Long Island's death doulas offer emotional, spiritual and practical support to individuals at the end of life

“Welcome, everyone, to Death Cafe.”

And so began a lively Friday night at Strega Rose Tattoo Arts in North Babylon last month.

Over the next hour and a half — with a side of cake, coffee and Day of the Dead-themed sugar skull lollipop rings — a group of mostly strangers broke one of life’s biggest taboos by talking openly about death.

They shared deeply personal stories of loved ones and peers they’ve lost, through unexpected tragedies and prolonged illnesses.

Tears were shed but they laughed a lot too, bonding over the grieving process, unresolved conflict with aging family members and feelings around their own mortality.

“It’s a nonjudgmental space where people from different walks of life can just chat about everything with no agenda. … It’s always so amazing,” said Kim Nicholetti, 37, who’s been hosting these free monthly gatherings since February. “We all carry our ‘griefcases’ with us every day. Sometimes we open it, sometimes we don’t.”

Death Cafe, which began as a concept in England in 2011 before versions were hosted in the United States in 2012, has been a rewarding extension of Nicholetti’s full-time job: after 15 years as a licensed veterinary technician, she became a trained end-of-life doula in 2025.

Just as birth doulas guide mothers through pregnancy, the birthing process and postpartum, death doulas provide nonmedical emotional, spiritual and practical support to individuals at the end, and their families, to ensure personalized, peaceful, dignified deaths.

The role has recently found its way into pop culture, with a representation of an end-of-life doula on season 2 of HBO’s “The Pitt.”

And in April, Oscar winner Nicole Kidman spoke at the University of San Francisco about her current journey to become an end-of-life doula after her mother’s “lonely” death in September 2024.

“There’s so much emphasis put on birth, but not so much on death,” Kidman said during USF’s Silk Speaker Series. “I think it’s an important part of our culture; loneliness is a big part of our world now, particularly for people in that stage of life. I want to be there. I want to be able to provide.”

For the 10 clients Nicholetti has had so far, ranging from 60 to 94 years old, this work has included being a nonfamilial sounding board for anxieties. The role can also involve writing letters; reading aloud; playing music; helping clients ensure their legal affairs are in order; applying mouth swabs and lip balm to dry mouths; and sitting vigil as a person is actively dying.

She likes to offer her hand in case they simply want human touch.

“We’re here to help you close your book nice and gently, the way you want.”

POST-PANDEMIC UPTICK 

Omni Kitts Ferrara started as a birth doula and is now active as a death doula, hospice nurse and the director of education at the New Jersey-based International End-of-Life Doula Association, or INELDA. She noted there’s been a major uptick of interest in the field since the pandemic when “there was a global recognition that death happens.”

“Grief is a very big process culturally and communally," Ferrara said. "A lot of the people that come to us are personally affected and want to help others have a good death.”

Pricing for the services fluctuate, with some end-of-life doulas offering pro-bono work and others either charging on a sliding scale, hourly rates and packages, according to Loren Talbot, INELDA's director of communications and partnerships. Talbot and other doulas reported hourly rates between $50 and $100, and packages costing $1,800. The organization has a directory of doulas on its website, inelda.org/find-a-doula.

Since INELDA's founding in 2015, the nonprofit has trained 10,000 doulas in 57 countries, 810 of whom are in New York, with Nicholetti among them.

Offered in-person and online, training takes 40 hours and includes reading, writing exercise, watching the documentary “Prognosis: Notes on Living,” plus 24 hours of intensive group sessions.

Makeetah Cochy, president of the Long Island Doula Association, which focuses on providing optimal pregnancy, birth and postpartum experiences, said the end-of-life expertise within the organization is slowly growing. Six end-of-life doulas are listed on its website, lidoulas.com/endoflifedoulas.

“It’s not something that’s been promoted for very long, but there are members within our community who have training to become death doulas,” said Cochy, of Deer Park. “I think it’s sweet that you can call on someone to help navigate your emotions through something so vulnerable and so intimate at the same time.”

MORTALITY ON HER MIND 

Nicholetti’s calming presence around death stems from a lifelong reckoning with it.

Born with a serious kidney disease and officially diagnosed at 5, she was left immunocompromised and spent her early years in and out of hospitals, getting treatments and missing school.

For a while, doctors were uncertain whether she would survive.

“It was weird thinking about my mortality at like 7,” she said.

By 12, she’d made a recovery and could live a more normal life. Finding a strong support system in family, friends and teachers, she graduated from Commack High School and followed her love for animals into the veterinary field.

Being in the room for pets' end-of-life appointments and euthanasia, both at the hospital and in owners’ homes, Nicholetti said she always marveled at the amount of care, physical support, preparation and emphasis on quality-of-life involved.

“I remember thinking, ‘This would be so nice on the human side’ because we treat animals and humans so differently in that space,” she said. “When I found out about death doulas, I was like, ‘This is it, this is what I want to do.’ ”

Nicholetti’s husband, Shane, a tattoo artist and the owner of Strega Rose, who also takes part in Death Cafe, said she was meant to do this work.

“I’m in absolute awe of her,” he said. “It really takes a strong human being, grace and vulnerability. It’s a lot more natural for her than I ever expected it to be.”

ACTING AS AN ADVOCATE

Davy Davidson, who lives in Northern California, was in desperate need of a long-distance doula late last summer.

A friend she identified only as Syed, a 92-year-old physicist and animal welfare activist, was nearing death and relocating to Long Island to be closer to his strict Muslim family. He feared, however, that they would push their religious views and rituals on him. 

Davidson was appointed to take care of things. With a background in transpersonal psychology, she was aware of doulas and their non-denominational approach, and found Nicholetti through a quick Google search.

Nicholetti and Davidson's friend clicked immediately, and she was at his bedside for the four months before he died in December.

“He had trouble voicing his needs, and Kim was a great  go-ahead between him and the family,” Davidson said in a phone interview. “By the end, they’d become accustomed to his wishes and could see she brought a sense of safety in the process of dying and [that he] was  grateful for her.”

'I'VE BEEN DOWN THIS ROAD' 

The number of death doulas is growing here on Long Island.

Diane Kideris, 58, of Plainview, who attended Nicholetti’s Death Cafe in April, is one.

Kideris said she wishes she'd known about end-of-life doulas back in 2014, when she lost her mother-in-law and then her brother, followed by her father-in-law. In 2018, she became the caregiver for her husband, who was diagnosed with ALS before he passed away a year later.

“It was just a lot all at once,” she said. “It would’ve been helpful to have had somebody hold my hand a little.”

A former early childhood specialist, Kideris met a death doula at a writer’s workshop before the pandemic, learned about the role and — after the deaths of her parents four weeks apart in 2021 — began training with INELDA.

Since January 2025, she’s been an active end-of-life doula at Huntington Hills Rehabilitation and Nursing Home in Melville. She’s currently studying at Stony Brook University to become a therapist, specializing in grief and loss, and will begin an internship at Good Shepherd Hospice in Port Jefferson in September.

“I’m a calming presence in their time of need, open to hearing their thoughts and feelings, and I’ve been down this road before,” she said, “so I’m a pretty good guide.”

Doula Lisa Vasquez Fedrizzi, in West Babylon, said she’s been with four clients — between 70 and 93 years old — right up until the end.

“Sometimes it’s just sitting in silence and sometimes I go through photos and memories and have great conversations about what they’ve done in the past and what their life was like,” she said. “Just giving them the opportunity to not think about being sick or dealing with pain … but really look back and celebrate their lives.”

'AFTERCARE' TOO 

Then there’s Gabrielle Gatto, 32, a Northport native, the manager of public programs at Green-Wood Cemetery in Brooklyn and a self-proclaimed “dear friend of death.”

She began working at Green-Wood in the events department on March 4, 2020.

“In the chaos of COVID, I started taking burial orders, cremation orders, worked in the crematory itself. … On average, I took 111 phone calls a day,” she said, eventually going through the cemetery’s certificate program in thanatology, the study of death, dying and grief. She also studied to be a doula through the training program Going With Grace. “There’s such a lack of literacy around the language of grief, so I thought ‘what can I do?’ I took a death doula course, and it completely changed my perspective on pretty much everything.”

As a grief and bereavement specialist, she facilitates peer-to-peer grief support groups, which she hopes to bring to Long Island libraries, community centers and American Legion halls, and she said she thinks young people should learn about death in school: “We have sex ed …why don’t we have death ed?”

Gatto also emphasized the importance of doula aftercare, which includes closing accounts and helping individuals and families through difficult milestones during the year.

'PEOPLE WHO UNDERSTAND' 

Back at the tattoo studio, the welcoming vibe of Death Cafe created instant community.

“Kim offering this for people is so healing and beneficial, and it was way better than any therapy I’ve ever done,” said Donna Geronimo, 61, of Patchogue.

Geronimo came to the cafe as a mother who lost two of her three sons — her middle son in a car accident in 2006 at 18, and youngest from COVID-10 complications in 2021, at 31.

Processing the losses has been hard, she said, but she found solace in the group’s like-minded support: “To know there are other people who understand the pain is different. The more you discuss it, the easier it is to speak about.”