspects of ACP
Advance directives are legal documents, but they stem from deeply personal beliefs. My job is to help people translate emotions into actionable plans. I ask questions like:
What kind of medical interventions align with your values?
How do you want to be cared for in your final days?
What brings you comfort, and what fears do you want to address?
Breaking these questions down into manageable pieces helps people move from abstract concerns to clear decisions.
3. Encouraging Family Conversations
Family dynamics can complicate ACP discussions. Some loved ones struggle to accept end-of-life plans, while others may have differing opinions on what’s best. I act as a neutral facilitator, guiding these conversations with honesty and compassion.
My role is not to push any particular decision but to ensure that my client’s voice remains at the center of the process. I help families find common ground and support one another through these discussions.
4. Providing Education and Resources
Many people hesitate to complete an advance directive simply because they don’t know where to start. I provide education on different care options, explain medical terminology in a way that’s easy to understand, and connect clients with tools like Thanacare’s digital advance directive platform.
I also emphasize that ACP is not a one-time task—it’s an ongoing process. As health circumstances and personal perspectives change, so can these documents.
5. Ensuring Wishes Are Clearly Documented and Honored
Having meaningful conversations is just the first step—ensuring that decisions are properly documented and shared is equally important. I help clients complete the necessary documentation, encourage them to discuss their wishes with medical providers, and remind them to store their Thanacare QR code in an accessible location.
I also serve as an advocate, ensuring that my client’s wishes are honored in real-time situations. Whether it’s reinforcing a decision to a healthcare team or reminding a family of previously expressed choices, I offer steady guidance when it’s needed most.
The Lasting Impact of Advance Care Planning
Advance care planning isn’t just about preparing for death—it’s about ensuring a life that aligns with one’s deepest values until the very end. It offers peace of mind, reduces stress for loved ones, and empowers individuals to take control of their own journey.
As an end-of-life doula, I see firsthand how transformative these conversations can be. When people take the time to plan ahead, they often experience a sense of relief, knowing that their wishes will be respected and their loved ones will not be left guessing.
If you’ve been putting off advance care planning, I encourage you to start the conversation today. You don’t have to do it alone.
About Meg
Meg Maher is an end-of-life doula dedicated to providing compassionate, holistic support to individuals and families navigating life’s final chapter. With extensive training from the University of Vermont and Doulagivers Institute, as well as grief work studies with The Institute for the Study of Birth, Breath, and Death, Meg offers non-medical, personalized support tailored to each unique journey. She serves as Secretary on the Board of Directors for the Florida End of Life Doula Alliance (FEOLDA) and provides services throughout Central Florida and remotely nationwide. Rooted in education, presence, and holding space, she believes end-of-life deserves the same care, intention, and reverence as every other stage of life.
