Q&A with Julia Brough about Death Doulas

Pearl Marvell • October 30, 2025

Julia co-founded End of Life Rhode Island, an organization with a mission to educate the public about the role of the end-of-life doula.

When Julia Brough is not sitting in front of a computer, she can sometimes be found by the side of someone who is dying. She is a death doula, also known as an end-of-life doula or death midwife, a growing vocation that is part of a larger movement that is changing how we look at death. 


Although the term “death doula” might seem new and different, for thousands of years, societies across the world have had individuals trained in helping the dying. Today, there are about 1600 death doulas throughout the U.S. 


Julia sat down with us to talk about her work and the organization she co-founded, End of Life Rhode Island, whose mission is to educate the public about the role of the end-of-life doula, as well as raise public awareness around death, dying, and end-of-life planning and support in Rhode Island. 


This interview has been edited and condensed for clarity.
 
Memorial Funeral Home:   So, Julia, tell me what you do and what got you into this work? 

 
Julia Brough: My 9-to-5 is a digital project manager, so I am at a computer a minimum of 40 hours a week. And then during 2020, I was speaking with my therapist at the time, I was just kind of ruminating on being on a computer for the majority of my week. I wanted to explore some other field to get involved in, ironically, during a healthcare shut down. 


I said, “What in this space could I do?” And I mentioned to her that I had just gotten a birth doula book, but I wasn't feeling compelled to open it, and she said, “Well, have you ever heard of a death doula?” I immediately went and googled it and found the University of Vermont Certificate program, which is one of the largest certificate programs, and signed up for it. I think it was about eight weeks. 


Throughout the program, I said, “This is literally what I'm equipped to do.”  It just felt like all the little puzzle pieces were coming together, being a project manager. And really, that's what an end-of-life doula is, we have a point A and a point B. You have to kind of see at a high level and understand what your client wants to accomplish within that time. So it felt like a really nice marriage of everything I have worked towards. 


After you get a certificate, there isn't really like a path. You have to either start your own business and have that entrepreneurial energy, or people will go and volunteer with hospice. So I went through the volunteer process with Hope Health. During that time, I was still talking about, “What do I want to do? How do I use this skill?” And I talked about it enough that at a dinner party, someone connected me to Judith Sutphen. Her and I met and we said, “We need a community.” So we started End of Life Rhode Island with the intention of public outreach, professional education, and giving ourselves a space to be together. 


We need to educate Rhode Island, like people don't know [what a death doula is]. And she happened to know a cohort of people that had gone through the program or were just really tangentially interested, like funeral celebrants and folks that work in grief therapy at the VA.  


We started organizing in 2022. And then we went through our strategic planning last year because we were like, “Okay, who do we want to be when we grow up?” And that was super helpful. Now, we're coming up on a year of having a marketing committee, a professional education committee, we've done a program every month and a  public outreach committee. 


MFH:  That's awesome. And how has the reception been? 

 
Julia: A lot of the first questions are, “How much does it cost?” We're not regulated at this point--some people are doing it for their livelihood, some people don't need to do it for income. I try to price myself  at a sliding scale. I'm very flexible. I have a full-time job. I'd like to make some money for the skill set, but also, I'd much rather get the work done. 

 

We most often get asked, "What is the difference between hospice and end-of-life doula work?" And so that's a really interesting question to get.


Mainly hospice is a medical provider and these medical professionals need to meet patients on a schedule. A doula can come at all of those in-between times and sit with their client, work with them, provide caregivers with respite. They are just more hands on deck, basically. 


I am 36 and I have talked a lot about this with a lot of my friends, many of them who are just starting a family or they already have kids, and a lot of them have responded with, “I could have really used this service with my aunt, uncle, grandfather, parent as they were dying of cancer.” Like just someone to sit in it with and be available.

 
MFH:   What do you think drew you to this work? 

 
Julia:  I've had a couple experiences that really resonated with me in different ways, one of them being my father died when I was 14 of a sudden heart attack at a a work Halloween party that I was not in attendance of - we were living in California at the time. I never saw him again. He went to the party with my mom, and then the next time I saw him was at the wake in Rhode Island.  


And then my two grandmothers passed. My mom's mom, she died in 2018. And my family, they know me to be very deeply emotional. And so there was this cajoling that needed to happen for me to come to her bedside. The whole family was around her deathbed and they reassured me, "Please come here, you can be here. We'll be here with you.” 


And then when I got there, I was like, “Oh, my gosh, I don't know if I can handle this.” I was encouraged to sit with her and speak with her, alone. That was incredible. To hold her hand and talk to her was something that I don't think a lot of people are reminded to do. 


And then my dad's mom passed, she was very lucid all the way up to the very end. And when she knew I was going through the doula program, she was like, “Will you come and be with me when I die?” She was in Laconia, New Hampshire. And the minute I heard she was not doing well I dropped everything and canceled my Thanksgiving plans with my mom's family. And I drove up there. I was by myself, and I spent two hours holding her hand, talking to her.


I got to experience her receive a prayer from the hospital chaplain. She held so tightly to her old worn scapular - a religious garment - as she nodded along with the prayer. And I relfected “I want to bear witness to that, to everyone's different religious views and like how that culminates at the end.” That was really, really intensely beautiful.


So these three stories kind of laid this foundation. When I learned that I can educate people on showing up and stepping into the death space and that it can be scary and it can be beautiful and you can be there for your people, it is really powerful and I wanted to do that work. 

 
MFH: That's really profound because it feels like we live in a very death-averse society and sometimes very emotionally averse, so to give people that opportunity to take those emotional walls down and give them that space, that's powerful. 

 
Julia:   I appreciate you reflecting that back. Our culture and relationship with death here in America is one of holding it all at arms length. This is a generalization of course, there are many cultures within this country that do handle death differently. But as a whole, we struggle with sitting close to death.


I can get a little extreme talking to my friends where I ask a question like, “Have you guys talked about your body disposition planning?” And a lot of them don't want to talk about it. I get it. I have two nieces: five and one years old, and that has definitely changed this journey of stepping deeper into the death care space.


It is scarier now knowing that I will miss time with them. But I try to ease that dread by reminding myself that our truth as humans is that we will all die. And to try to live a full and beautiful life with the time that we have is all we can do.

 
MFH: You refer to yourself as an emotional human being, does that work to your favor in this work? 

 
Julia: Oh yes, you can still be emotional in that space. Your humanness is what makes you relatable and approachable to those that are going through a very intense time of grief.  Doulas are providing their clients with the space and the strength to reach within themselves and navigate this new and final chapter. As well as the caregivers!


We all have these tools within us to advocate for ourselves and lean into vulnerability - we just need a little help from time to time. Doulas don't need to solve any problems. Doulas provide resources and ask questions to help clients travel through the forest of their final chapter.


The work that a doula is doing is showing up and saying, “Okay, we're going to sit in this space. We're going to talk about this, if you want to talk, and you're going to get to whatever that next point is.” 


MFH: So, walk me through what you're offering a family. Are you coming in weeks before a terminal diagnosis is given? 

 
Julia: You can start working with an end-of-life doula when you're healthy. One thing I have been doing is hosting death dinners where I make dinner for up to four people and facilitate conversation around death. Even just having these conversations when there are no ailments is a great way to work with a death doula - maybe once a year or so to keep documents up to date. 


You can start with working on an end-of-life planner! I have one that is titled, “I'm dead. Now what?” In it you have your passwords, you have who you want to be called upon death, which I love because I'm like, “Oh my gosh all my best friends.” And then there's also a document that we love to promote which is called Five Wishes and that is acknowledged in Rhode Island as your end-of-life document. There's like a whole bunch of things in there that you can circle. I've gone through it with my mom in pencil, and I just kind of reiterate to people that you can go through and change these documents at any point, as life evolves. This will help your end-of-life planning to start early and not be left for the last minute when things get very tied up in immense grief. 


Then when there is a timeline due to a diagnosis, working with that client to understand what they want their days to look like, if there are any efforts that they want to get such as recording your life's story, finishing a project that may be half complete, or combing through belongings to give them to friends and family - to name a few. 


I'm working with them to understand their body disposition options, because there are options that are not legalized yet in Rhode Island that they can take advantage of elsewhere, whether it be water cremation (aquamation) or human composting (natural organic reduction) or a natural burial verses a green burial. 


Then working with them to map out what their memorial would look like, in partnership with a funeral home. A living funeral could be a nice option where the client is able to attend and say their goodbyes, maybe pairing it as an opportunity to give those belongings away either to friends and family or donated in a specific manner (this is also known as Swedish death cleaning).  


Also taking time to understand what they want their space at the end of life to look like, feel like, smell like, and sound like. There is such a beautiful sense of autonomy that can be woven into this planning. 

Other things that can be planned is if the client would like a pet to be around or if there are people that they do not want to have in their space or if they would like to have their hands and feet lotioned - to again, name a few.

 

Doulas can help in so many different ways, and it really comes down to what that person's life looks like and what they need and you're kind of tailoring it for them.  

MFH: Once someone has died, does the work of the doula continue after that? 

 
Julia: Oh yes, we of course refer back to what the client's wishes are or what the family is comfortable with. Some doulas are available and able to help wash and shroud or dress the body. Putting the body on ice so visitors can come spend time to say final goodbyes. Prepping the body for the various internal changes that it will be going through - especially if it is not to be embalmed. A doula can assist with calling the doctor, calling the funeral home, spearheading that communication so that the loved ones can grieve. Doulas can help caregivers receive various tasks if they are interested in being involved such as opening the window to let the soul out or leading a prayer or song or poem. And finally, doulas can be available for the memorial / funeral / wake to make sure things go smoothly. There are lot of ways a doula can help after death. It is worth noting that not all doulas offer all of these services.

 
MFH:  Say there are people that you don't want in the room in those last hours or minutes. Do you designate someone within the family to be like, “Hey, you can't come in here?” Or does the doula take on the role of having those hard conversations with family? 

 
Julia:   Going back to whatever the client prefers - there definitely can be a bit of mediation involved in this role. Doulas show up as a neutral presence to create space for the dying to live their final days in the best manner they can. Being able to have those hard conversations, it's really guided by the client's wishes or if they are unable to communicate, deferring to what the immediate family would prefer. And maybe there's another way that you could communicate this to the individual. The client may not want the person in their presence physically so you could ask them to write a note instead or send flowers. As a doula, I am happy to have those conversations.

 
MFH:  Julia, thank you so much for this conversation. 


Julia: Thank you! And a should out to the folks I have been working with at End of Life RI, they are an incredible group of humans bringing so much to this corner of the death care space. If you are interested in learning more, we welcome you to join us to learn about our organization at endofliferi.org.  And I am always down for a coffee or tea or cocktail to chat more!


Thank you so much for your time and the space. 

 
 


Losing the pear tree

By Kim Shute • July 30, 2026
We talk almost every Wednesday morning. It is a standing check-in, but the details of our lives rarely stay on the surface for long. An errand or a passing remark about the weather has a way of leading somewhere more private, a question worth sitting with, something one of us has been mulling about and needs the other to chime in with another perspective or a perfect sentiment. We have built up enough trust over the years to say the harder things out loud, the things you cannot say to just anyone. Last week she took a full breath, the kind I know comes from deep within, even before she told me. The pear tree had to come down. I used to be her gardener. I know that tree well. Not only that, but I know the roughness of its bark through gloved hands because I touched it so many times over the years, pruning, harvesting, collecting fallen refuse, and just resting a hand on it the way you do with something familiar. It was a good climbing tree once. It was a gnarled, opinionated old thing, the kind of tree that drops its fruit everywhere in the fall and does not apologize for it. The pears would pelt the grass, and sometimes an unlucky passerby would draw in the sweet-loving stinging insects that come for anything left to soften in the sun in late fall. I used to race those insects for the pears. I would gather as many as I could before they found them or before they found me. Homegrown pears are not perfect. They get little hard spots, the kind that make a bite less pleasant than the grocery store variety or the local orchard. It never mattered to me. Food is food, and these were never just pears. I turned them into pear butter, into pies, into fruit leather that lasted long after the season had ended. She gave them to me out of love, and I took them out of love for her. That tree held a place in her heart that went beyond the fruit. Her husband, an engineer through and through, was the one who tended the hedges and the lawn. Together they decided about the trees on their land. He has been gone nearly five years now, and his absence still finds her in small ways every day and in bigger ways that arrive unexpectedly. Losing the tree was one of those bigger ways. It brought the grief back up, sharp and unexpected, almost like waiting for that first anniversary all over again. This is the part of grief that nobody quite warns you about. You think you have done the work. You think you have found your footing after a loss, and then something ordinary happens; a tree needs to come down, a chair gets replaced, a song comes on the radio, and you are right back at the beginning of the feeling, even though the actual loss happened years ago. Grief does not stay contained to the one door it came through. It finds new ones, ones you did not know were there until they open. The tree came down last Friday. What is left now is the work of finding something new to plant, something that will one day offer its own shade on a hot afternoon. There is a short list developing for consideration. That will take a bit more time, and it should. What does not need replanting are the pictures we already have, the ones in our memories and the ones she captured herself over the years with her photographer's eye. And there is still a Wednesday morning phone call, where two people can sit with a hard feeling together and know they will be safe saying it out loud. 

A Natural Return: Inside Prudence Memorial Park

By Pearl Marvell • July 30, 2026
Tucked into the landscape of Prudence Island, a new kind of resting place is taking root—one guided not by manicured lawns and polished headstones, but by the rhythms of the natural world. Prudence Memorial Park was founded on a simple but powerful idea: that the land we return to in death can also be the land we protect for life. The 3.2-acre natural burial ground is located on the southern end of Prudence Island’s highest ridgeline and overlooks the east passage of Narragansett Bay. Prudence Island is accessible by a 30-minute ferry ride from Church Street Wharf in Bristol, Rhode Island, with the on-island ferry landing located near the intersection of Pier Road and Narragansett Avenue on Prudence Island. For more information, visit Prudence & Bay Islands Transport for scheduling and reservation information. A place shaped by purpose Prudence Memorial Park exists to serve several intertwined goals at once. It aims to shape and preserve a natural area for the benefit of the environment and offer a final resting place for not just Prudence Island residents but anyone who wants a more natural option after their passing. The scenic landscape creates a quiet space for reflection that will welcome visitors for generations to come. Rather than treating burial as separate from conservation, the park treats them as one and the same effort. What natural burial means At the heart of the park's mission is natural burial—an approach to interment that allows a body to decompose and return to the earth without interference from embalming chemicals, non-biodegradable caskets, or concrete vaults. It's a practice built on minimal environmental impact, letting the natural cycle of decomposition unfold as it always has in nature. The park supports this through services connected to the burial of human remains and cremated remains, all grounded in green burial principles. What the park offers The organization handles the practical, land-based side of natural burial: selling burial rights, allotting plots, opening and closing graves, installing memorial markers, maintaining records, and caring for the property itself. A full breakdown of these services is available in their price list . What the park does not do is act as a funeral home. It doesn't provide funeral directing or handle other after-death care needs. Here at Memorial Funeral Home, we are proud to work with Prudence Memorial Park and our community members. With us, you will be able to work with a licensed funeral director for every step of the way to ensure that all the wishes of your loved one are accomplished. We are constantly working to understand better the needs of our community, as well as what is required by our associates who offer these different types of services. For example, at Prudence Memorial Park, there are several options for internment; a body can be placed in a simple shroud that is made of natural materials, and/or be placed in a cardboard or wooden coffin. Educating yourself before you decide Because green burial is still unfamiliar territory for many, the Green Burial Council offers educational resources designed to help people understand their options clearly before deciding. Taking time with this material—whether you're planning for yourself or a loved one—can make an emotionally difficult process feel more grounded and intentional. This form can also be helpful in organizing your wishes. It is important to note that purchasing the right to be buried at Prudence Memorial Park does not mean you purchase a specific plot, although you can generally choose roughly the area of the 3.2 acres where you would like to be. The specific location is assigned sequentially so that the land can be left undisturbed after the burial to encourage the return of native vegetation. As a result, it is Prudence Memorial Park management, not the family, who determines the exact location of the plot, and this determination is not made until it is time for the burial.  Burial rights can be purchased on a pre-need basis (before a burial is needed) or on an at-need basis (when a burial is needed), although it is recommended to buy burial rights on a pre-need basis because it gives people the opportunity to learn more about natural burial and make an informed decision about final disposition when they are free of the stress that comes with the death of a loved one. If two or more people choose to be buried together, Prudence Memorial Park management also determines the location of the combined lot placement, and that determination is made when the first grave is used. The purchase of burial rights requires a signed purchase agreement that includes an agreement to abide by the rules and regulations concerning the type and placement of memorial markers and the planting of trees and flowers. A certificate of ownership will be issued by Prudence Memorial Park and should be retained by the purchaser to serve as proof of purchase. The one step that matters most Whatever path you choose, one piece of advice stands above the rest: document your wishes and share them with the people who will carry them out. Even the most thoughtful, carefully researched plan is only as good as the people who know about it. Prudence Memorial Park offers the land and the framework—but the conversation, the paperwork, and the sharing of your intentions are steps only you can take.

Review of André is an Idiot

By Pearl Marvell • June 30, 2026
A documentary that will make you laugh and cry.

Kim Shute's Review of Remarkably Bright Creatures

By Kim Shute • May 27, 2026
Before this review begins, a confession: when a book becomes a film and a reader walks out of the movie disappointed, whose problem is that? The filmmakers or the readers? I have been sitting with that question since the first Harry Potter movie came out.  This month I was eagerly awaiting the release of Remarkably Brights Creatures based on the Shelby Van Pelt book I adored. When Netflix announced the adaptation, I allowed myself to get excited. What arrived is a film that is not bad, exactly, but one that never settles into the unhurried, heartfelt book I remember. Tova is the stoic, lonely, and tormented protagonist who is plagued by an unresolved grief event 30 years earlier. Marcellus is her aging, intelligent, and determined giant Pacific octopus friend from the aquarium where she works. Unfortunately, the film doesn't trust the patience that the slow unfolding of the book required. It wants to get somewhere fast, and in doing so, it loses the slow build that gave the book a quiet, magical power. Computer-generated imagery is a real stumbling block for me. I want to trust what I see and that is becoming harder here in 2026. Marcellus’ digital rendering and other underwater scenes pulled me out of the moment as I was so aware that it was not “real”. I was so aware of the artificial nature that I couldn’t stay in the moment. A story that depends on a genuine emotional connection between a woman and a cephalopod cannot afford to look fake, unless it is claymation which this film is NOT. What the film does carry is grief and loss at its core. The grief has touched Tova through the loss of her husband and their son; it touches the aspiring musician, Cameron, through the recent loss of his biological mother, and Marcellus has loss in his captivity. Their bond is supposed to be the film's steadiest ground, and yet even here, something feels held at arm's length; the performances occasionally unable to close the distance. The ending wraps everything up so neatly that it undercuts the bittersweet sadness that made the book what it was. Life doesn't resolve like that. I found myself wondering whether, after a few years of things not resolving cleanly in the real world, we have started to ask our stories to do it for us. I understand that impulse, but I'm just not sure it serves this particular story. If you haven't read the novel, you may find more to enjoy here than I did. If you have, go in with tempered expectations and maybe give Marcellus the benefit of the doubt even when the screen doesn't quite do him justice.

Grief Myths Busted: The Five Stages of Grief is Misinformation

By Kim Shute • May 27, 2026
This month we are going to try something new because there are so many myths circulating out there. We are going to begin with the most famous one: the five stages of grief by psychiatrist Elisabeth Kubler Ross which came out in the late 1960s. This theory was developed after conducting qualitative research interviews of 200 terminally ill older adults. I want to point out, loud and clear, this study was completed with people approaching the end of life, not the people who lived through the death of a significant person in their lives. This model is well known to most people and for those who are not familiar with it, the stages are sequential emotions/reactions. The stages are denial, anger, bargaining, depression, and acceptance. Many people believe that this is like a checklist that follows a linear timeline. This means denial is the beginning of the process of grief and you are done once you complete all five. What we know now in 2026 is that is NOT how grief works. These five emotional reactions are just a few of the things a person can feel after a death of someone in their life. Not every feeling listed is felt by everyone and certainly not in a specific order. Since that study was released nearly 60 years ago, researchers and grief practitioners — the people who study loss and the people who show up trained to support the grieving — have raised serious questions about it. The main critiques? The stages aren't defined clearly enough to actually help anyone supporting a grieving person, and the study never accounted for how personality or culture shapes the way someone experiences loss. The research world has moved on and so has our understanding. In the decades since, far better models have emerged, ones that actually reflect how real people experience loss. That said we cannot dismiss her contribution entirely. Kubler Ross did something very few had done before, she put a national spotlight on grief. For that the field of grief owes her a debt of gratitude.  If you take nothing else away from this article, I hope you understand there is no right or wrong way to do grief and there is no timeline.

Grief in the Real World

By Pearl Marvell • May 27, 2026
Grief doesn't follow a schedule. It doesn't end after the first year, and it certainly doesn't come with instructions. On Thursday, June 18, from 12:30 to 2:30 PM, Middletown Public Library is hosting a free class designed to explore those quieter, often invisible dimensions of grief. The session, titled Grief in the Real World: People, Identity & the Long Haul, will take a candid and compassionate look at what grief really looks and feels like beyond the early stages. The session will be facilitated by Memorial Funeral Home's Director of Community Relations, Kim Shute. Topics will include how to respond when others say the wrong thing — something many grieving people encounter more than once — and how loss can quietly reshape your sense of who you are. It will also address why grief can feel different, or even more intense, as time passes, a phenomenon that often catches people off guard. The goal is to offer a supportive, approachable conversation with practical tools that attendees can carry into daily life. Sharing is entirely optional — there is no pressure to speak. The event is open to everyone, and no registration is required. Everyone is welcome. When Thursday, June 18 12:30 – 2:30 PM Where Middletown Public Library Free & open to all

Learning to Talk About Death and How We'll Be Remembered

By Pearl Marvell • April 28, 2026
May 14: New & Innovative burial options  There's a reason most of us avoid talking about death. It feels morbid, premature, or simply something that we'd rather not think about. But a new lecture series at Island Cemetery in Newport is making a gentle, practical case that these conversations — held early, held openly — are among the most meaningful we can have. Death and Dying is an evening series of talks that brings together experts and community members inside the historic Belmont Chapel at Island Cemetery for evenings that are all about intention. Memorial Funeral Home's Kurt Edenbach will be leading a conversation on May 14th in which he will address a question more people are asking: are there alternatives to traditional burial and cremation? The answer, increasingly, is yes — and the options have grown significantly in recent years, shaped by environmental concerns, personal values, and new technology. From green burials and conservation cemeteries to aquamation, human composting, and other emerging methods, the landscape of end-of-life choices is expanding in ways many people haven't yet heard about. This lecture offers a grounded, accessible look at what's available, what's legal, and what might align with your own wishes — or those of someone you're helping plan for. To reserve your spot, click on the link here .

Kim Shute's Review of Nothing to See Here

By Kim Shute • April 28, 2026
I just love it when I pick up a random book and it transports me to places, I never could have imagined. Nothing to See Here by Kevin Wilson is one of those rare finds. I was pulled in from page one by the story of a poor girl trying her luck as a scholarship recipient at a private boarding school for the ultra-elite, set against the backdrop of down-home Tennessee. The book vacillates between current day and flashbacks from her earlier life. Our narrator and main character, 28-year-old Lillian Breaker, is, quite honestly, a bit of a mess. She is living in the attic of her self-absorbed mother’s house, and her life feels stagnant at best. Beneath the humor, this is a story that touches on childhood neglect and the sharp divides of income and social status. We learn about Lillian’s complicated relationship with Madison, her former boarding school roommate who reappears with a mysterious and highly confidential job offer. What unfolds is a story about misfits that made me laugh out loud one moment and feel unexpectedly emotional the next. I struggled at times with the dynamic between Madison and Lillian. Given their history, I found myself questioning why they remained connected at all. Yet many of us are guilty of staying in relationships that do not reward us with reciprocity. Still, as the story unfolds, witnessing the trust develop under such unusual and often untenable circumstances helps to restore a bit of faith in human connection. There is a strange magic to this book. It leans into the weirdness in a way that is both disarming and oddly comforting. As Lillian herself suggests, I hope this story “hypnotizes you with weirdness” as you make your way through it. Let us know if you decide to give it a read or a listen, and what you think.

What is terramation and why should I care?

By Pearl Marvell • March 27, 2026
It's likely that you've never heard of it before, but it is the process of naturally breaking down the body into soil.

Kim Shute's Review of The Borrowed Life of Frederick Fife

By Kim Shute • March 16, 2026
A case of mistaken identity turns into a sense of security for an octogenarian.