All aboard: advancing the social work research agenda in end-of-life and palliative care

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.     

Family-centered care: a resource for social work in end-of-life and palliative care

Recent trends in medicine reflect an attempt to be more patient-centered and while this is progress from the disease- or provider- focused model familiar in healthcare, the experiences and contributions of family as caregivers continue to be overlooked in some settings. The family-centered care model, developed most notably in pediatrics, but emerging in HIV, cancer, and aging, is presented as a resource to increase family involvement at the end of life. In this paper, family-centered care is defined, caregiving trends including support needs of formal and informal caregivers are discussed, and barriers to family-centered services are identified. Reintroducing family into the focus of care at the end of life is the primary goal of this paper. The family- centered model of care offers an appropriate framework for understanding the value of family in end-of-life care and fits well with social work perspectives that understand individuals in the context of their family system and greater environment.     

Shaping the future of social work in end-of-life and palliative care

The second Social Work Summit on End-of-Life and Palliative Care was held from June 1 to June 3, 2005. Sixty representatives of more than 35 social work and other professional organizations with a commitment to improve care for the terminally ill, dying, and bereaved, attended and formulated key priority directions and initiatives that will further the field.     

Clinical social work education in palliative and end-of-life care: relational approaches for advanced practitioners

This paper describes the first post-Master's program in the US in end-of-life care for social workers. Developed at the Smith College School for Social Work, this program used innovative relational methods in student recruitment, curricular design, supervision, and leadership development, based upon input from the faculty, students, and field supervisors. Collaborations emerged with funders, agencies, and programs nationally. The program was based on a pedagogical stance that clinical work with dying people requires the capacity to be fully present- in individual, group, and family work; in interdisciplinary meetings; and in advocating for quality and equity of care-while attending to diverse and at-risk populations. Students deepened their clinical skills and took leadership in the field of end-of-life care.     

Linguistic competence/language access services (LAS) in end-of-life and palliative care: a social work leadership imperative

Despite the mandated and moral imperative to advance linguistic competence in all health care contexts, leadership that addresses this area of practice and study in end-of-life and palliative care is not readily obvious. Because social work is ideally suited to lead efforts to advance linguistically-accessible end-of-life and palliative care, social workers are encouraged to assume the challenge. This article focuses on topics that are elementary yet central to discussions on language diversity and leadership initiatives to advance language access in end-of-life and palliative care contexts: importance and function of language, extent of language diversity, inequity related to language diversity, mandates and standards related to language access, and approaches and competencies that contribute positively to language access.     

Pediatric palliative and end-of-life care: the role of social work in pediatric oncology

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 pediatric 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.     

Social work practice in palliative and end-of-life care: a report from the summit

In 2005 a Social Work Summit on End-of-Life and Palliative Care was hosted by the National Association of Social Workers (NASW) with support from the Project on Death in America (PDIA) and National Hospice and Palliative Care Organization (NHPCO). Building on the work of a first summit held in 2002, work groups focused on practice, research, policy, and education with "State of the Field" presentations used as a point of convergence for setting priorities and developing action plans. This article describes a process of document selection and review which was designed to isolate aspects of social work practice and to determine concordance with domains and guidelines detailed in the interdisciplinary consensus document, Clinical Practice Guidelines for Quality Palliative Care, a publication of the National Consensus Project for Quality Palliative Care (http://www.nationalconsensusproject.org). In addition, a group of documents written by colleagues in medicine and nursing were chosen for evaluation as they reflect the emerging and valued incorporation of palliative care principles into specialties such as pediatrics and intensive care. This second review was focused on determining the nature and scope of social work presence and participation and on understanding if the role of the profession was clearly articulated in these specialty areas. This article discusses the historical context and relevant findings that may contribute to the growth of the profession in this rich and burgeoning specialty.     

Zelda Foster and her contributions to social work in end-of-life care

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.     

Advance care planning throughout the end-of-life: focusing the lens for social work practice

Advance care planning throughout the end-of-life is an increasingly important aspect of professional practice with older adults and their families. As the nation's population continues to live longer, more and more people will experience years of functional and cognitive decline prior to death. This article discusses the growing importance of advance care planning using a long-range, holistic perspective of examining care needs throughout the end of life. End-of-life care is conceptualized by three trajectories of decline leading to death, with about two-thirds of all older adults succumbing to four key conditions: congestive heart failure, emphysema, frailty, and dementia. Research regarding the advance care planning needs of older adults with the key conditions is presented. Further research is needed to enhance social work practice in this area.     

Results of a nationwide hospice and palliative care social work job analysis

The role of the hospice and palliative social worker is often ambiguous and misunderstood by colleagues and fellow team members. One reason for this is the lack of identified, clearly delineated roles, skills, and tasks employed by these specialty social workers in their daily work. This article summarizes the first nationwide job analysis of hospice and palliative social workers. A contextual, cross-sectional survey design was used to identify current and relevant job tasks from practicing hospice and palliative social workers. A sample of 482 social workers representing 46 states responded to a survey that included demographic questions and ranking of 152 tasks and importance to the position. Tasks were categorized into four broad categories: assessment and reevaluation; planning and intervention; death, grief, and bereavement; and professionalism; which includes subcategories consisting of multiple tasks and skills. Respondents identified performing a psychosocial assessment from a patient/family centered care perspective, assessment of the patient’s current and desired quality of life and of coping skills as the tasks most important to their role. This outline of the role of the hospice and palliative social worker was then used in the development of an evidence-based certification exam that may be required of those who want to receive specialty certification in the field.     

Developing practice tools for social workers in end-of-life care

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.     

Child and family social work: organizational context and identity

In the years since 1948, child and family social work has, to differing degrees at different times, sought to identify itself with a national centrally directed service, with the local service organization, with its clientele and with an independent source of professional regulation. Changes in the organizational context in which the work has been carried out over this period have affected the prospects for the development of a secure identity. The effects of the following are considered: national structures, particularly in relation to children's departments between 1948 and 1971; the corporate local authority; the managerial function in social services departments; social care; specialization; the detailed scrutiny of practice; care management and the Children Act 1989.     

Home and hospital; hospice and palliative care: how the environment impacts the social work role

Social workers play key roles on interdisciplinary hospice teams and in hospitals on oncology or palliative care teams. Though palliative care settings include both home hospice and hospital-based consultation services, the different environments and scope of practice impact the role of the social worker. The purpose of this article is to examine the similarities and differences in coordination of care, teamwork, and collaboration in these two fields in order to highlight opportunities for enhancing clinical skills and developing our confidence and presence in asserting social work expertise with our transdisciplinary colleagues.     

The environment and social work: An overview and introduction

Coates J, Gray M. The environment and social work: An overview and introduction This article provides an overview and analysis of social work's engagement with the modern environmental movement. Major trends and themes in environmental social work scholarship and the significance of interdisciplinarity are discussed. Attention is drawn to the importance of a broad knowledge base and of working in unison with other professions in order to respond effectively to the many dimensions of climate change and environmental degradation. Responding to the challenges of environmental destruction has opened opportunities for the profession to review its foundational knowledge and obligations to people and environments. The articles in this Special Issue are introduced and include theoretical frameworks, examples and case studies of what social workers are doing, or might do, in relation to environmental and educational initiatives.     

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.     

Professional social work education in end-of-life care: contributions of the Project on Death in America's Social Work Leadership Development program

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.     

A code of ethics for social work and social care research

Summary This Critical Commentary is the final product of the Economicand Social Research Council sponsored seminar series, TheorisingSocial Work Research to appear in the BJSW. The special editionof the British Journal of Social Work published in August 2000carried several key papers arising from the seminar series aswell as reports of some of the events themselves. The responsibilityfor drafting the Code of Ethics for Social Work and Social CareResearch fell to me and although discussed at the Luton Seminarand at the final conference in Manchester, the text presentedhere is much as it first appeared. This is simply to reaffirmthat it has no particular status and is reproduced in the Journalas a prompt to further discussion, precisely the purpose itwas to serve for the seminar series. Before reproducing the Code, it might be helpful to revisitsome of the main points which were raised in the paper presentedat the Luton Seminar which set the context for the Code (Butler,2000).     

Spirituality and social work in long-term care

The spiritual aspect of care of elders in long term care has only recently been re-affirmed. A social worker who has volunteered, worked, and consulted in nursing homes shares her perspective on the importance of the "spiritual" to nursing home social work. From the perspective of 40 years of involvement in long term care, she offers suggestions for assessment, education of staff, affirming rights in the religious arena. Workers are encouraged to keep hope alive for themselves as well as for those with whom they work.