May 28, 2025
As the new Support at Home Program prepares for rollout in July 2025, many of us in the end of life space have been attending conferences and webinars and reading with confusion — and growing frustration — at the proposed structure of the End of Life Pathway.
Let’s be clear: Australia has been building a quiet, determined, community-led movement of people who are trained and committed to improving end of life experiences. These people are end of life doulas — people who have completed relevant, non-clinical training and now work alongside families, care workers, aged care teams and palliative services to support dying people and those around them.
There is a nationally accredited qualification in End of Life Doula Services, and in New South Wales, this course is subsidised under Smart & Skilled, clearly recognising the importance of this emerging role at a government level.
And yet — incredibly — this entire workforce has been left out of the End of Life Pathway in the Support at Home manual.
We have to ask:
This omission has consequences. Without meaningful integration of non-clinical support roles, families and support workers will continue to feel lost, unsupported and overwhelmed. Many will default to calling an ambulance when they feel out of their depth — adding pressure to an already strained hospital system. People will continue to die in clinical settings, rather than being supported to stay in their own homes if that’s their preferred choice.
Palliative care services are already under pressure, and this will only increase with the needs of our ageing population in the coming years.
Meanwhile, a trained, cost-effective, community-rooted workforce of doulas stands ready.
We are death-literate. We are person-centred. We are non-clinical but deeply skilled.
We work alongside GPs, nurses, palliative care and aged care teams — not in place of them.
We’re growing. Every week, new doulas complete their training across the country. More community members are seeking this kind of support. More families are asking questions. The momentum is building — with or without formal recognition by some areas of government.
We call on those designing and implementing the Support at Home Program to take a step back and see what’s been missed. The End of Life Pathway can’t be as truly person-centred, flexible or sustainable as it could have been without acknowledging and integrating end of life / death doulas — people who walk beside others in one of life’s most vulnerable moments.
We’re ready. We’re trained. We’re already working with community organisations, aged care providers and families. And we’re urging you to recognise the value that doulas bring.
Together, we can ensure everybody has the right to a meaningful, supported end of life experience.
