Social work and end-of-life care: reviewing the past and moving forward

This paper reviews the professional literature with respect to the social work profession's involvement in end-of-life care. The search process was conducted by entering key words in various combinations to electronic databases. Eligible articles were required to address one of the following: roles and activities of social workers in providing end-of-life care; core principles valued by social workers in the provision of end-of-life care; and barriers to provision of effective end-of-life care. The literature from 1990 through July 2004 was searched most rigorously. Based on this review, suggestions for where the profession of social work should focus its energies are offered. These key areas include focusing on generating empirically-based knowledge for practice and policy analysis and developing a system of social work education that addresses the unique knowledge and skills needed to participate in end-of-life practice as competent and informed professional practitioners. Current initiatives with regard to critical areas are summarized.     

End-of-Life Care and Social Work Education

Summary

Social workers are major service providers to people who are facing end-of-life issues including the terminally ill and their families. Yet, exemplary models for social work education and intervention methods are limited in rural states. A statewide survey conducted in Kentucky found only two social work courses dedicated to end-of-life care currently being offered by accredited undergraduate and graduate institutions. Another statewide survey found that many hospice social workers are relatively inexperienced and have a need and desire for more education on death, dying and loss. Also, unique cultural, economic and geographic areas, such as Appalachia are enigmas when it comes to the provision of end-of-life care. This partnership provides a varied perspective on delivery of end-of-life care services with an emphasis on social work interventions and education.     

Professional Social Work Education in End-of-Life Care

Abstract

Social work education in both BSW and MSW level courses is missing vital content about end-of-life care, palliative care, and bereavement. End-of-life care training opportunities through continuing education programs have also been limited. This deficit is significant because a vast number of social workers are already confronted with end-of-life issues on a daily basis in a variety of practice settings. Through the Project on Death in America, Social Work Leadership Development Awards initiative, many programs and models for professional social work education and training in end-of-life care have been developed and are presented in this article. These include: end-of-life care courses, symposia, training manuals, certificate programs and fellowships. Although the curricula continue to be refined, many of these programs are available to practitioners to advance their knowledge and skills and their curricular models are available to social work educators for possible replication.     

Pediatric Palliative and End-of-Life Care

Abstract

Pediatric oncology social workers are often engaged in the psychosocial care of dying children and their families. Despite their participation on the interdisciplinary team, the role for social work in pe-diatric palliative and end-of-life care has not been clearly defined. This survey of 131 pediatric oncology social workers identified current and best social work practices for care of children and their families at the end of life. Implications for practice, education, and research are discussed.     

All Aboard

Abstract

Social workers in all practice areas have the potential to contribute to the National Agenda for Social Work Research in Palliative and End-of-Life Care. The purpose of this article is to invite social work practitioners and researchers to identify research needs and work with others to address them. We offer a conceptualization of the broad scope of social work's involvement in end-of-life issues, and articulate the difference between end-of-life care and end-of-life issues in social work. Suggestions are offered to advance the national research agenda.     

Facilitating Forgiveness and Peaceful Closure

Abstract

The importance of addressing psychosocial concerns with dying patients is pivotal to facilitating peaceful closure in end-of-life care. The social worker's role in recognizing and providing skilled, psychosocial intervention with patients and families in hospice programs is significant. In this article, the literature in this area is examined and a case example of a hospice patient's need for closure and the responsive social work intervention for the patient in his moment of death is provided. The case offers social work knowledge and skills and demonstrates the therapeutic benefit of addressing psychosocial needs in end-of-life care. The importance of targeted training and continued skill development for social workers in end-of-life treatment settings is emphasized.     

Zelda Foster and Her Contributions to Social Work in End-of-Life Care

ABSTRACT

This article is both a memoir of one social worker's professional collaboration with Zelda Foster and a tribute to Zelda's legacy in the form of an educational resource on end-of-life care. It reviews achievements of Zelda Foster in social work practice and teaching related to death and dying. Resources presented in this article were supported by the Soros Foundation's Project on Death in America, a funded grant project to which Zelda contributed. The end-of-life care education, training and informational tools discussed in this article are examples of ongoing efforts in the social work profession to improve the lives of the dying and bereaved.     

Importance of Research in Social Work Practice: A Pilot Study From Turkey

Abstract

It is highly important that social work practice be guided by scientific research and the resultant practices introduced to the literature. Social work research in Turkey is carried out by social work academics and practitioners. This dual position they occupy has not been thoroughly investigated in recent years; therefore, the aim of this research was to scrutinize the relationship social workers take when completing research in Turkey. Within the scope of this research, data were collected by conducting an online survey of 365 social workers. Results of the study show that 45.8% of the social workers have conducted research before. Nonetheless, 93.7% of the social work practitioners do feel the need to carry out scientific research in order to shape their professional practices. Considering these results, future research should concentrate on social work practitioners’ problems taking into account their dual position as both the producer and consumer of the research.     

Seeing flowers through the mist: how social workers in disability services retrospectively view their educational experiences related to case management in Hong Kong

ABSTRACT

This article is principally designed to examine social workers’ retrospective views on their past educational experiences with case management in disability services to supply a deficiency that very little literature attention has been paid to how prior professional education shape their case management practice. Using qualitative methods, 13 social workers selected by purposive sampling were invited to participate in in-depth interviews. The qualitative data were analysed to generate some themes. Three themes found are “from ‘rarely heard of it’ to ‘remember it being referred to’”; “buy a lottery ticket before starting a field placement”; and “Ambiguity”. These themes indicate that social work education related to case management was lagging behind, which may exacerbate social work’s polarisation and lead to social workers’ confusion about their professionality. As a result, an urgent need for greater knowledge of case management in university education and in-service training should be addressed in Hong Kong.     

The Perception of Organizational Issues of Social Work Practitioners in Saudi Hospitals

ABSTRACT

Health care has evolved rapidly in Saudi Arabia, based upon a Western model of service that incorporates multidisciplinary professional teams. Social work practice forms part of patient care. This study explores how Saudi social workers perceive their role and how they describe their practice within the hospital context. A quantitative methodology was employed using a self-administered questionnaire. Analysis revealed that 219 social workers perceived formidable limitations to their daily work practice. The study identified factors relating to the hospital's organizational circumstances where a) organizational structural aspects, b) organizational resources, and c) hospital management and interprofessional teamwork impacted best practice. Future research and recommendations for further study are outlined.     

Developing Practice Tools for Social Workers in End-of-Life Care

Abstract

This article describes the National Association of Social Workers' (NASW) strategies for providing social workers with important practice and policy information about palliative and end-of-life care. With funding from a Soros Foundation's Project on Death in America grant, NASW developed practice standards, a Web-based continuing education course, and drafted a new policy statement to guide social workers in end-of-life care practice. The article provides an in-depth view of the development and scope of these resources for professional social workers.     

Setting an Agenda for Social Work in End-of-Life and Palliative Care

Abstract

This article describes leadership efforts within social work to promote, enhance, and shape the future of social work practice, education, and research in end-of-life and palliative care. The background and outcomes of the Project on Death in America, Open Society Institute's Social Work Leadership Development Award Program, and the 2002 Social Work Leadership Summit on End-of-Life and Palliative Care are reviewed.     

Physician-Assisted Suicide and Midwest Social Workers: Where Do They Stand?

ABSTRACT

Physician-assisted suicide (PAS) is explicitly legal in five states and by court decision in one. Legislative bills have been introduced in other states including Minnesota, Iowa, and Wisconsin. This quantitative study was designed to understand Midwest, hospice and palliative care at end-of-life social workers’ attitudes toward PAS, preferred terminology, perception of preparedness for the implementation, and awareness of PAS legislation in their state. Sixty-two social workers from Minnesota, Iowa, and Wisconsin completed an anonymous online survey. The results indicated that over one-half of the participants supported PAS legislation and is consistent with previous research on social workers across the country. While there was a range of perceived preparedness for implementation, a majority felt moderately to very prepared. Professional and personal values as well as professional experience influenced their perceived preparedness. Few social workers had accurate awareness of PAS legislation in their state or had attended workshops/events for further education or as a policy advocate. To practice competently and advocate at all levels of practice, hospice and palliative care at end-of-life social workers’ need to understand their own attitudes and values toward PAS and pursue additional education around this ethical issue.     

Build the social justice bridge: participatory photography with the international group work community

ABSTRACT

“Build the Social Justice Bridge” was a participatory photography project that engaged international group workers in an assessment of group work as a social justice profession. Inspired by principles of photovoice research, the project invited social work students, educators, and practitioners from around the world to contribute photographs and brief narratives that represented the relationship between group work and social justice. The photographs were exhibited during the opening session of the 2018 Symposium of the International Association for Social Work with Groups (IASWG) in South Africa, where more than 200 participants from ten countries reflected on the meaning of the photos for the group work community. In viewing the photos, symposium participants identified a common vision of social justice as well as culturally-specific approaches to group work. Implications are drawn for the internationalization of professional knowledge.     

Beliefs,Death Anxiety,Denial, and Treatment Preferences in End-of-Life Care

Abstract

This study examined cultural and religious beliefs, death anxiety, denial, and medical treatment preferences in end-of-life care in a sample of social work students, community residents, and medical students in a mid-western city of 49,000. Results indicated that most social work students, community residents, and medical students preferred palliative as opposed to life-prolonging care during terminal illness. The three groups differed in cultural and religious beliefs and all three reported a moderate amount of death anxiety. Students reported less denial of terminality than community residents. Implications for personal and professional preparation to provide end-of-life care are discussed.     

Being with a Person in Our Care: Person-Centered Social Work Practice that is Authentically Person-Centered

ABSTRACT

Person-centered care (PCC) has emerged over the last several decades as the benchmark for providing quality care for diverse populations, including older adults with multiple chronic conditions that affect daily life. This article critiques current conceptualizations of PCC, including the social work competencies recently developed by the Council on Social Work Education, finding that they do not fully incorporate certain key elements that would make them authentically person-centered. In addition to integrating traditional social work values and practice, social work’s PCC should be grounded in the principles of classical Rogerian person-centered counseling and an expanded conceptualization of personhood that incorporates Kitwood’s concepts for working with persons with dementia. Critically important in such a model of care is the relationship between the caring professional and the care recipient. This article recommends new social work competencies that incorporate both the relationship-building attitudes and skills needed to provide PCC that is authentically person-centered.     

Utilizing a Required Documentation Course to Improve the Recording Skills of Undergraduate Social Work Students

ABSTRACT

Baccalaureate social workers respond to documentation and record-keeping demands of regulatory organizations that oversee or fund social service agencies. Learning to accurately document client needs, progress, and service delivery outcomes is important in ensuring that clients are receiving effective services. Despite the importance of documentation skills, many undergraduate social work programs do not provide sufficient curriculum content on client record keeping. The authors report the results of a study that examined changes in baccalaureate social work students’ perceptions of their documentation skills after completing a required documentation course. The sample size included 101 students at pretest and 97 students completing the post-test. Statistically significant findings show students perceived an increase in knowledge in three areas of documentation: 1) formats, 2) content, and 3) writing skills. The authors discuss implications for social work education and practice.     

实用专业主义:广州市家庭综合服务中心社会工作者“专业能力”的界定及其逻辑

本研究的目的是找出中国社会工作者专业能力体系及其背后的判定逻辑。本研究运用“模糊德尔菲法”的设计,让广东省高校教育界和实务界的专家参考英格兰、美国和中国香港地区的专业能力,选择其中他们认为对广州市家庭综合服务中心社会工作者重要的指标。结果显示,共有价值伦理、理论知识和实务技巧等3个层面,合计24项能力指标被纳入本地的能力体系。经过分析这些专家判定逻辑,本研究还发现该能力体系存在“实用专业主义”的倾向,包括“犬儒思想”“去政治化”和“技术化”等特征。     

Social Workers and Policy- Practice: The Role of Social and Professional Values

ABSTRACT

Although policy practice is regarded as an essential component of social work, the actual involvement of social workers in policy practice is apparently very limited. This article presents the findings of a study that seeks to explore the role of social and professional values in support by social workers in Israel for engagement in policy practice and their actual involvement in this type of practice. The findings indicate that socioeconomic orientations and professional values have an impact on social worker's perception of policy practice and the degree to which they are actually involved in the social welfare policy process. In particular, it was found that attitudes toward social justice played a major role in the social worker's perceptions of, and involvement in, policy practice.