Q. Is licensing or certification required for EOLDs?

A. Licensure refers to being granted permission to legally practice or work in a profession that is tied to legislation on a state-by-state basis. Currently, however there is no national, regional, or state governing body that oversees EOLDs and standards of practice, nor is there any universally recognized academic agency, board, or other accrediting body that holds the liability or provides monitoring for EOLDs. Simply put, because the EOLD profession is unregulated, anyone can call themselves an end-of-life doula, regardless of training, experience, area of interest, etc. 

Q. What does it mean when someone promotes themselves as a “CERTIFIED EOLD?”

The term "certified" generally means that one has obtained a certificate of completion from one of many training programs available. Another type of credential is a simple “certificate of attendance” that indicates attending a workshop or training; it has no assessment process and does not assess knowledge or skills. However, some individual training organizations offer certification that entails a robust, complete feedback process and assessment of learning, knowledge, skills, and experience. Field experience, writing assignments, an exam, and other assessments may be required before conferring certification. A “macro-credential” of this type usually requires active involvement in the field, continuing education, and periodic renewal of the doula’s certification status. These certifications can help the public understand that you have completed some formal instruction that can help with your professional credibility. Still there is no way to measure similar level of knowledge or skill beyond that set by each separate organization. Certification does not always speak to experience, capability, or competency. 

Q. How then, can anyone know whether someone has the ability to effectively practice as an EOLD? 

Currently, it is left up to the individual or family to discern whether a doula is right for them or not. However, one of the main reasons NEDA exists is to help in this process. Although NEDA is not, in itself, a training or accrediting organization, our goal is to help ensure that the support our members provide to others is based on a strong foundation of knowledge, compassion, integrity, and skill. To that end, NEDA has developed and advocates for practical standards and practices as outlined in a doula model of care, scope of practice, code of ethics, as well as a carefully constructed Proficiency Assessment Processes which assesses general knowledge of a topic through testing. These "micro-credentials" were developed to help families, hospice agencies, and doulas and after-death care educators know that a certain standard has been met. 

The decision whether to professionalize one’s practice by pursuing credentials is up to each individual. It is a voluntary process and is not required in any state in order to practice as an EOLD or ADCE. Many doulas and educators who have been working in their communities for a while may feel that they do not need this extra "stamp of approval" and choose not to take the exam. A proficiency badge is but one step that some will choose to take. At this time, doulas can choose to: (1) pursue certification through their affiliated training organization; (2) earn the NEDA Proficiency Badge; (3) do both; or (4) do neither.

Q. Why did NEDA develop a proficiency process:

There are so many regional and stylistic differences in training programs and ways of being an EOLD, leaders in the field agreed on the need to self-regulate by setting national standards and a defined scope of practice. The NEDA Proficiency Assessment Process was developed to create more consistency to the definition of what an EOLD is and does, and to provide a degree of assurance to organizations and families that refer or utilize EOLD services. By earning the proficiency badge, EOLDs receive confirmation that their knowledge compares to other EOLDs who have done so. Similarly, any healthcare organization (such as hospice or palliative care) or any family, also can know that an EOLD with the badge has achieved a certain standard and has agreed to the NEDA Standards of Practice. This is especially important because there are so many different training organizations, definitions, and experience levels that result in confusion about the profession. 

Q. How does NEDA’s proficiency assessment process differ from certification awards received from training organizations?

A. The NEDA proficiency process is not meant to replace any individual training programs' certification. Although certificates of course completion are often awarded by different training entities, earning a particular program's self-certification is not required to practice as an end-of-life doula. Individual training programs that have designed their own curriculum sometimes offer what is called an in-house certificate where they attest to successful completion of a course of study. Therefore, holding a certificate from a trainer or training entity—while valuable in confirming a certain degree of accomplishment and identifying the training type—is not the same as being certified or licensed by an independent, third-party certifier in the way that nurses, CNAs, counselors, therapists, contractors, cosmetologists, funeral directors, and others are. With an individual organization’s certification, doulas can be confident that their knowledge, skills and experience compare favorably to others who have achieved that organization’s certification only. Each organization’s certification can only be compared to itself. NEDA offers a quick and simple way to compare everyone. The reason NEDA offers a micro-credential is that NEDA is not a training and certifying body and does not intend to assess experience level and skills; it assesses knowledge only.
There are many EOLD training organizations throughout the US that all have their individual strengths, philosophies, and teaching styles. No one organization is the definitive source. Students will want to know that they are well prepared to become an EOLD and/or an ADCE, and those already in practice may want to see if there are gaps in their understanding about what an EOLD or ADCE is and does. We anticipate that as more hospice and palliative care organizations become aware of what EOLDs and ADCEs are and do, they will want to know that EOLDs and ADCEs possess a certain body of knowledge and skills. The purpose of NEDA is to be a neutral group of doulas and educators who have come to consensus on the definition of an EOLD and ADCE. As a trainer, please help us by educating your students, spreading the word about the work of NEDA, and sharing your thoughts with us.

Q. What is a NEDA proficiency badge?

A. A proficiency badge is the end result of awarding what is known as a micro credential to a student who endeavors to excel in a specific area of inquiry and wishes to demonstrate a mastery of the subject. This type of credentialing has become the gold standard in technology and education because it identifies measurable skills and accurate knowledge of specific areas of expertise based on standards, rather than simply attesting to whether someone has attended a course. It validates everyone who successfully passes the assessment based on comprehensive, in-depth knowledge.

Currently, NEDA offers the opportunity to earn two different proficiency badges—one for End-of-Life Doulas (EOLD) and one for After Death Care Educators (ADCE). NEDA is also considering developing additional badges in the future for specific areas of practice.

To learn more about how EOLD support differs from ADCE support, watch a brief video explaining the premises in this article to help doulas understand the issues around providing after death care (vuisit : https://vimeo.com/638792393

Q. Who is eligible to earn NEDA’s Proficiency Badges?

A. To earn either of the NEDA Proficiency Badges, one must be a member of NEDA and agree to abide by the NEDA Standards of Practice (Scope of Practice and Code of Ethics) for EOLDs, or ADCEs respectively. Any member of NEDA (doula, doula trainer, or doula/trainer combo) can earn a proficiency badge in their discipline(s), regardless of formal training or level of experience, by successfully completing an assessment based on core competencies created for each area of practice. Individual practitioners may have been working in the field for a long time and amassed a wealth of knowledge, they may have taken training in preparation for service. Neither method of obtaining knowledge and skill is more or less valid as long as the individual knows the fundamentals of best practices in their field(s). 

Q.What are the benefits of earning a NEDA proficiency badge?

Those who wish to receive EOLD support can know that a practitioner who has earned a NEDA Proficiency Badge has met certain standards. Hospice and palliative care organizations can have the same confidence when hiring or making referrals to end-of-life doulas who have a NEDA Proficiency Badge. And end-of-life doulas who have a proficiency badge can themselves know that their knowledge compares to others who are providing EOLD and ADCE support services. Therefore, regardless of the type of training a doula receives, NEDA's micro-credential proficiency assessment process screens for continuity and a proven shared knowledge base across all training providers.

The NEDA micro-credential assessment is a direct reflection of the standards, or core competencies, that NEDA developed and provides to doula trainers. Successful completion of the test will earn NEDA members a “micro-credential” that recognizes a standard level of proficiency in the field. As the profession develops, the NEDA EOL Doula Proficiency Badge may become the micro-credential that is recognized by outside organizations in related fields. Those who hold the NEDA EOL Doula Proficiency Badge may eventually be able to collaborate with or be hired by hospice and palliative care organizations, or they may receive referrals from them. In addition, the badge may be used on written materials and websites.

Here are just a few of the benefits of earning a NEDA proficiency badge:

Establishes Credibility: Earning a NEDA Proficiency badge demonstrates that you possess the necessary skills and knowledge to perform effectively. This can establish your credibility and help you to gain respect and recognition from your communities you serve, peers, and employers. 

Demonstrates Expertise: Earning a NEDA Proficiency badge demonstrates that you possess a deep understanding of the subject matter and have acquired the necessary skills and knowledge to perform well. It shows that you are committed to your profession and have taken the initiative to acquire the necessary skills and knowledge to excel in your career. 

Boosts Confidence: Preparing for NEDA’s proficiency assessment can be a challenging but rewarding experience. It can boost your confidence and provide you with a sense of accomplishment and personal growth. 

Develops Professionalism: Earning a NEDA Proficiency badge can help you to identify areas where you need to improve your skills and knowledge. This can lead to targeted professional development activities and help you to advance your career. 


Q. Why are there two separate assessment processes for EOLDs and ADCEs?

A While clearly a significant part of the end-of-life care continuum, after-death care is NOT considered to be part of the EOLD Scope of Practice. EOLDs work focuses on pre-death matters ADCE’s are more involved with activities that take place post-death. However, because the two are so closely related, it's important for those who practice either EOLD and/or ADCE work, particularly for pay, to be aware of and understand the significant differences between these two roles—especially the legal parameters surrounding them.

Just like EOLDs who focus their practice on the time before and during the dying process, after-death care educators (ADCEs) come from all walks of life and have varying interests and skills. Similarly, there is no singular training curriculum or formal oversight or licensing requirements for ADCEs either. However, to help create a basic reference for consistency and continuity in this emerging field, while clearly distinguishing it from EOLD work, NEDA has created a separate ADCE Scope of Practice, Code of Ethics, and Core Competencies. 

Because the pre-death legal parameters of practice are different from post-death, it is important that anyone choosing to practice both end-of-life doula and after-death care educator work, particularly for pay, consider earning a certificate in both areas.

Q. Who determines what the core competencies are for EOLDs and ADCEs?

A. The NEDA core competencies were developed through an arduous process of discussion and research by experienced trainers in both fields. These trainers met regularly and shared their wisdom and understanding of the common areas of necessity and expertise over the course of a year. For more information about core competencies, please click HERE.