End of Life Doula Service Agreement

This Agreement is written with the intention of providing guidelines and outlining realistic expectations for the scope of services provided by AnneMarie Olson, End of Life Doula

As an End of Life Doula, I provide an additional layer of nonmedical support, advocacy and education to a client or family caregiver. Family caregiver in this document refers to a spouse, family member, partner or friend who is the primary person assisting with care. I am independent, insured, self-employed, and work for the client, not a specific hospice, palliative care organization or hospital, assisted living or skilled nursing facility. I do not practice under my Social Work license.

WHAT IS AN END OF LIFE (EOL) DOULA?

An End of Life Doula is a companion to someone who is dying and the dying personโ€™s loved ones. An EOL Doula is a non-medical person who offers physical, emotional and spiritual suport presence to the dying and their loved ones.

SERVICES OFFERED 

Having been trained in the three phases of end of life care, an EOL doula can be a resource for the patient and their family or unit of care. A doula can offer companionship, practical support and resources, facilitating legacy projects, planning for the vigil, finding peace and acceptance with letting go and those they are leaving behind, helping to find meaning, and offer presence through the final days and after into bereavement after a death.

  1. HEALTH CARE ADVOCACY 
  2. ADVANCE CARE PLANNING 
  3. END OF LIFE PLANNING 
  4. LEGACY SERVICES 
  5. KEEPING VIGIL 
  6. BEREAVEMENT SUPPORT 

LIMITATION OF SERVICES

AS AN END OF LIFE DOULA, I DO NOT: 

  1. Perform clinical tasks, such as taking blood pressure, dressing wounds, catheter care, or breathing treatments. The End of Life Doula is not a nurse or home health aid and does not do any hands on care e.g. Bathing, toileting, feeding etc.
  2. Administer medication of any kind, including pre-filled oral syringes ordered by a healthcare provider. 
  3. Make any medical or nonmedical decisions for clients. I will assist with facilitating conversations around decision making and getting the necessary information to make full informed decisions on your behalf. If there are questions, or advice needed about medical care, I will work to direct you back to your medical care team.
  4. 4. Speak to medical staff or providers on behalf of a client. I will coach, counsel and encourage the client or family caregiver to voice opinions, questions, and concerns to their medical providers and collaborate as appropriate and invited.

EXTENUATING CIRCUMSTANCES: 

COVID โ€“ 19 

How the current pandemic limits direct contact with clients and family caregivers is always subject to change. CDC and California State guidelines will be followed for any home visits while considering vaccination and risk status. I am available via phone calls, face time, online video conferencing and scheduling in-home visits.

MEDICAL EMERGENCIES 

I am unable to provide 24-hour crisis service. In the event that you are feeling unsafe or require immediate medical or psychiatric assistance, you should call 911, or go to the nearest emergency room. The following national and local Marin county resources are available to assist those in crisis:

  • Buckelew 24/7 Suicide Prevention Hotline: 415-499-1100
  • National Suicide Prevention Hotline: 800-273-8255
  • Domestic Violence Helpline: 415-924-6616

PHONE CALLS

You are welcome to phone me in between scheduled meetings. However, I will attempt to keep those contacts brief. Should the contact be lengthy (longer than 10 minutes), you will be charged for a pro rated phone session according to my fee schedule. 

You may leave a message for me at any time on my confidential voicemail. If you would like me to return your call, please be sure to leave your name and phone number, along with a brief message concerning the nature of your call. Non-urgent phone calls are returned during my normal work schedule within 48 hours. 

CLIENT EMAIL/TEXTING POLICY

As a general rule please do not text or email me to communicate issues more than scheduling needs or basic questions. You will receive automated appointment reminders, but all other communication should be kept for meeting times or made via phone call. This is due to the inherent risk and challenge of safeguarding confidentiality with these methods of communication.

Conditions for Use 

I cannot guarantee but will use reasonable means to maintain security and confidentiality of email and text information sent and received. I am not liable for improper disclosure of confidential information that is not caused by my intentional misconduct. Clients  must acknowledge and consent to the following conditions: 

  1. Email and texting is not appropriate for urgent or emergency situations. I cannot guarantee that any particular email and/or text will be read and responded to within any particular period of time.
  2. Email and texts should be concise. Please call and/or schedule time together  to discuss complex and/or sensitive issues. 
  3. Clients should not use email or texts for communication of sensitive medical information.
  4. I am not liable for breaches of confidentiality caused by the client or any third party. 
  5. It is the clientโ€™s  responsibility to follow up and/or schedule an appointment if warranted.

RESPONSIBILITY OF THE CLIENT/FAMILY CAREGIVER 

  • If you need to reschedule a session, please notify me as soon as possible, via text or email or phone message. 
  • PLEASE DO NOT EMAIL ME WITH URGENT OR TIME SENSITIVE INFORMATION, QUESTIONS, OR CONCERNS. 
  • My cell phone and computer are not encrypted and you should not communicate any sensitive personal or medical information in this context. 
  • If for any reason you decide to discontinue working with AnneMarie Olson, End of Life Doula, please communicate this as soon as possible.

RESPONSIBILITY OF THE END OF LIFE DOULAS

  • Model of Care: I will keep the scope of my End of Life Doula practice within the End of Life Doula Model of Care endorsed by the International End of Life Doula Association (INELDA). As outlined, it is a collaborative, nonmedical, nonjudgmental, family centered role with a holistic approach that can help empower clients and their caregivers to make informed decisions. 
  • Confidentiality: It is my professional responsibility to maintain confidentiality regarding any identifying personal or medical information that is shared with me. As a Social Worker,  however; I am a mandated reporter, meaning that if there is any suspicion of child, vulnerable adult or elder abuse or neglect it must be reported. 
  • Respect: Clients and/or family caregivers should expect to be treated with respect, dignity and compassion at all times.
  • Response Time: I will make every attempt to respond to phone calls/voicemails, emails and texts within 24 hours. If you do not hear back in that timeframe, please recontact me. 
  • Availability: I will make every attempt to be available as needed when issues arise and/or when symptoms change, but I am not able to provide 24-hour on-call service. My hours are listed and updated on my website, but arrangements can be made outside of those hours dependent on need.

FEES

  • An initial 15 minute consultation is free.
  • A weekly or monthly invoice (based on the frequency of visits or sessions) will be mailed or emailed for services rendered. I accept credit card payments via Square.
  • Meetings are offered at a rate of $100/hour for phone calls, Google Meet online conferencing, or home visits.
  • Vigil and service packages are available upon request.