While death has long been recognized as life's only certainty by philosophers from Plato to Heidegger, discussing finitude remains a taboo in contemporary society. In response to this silence, the practice of death doulas is gaining traction in Brazil. Silvia Onofre, a yoga teacher and integral therapist based in Piracicaba, São Paulo, has specialized in this field to support individuals facing grief and the end of life.
Onofre's journey into death doulage began after she experienced two significant family losses within five months in 2017: her father died of cancer, and her 36-year-old brother-in-law passed away from a stroke. Although she discovered the concept of death doulas at that time, she felt it was not the right moment to begin her training. She completed her formal preparation in 2025, transitioning from a decade-long career in corporate school administration to focus entirely on education regarding life and death.
The role of a death doula involves accompanying individuals and families through the dying process and grief, offering emotional support, active listening, and care. Onofre emphasizes that this work is strictly complementary to clinical treatments provided by doctors, nurses, and palliative care specialists, rather than a replacement for them. Currently, the profession is not regulated in Brazil, unlike traditional birth doulas, which are covered under Federal Law No. 15.381/2026.
Onofre's services include individual sessions, group support, and "finitude retreats" designed to promote well-being by reflecting on mortality. Her first retreat, held in March of this year, addressed symbolic deaths such as the end of relationships or job changes. A second retreat is scheduled for April 2027 with the theme "Living is a Choice," focusing on physical death. She also facilitates voluntary grief support groups with approximately 20 members who meet monthly.
The doula assists clients in practical preparations for their own passing, such as choosing coffins, makeup, nail polish, and preparing advance directives. This planning can extend to leaving personal legacies, like writing letters to loved ones for posthumous delivery or selecting specific music for funeral ceremonies. Onofre also addresses anticipatory grief and post-death mourning through sessions that incorporate touch, massage, aromatherapy, and yoga postures.
Rafaela Pereira Santos, a 38-year-old teacher, sought Onofre's help after an unexpected job dismissal in April 2026. Having attended Onofre's March retreat, Rafaela found the experience helped her reframe the end of her professional cycle and reorganize her personal plans. The therapeutic alliance later evolved to address a deeper wound: the death of her first son, Lourenço, 11 years prior due to complications from eclampsia at 32 weeks. Unable to attend his funeral or burial due to hospitalization, Rafaela participated in a symbolic farewell ceremony proposed by Onofre, which she described as essential for healing an open wound.
Kelvin Jones, a 26-year-old barber, also sought support two months after losing his mother, Íris, to a rare brain cancer. Jones described feeling lost and found relief through the doula's guidance, which included specific massages to alleviate the physical pain often associated with grief. He noted that while the process remains difficult, the support has helped him navigate the highs and lows of recent loss.
Medical professionals view this type of support as a valuable addition to mental health care. Psychiatrist Arthur Cardoso notes that cultural taboos surrounding death can make the grieving process more uncomfortable, often focusing solely on the disease rather than the person. He argues that professional assistance helps preserve the patient's dignity and legacy, preventing emotional complications like guilt for family members.
Family doctor Lucas Fernando Zorzetto highlights that palliative care teams are already multidisciplinary, including doctors, nurses, psychologists, social workers, and spiritual volunteers. According to guidelines from the World Health Organization and the National Academy of Palliative Care, these teams aim to relieve physical symptoms while providing integral emotional, social, and spiritual support to both patients and their families.
Sources: G1.