When Sasha Primakova reflects on her journey from the world of research in Moscow to the quiet corridors of St Christopher’s, she describes it as a total transformation.
After 20 years leading a successful qualitative research department in Russia, a sudden and forced relocation due to the war in Ukraine became the catalyst for Sasha to pursue a calling she had felt for years: exploring the topic of death and dying.
Having witnessed a funeral culture in her home country that she describes as “inhumane” and “impersonal,” Sasha became determined to learn how death could be handled with more dignity and presence and trained as a ‘doula’.
While the term ‘doula’ is often associated with birth, an end-of-life, hospice or death doula supports the other end of the life cycle. They are a non-medical professional trained to provide holistic support – emotional, physical, spiritual, and practical – to individuals approaching death and their families. Their work is highly personalised and varies based on the needs of the person, but it mostly includes emotional and spiritual support, practical admin and logistics assistance, advocacy and education, and after death care.
Throughout the two years she lived in Georgia after leaving Russia, Sasha completed international training as an end-of-life doula and flew several times to London, for placements at St Christopher’s. “I was absolutely stunned”, she says, “to see nurses who are so medically knowledgeable, but at the same time, the way they spoke to people was perfect. There was not only respect, but true compassion.”
She was particularly impacted by seeing the staff’s genuine sadness when discussing a patient who had died, proving that even in an environment where death is expected, every individual life is deeply valued.
The most common term for Sasha’s role is a death doula, however the term Hospice Doula reflects her integration with the medical team more clearly.
“I’m not here to replace a doctor or a nurse, but to be the extra pair of eyes that a busy clinical team might not always have,” she says.
“In some cases, it’s probably important for patients and families that I’m not medical,” she says.
Sasha usually describes her role to her colleagues in a simple way: “If you’re leaving the patient and your heart is aching, and you would want someone to come and help, just refer them to me and I’ll see what I can do.”
Doulas often work as volunteers or as a paid-for service so what makes Sasha’s role unique is that she is employed by St Christopher’s, making her the first ever contracted doula in a hospice in the UK. Initially commissioned by the borough of Croydon for a project to tackle inequalities, her role has expanded since January 2026 to St Christopher’s patients living in Southwark, Lewisham, and Lambeth.
But what does a doula actually do? For Sasha, no two days are the same. Her role is defined by whatever the patient needs in that exact moment to feel more at peace.
“It could be anything,” Sasha says. “Fixing their phone or bringing them an ice cream or sitting with them while they’re too anxious to sleep… or I can help to navigate really challenging discussions with their family.”
Reflecting on recent successes, she highlights her ability to bridge emotional gaps and provide steady support, even during crises.
She recently helped a couple confront a terminal diagnosis together, guiding them to communicate openly rather than withdrawing in an effort to protect one another. Sasha also shared how she provided immediate support to a young girl following the sudden death of her mother; she stayed with her until other family members arrived.
“I also think of a gentleman whose wife had a sudden loss of speech and cognitive decline”, she shares. “To lower his anxiety, we listened to music and looked at old photos together”.
For Sasha, success isn’t measured in big gestures, but in the subtle shift of a patient’s experience.
Sasha mentions four aspects she tries to bring to her work to impact people positively. The first is to make the process more meaningful: facilitating conversations, listening to people’s stories and planning parts of their legacy.
Secondly, she wants to make the experience better, for example, by making sure someone isn’t alone during a moment of high anxiety. The third aspect is to make it more like people want it to be, supporting with tasks such as documenting someone’s final wishes. Lastly, Sasha wants to make sure the wider team feels she has been helpful. “Every nurse on my team has now referred a patient to me”, she says, proving that a doula is not just a luxury, but a vital part of the modern hospice ecosystem.
“Dying is a very dignifying thing”, she says, “And our main mission as people who work with palliative patients is to show that the moment you get your palliative diagnosis, it doesn’t mean that you’re dying.”
If we use the comparison of a diagnosis or prognosis with the beginning of life, then we all know that the moment a person gets two stripes on a pregnancy test just means they are pregnant, not that they’re giving birth.
“There is time until it happens”, Sasha says, “and that time can be so intense and so meaningful.”
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This news article was first published on the St Christopher’s Hospice website and is republished here with permission.
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