For Whom Is This Service?

Individuals who have been diagnosed with a serious or life limiting illness and their loved ones and caregivers.
Individuals who are receiving palliative or hospice care and their loved ones and caregivers.

Individuals who are interested in doing illness or end of life preparedness work and planning

In-home visits are provided 35 miles around Hood River, OR in OR and WA.

Benefits Of This Service

The individual, the loved ones and caregivers feel well resourced, supported and as prepared as possible during the end of life journey.

Advance Directive Facilitation

This work supports an individual in the exploration of their goals, values and beliefs so they are comfortable filling out an Advance Directive and documenting future medical care options. This ideally happens with their health care agent present. If indicated, discussions related to the POLST (Portable Orders for Life Sustaining Treatment) form are also an option. This service is offered via Zoom.

End of Life and Vigil Planning Services

This involves assistance with consciously planning for the final days of life, choosing the setting and being present at the bedside during the final hours of an individual’s life.

Hands on caregiving and symptom management instructions

This overlaps with Nursing Services.

Also Includes…

Companionship, listening and emotional support for the individual, their loved ones and caregivers.

Referrals and resources.

Some skills and traits used by Hospice Nurses and End of Life Doula are similar.This testimonial pertains to Carola Stepper’s role as a Hospice Nurse:

“We were lucky to have Carola care for our mom. Her compassion, patience and commitment were amazing. She was present, caring and listened to mom and us. She was able to connect with mom, having difficult conversations, even using humor, to understand her wishes. She provided valuable information at the right time as well as practical guidance and emotional support.”

— M.S.


Completed End of Life Doula training by The Peaceful Presence Project

End of Life Doula certified by the National End of Life Doula Alliance (=NEDA)

Carola Stepper is a multi credentialed End of Life Doula and offers blended services as an End of Life Doula, Advance Directive Facilitator, Registered Nurse, Licensed Acupuncturist and Grief Recovery Method Specialist.

Frequently Asked Questions

What is an End of Life Doula?
End of Life Doula care involves a broad range of holistic, non-medical, and non-judgmental guidance and resources to empower individuals who are preparing for or experiencing end of life. This includes supportive resources for their loved ones.

Services are provided both within the home, or virtually. The End of Life Doula collaborates with all other care providers and complements the involvement of the individual’s loved ones and caregivers.

Please see: National End of Life Doula Association (=NEDA): The Doula model of care and Scope of Practice.

How are your services offered?
Via phone or video conferencing, or in-person, in the individual’s home, or a hybrid of both.
How often do people usually need to receive those services?
This is each individual’s choice and ranges from one time to regularly scheduled visits, ranging from every few weeks to multiple times per week. The more often the End of Life Doula visits, the more the individual, their loved ones and caregivers are able to benefit from these services.
Is this service covered by insurance? How much does it cost?

Please see Fee Schedule

End of Life Doula services may also be combined with Advance Directive FacilitationAcupuncture/Acupressure and/or Nursing services.

What kind of End of Life Doula Services are not offered?

When a person dies, the hands-on care from an End of Life Doula ends. This is due to FTC (Federal Trade Commission) regulations connected to the practice of funeral directing. The End of Life Doula services after death may include consultation, education and emotional support, as well as providing resource information, but not hands-on care.

No on-call or after hours services are provided.

Carola doesn’t transport clients or provide pet-sitting or childcare services.

We are already receiving palliative or hospice care. Why should we hire an End of Life Doula?

Ideally Carola’s clients receive medical, emotional and spiritual support from palliative or hospice care teams.

Hospice services are covered under Medicare and are subject to rules and regulations and require medical orders. Typical hospice team member visits are usually around 1 hour.

End of Life Doula services offer non-medical, holistic, logistical and emotional and resource support. These services are not covered by insurance companies. They provide an extra layer of support. As a former hospice nurse, Carola integrates End of Life Doula services which are intended to complement what is typically offered by hospice team members. Her visits can extend up to 4 hours, if requested. She can become involved while the individual is still feeling well and to help plan for future needs.

Additional Caregiving and Doula Resources

Bobbi’s Way In-Home Health Care is licensed in OR and WA.

Please see information about local Care Giving and In-home care agencies under Gorge Local Resources.

Carola is recommending and collaborating with these Columbia Gorge End of Life Doulas:

phone icon (541) 399-1919