Keough, the granddaughter of Elvis Presley, shared the news on Instagram.

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In July 2020, actress Riley Keough's brother, Benjamin, died by suicide at age 27. Now Keough, the daughter of Lisa Marie Presley and granddaughter of Elvis Presley, is dedicated to helping others deal with dying and grief. On March 21, she shared that she'd completed her training as a death doula at an "alternative" funeral home in Los Angeles.

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"I guess I'm an almost certified death doula now hehe," she wrote. "And I just felt like writing such a deep thank you to this community who are teaching and training people in conscious dying and death work."

Riley continued, "We are taught that its (sic) a morbid subject to talk about. Or were so afraid of it that we're unable to talk about it... then of course it happens to us, and we are very ill prepared."

"I think it's so important to be educated on conscious dying and death the way we educate ourselves on birth and conscious birthing," Riley wrote. "We prepare ourselves so rigorously for the entrance and have no preparation for our exit. So I'm so grateful for this community and to be able to contribute what I can."

What does a death doula do?

The term "doula" is usually associated with birth; having a doula assist with labor and delivery is something an increasing number of pregnant women are opting for. The role of a death doula is similar. A death doula helps those who are dying, and their loved ones, navigate the process. It just happens at the end of life rather than the beginning.

"A death doula supports and guides a dying person and their loved ones through the journey of dying," Henry Fersko-Weiss, executive director of the nonprofit organization International End of Life Doula Association (INELDA), tells Health. "They will provide emotional, spiritual, and informational support to open the door to deeper meaning for everyone involved and bring greater peace to end-of-life."

A death doula (also known as end-of-life coach, death midwife, funeral guide, or death-and-dying guide) offers a range of services to suit each person's circumstances, such as helping with the emotional and caretaking aspects and assisting with the practical side of things, like organizing the funeral.

If a death doula is helping a person who is dying, that may involve mainly being by that person's side, listening to their wishes, and answering questions. If their main role is to support the family of the dying person, they may assist with basic chores to help ease stress, act as a mediator in complicated conversations, and even help with writing a eulogy or saying a final farewell.

The emergence of death doulas is a good thing

A death doula may offer a great many benefits to a dying person and the loved ones who are caring for them, Fersko-Weiss says. "Doulas are an extra layer of support," he explains. "They guide everyone through the experience based on their deep understanding of the dying process, which helps everyone to feel less afraid and anxious. They can also explain the signs and symptoms of dying so people are better prepared, and use guided imagery and ritual to lessen the suffering in dying and bring a more profound acceptance and understanding. After a person dies, the doulas can then support the loved ones as they begin their journey through grief."

"Some individuals find the support of an end-of-life coach significantly therapeutic and healing," Leela R. Magavi, MD, psychiatrist and regional medical director for California-based Community Psychiatry, tells Health.

New York City-based grief and loss counselor Diane P. Brennan tells Health she welcomes the emergence of death doulas. "The dying process is challenging to navigate and a doula can lead they way to make sure our death experience reflects our personal choices, which lifts the burden off of the family," she says. "Many people don't know what to expect when someone is dying, and a death doula offers a level of support that does not currently exist."

Why do some people need help to deal with loss of a loved one?

First of all, it's completely normal for grief to be a difficult thing, Ernest Rasyidi, MD, a psychiatrist with Providence St. Joseph Hospital in Orange County, California, tells Health. "The death of a loved one is a very significant loss," he explains. "Humans tend to find it hard to adjust to change in general, and the permanent loss of someone precious is potentially the biggest change of all. We know life and the world in a certain way, and then they're gone, so it takes a while to recalibrate."

Dr. Rasyidi says he isn't familiar with the term "death doula" specifically, but his hospital has a program called "No One Dies Alone," a volunteer service provided by staff and members of the community—who feel it is important that a dying person have someone with them in their final moments so they wouldn't die alone if they didn't want to. (In the age of COVID-19, this is particularly meaningful.)

"Accepting death as part of life is very difficult," Moe Gelbart, PhD, a psychologist with Torrance Memorial Medical Center in Torrance, California, tells Health. "A denial of death is a built-in part of who we are—we live our lives as if we're not going to die."

Having someone to explore those thoughts and feelings with is important, Gelbart adds, whether it's a priest, rabbi, psychiatrist, best friend, family member or, indeed, a death doula. "The bottom line is to have someone to open up with and share your thoughts," he says. "Ideally, that should be someone you care about and trust."

Credit: Julia Bohan-Upadhyay

How to Be OK When You're Not OK  Check out Health's special series on life after loss.