Doulas are hired by the dying person, or by families in concert with the dying person's wishes. As with birth doulas, insurance doesn't cover death doula services. Christy Marek of Lakeville likened her work to personal coaching services, which also are private pay.

While some programs offer certification, there is no governing or accrediting body in the United States for end-of-life doulas. Marek sees that as a positive, "because then we aren't tied by regulation that defines what services we provide." A doula and a dying person work together to develop a plan for care and payment.

Because doulas provide an intensely emotional service, Jeri Glatter of the International End of Life Doula Association recommends interviewing several, if possible, to find someone with whom there's a strong connection.

A number of groups offer training in Minnesota and elsewhere. Some also offer doula listings, including several with state-by-state directories. Here are some options:

International End of Life Doula Association:

The Death Midwife:

Aslan Institute:

Threshold Care Circle:

Conscious Dying Institute:

Sacred Art of Living Center: