“They Don't Want to Hear Us”

Abstract

This study used focus groups to understand Hispanic elders' and adult children's concerns about end-of-life planning. Ten older persons participated in the elders group, and ten adult children in a separate group. Themes in both groups included communication, control, burden, spirituality, religious issues, and importance of family relationships. Communication regarding end-of-life planning was of particular importance to both elders and adult children. The most striking indication of the challenges in communication about end-of-life issues is the insistence by both the elders and the adult children that their children/parents do not want to have these discussions.     

Social Work and End-of-Life Care

Abstract

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.     

The Impact of Time and Place on Mutual-Aid Practice with Short-Term Groups

ABSTRACT

This paper aims to help practitioners promote mutual aid to short-term groups. It describes and discusses the impact of time and place on the process of such groups. The challenges of the short-term group are identified and implications for practice are drawn.     

Helping each other: a peer supervision group with facilitators of mutual aid groups

ABSTRACT

Mutual aid groups can help people cope with life’s problems. A peer supervision group can help facilitators to better understand their role and improve their facilitating skills in mutual aid groups. Peer supervision groups aim to support facilitators ability to reflect on their difficulties in working with groups, deepen their methodological questions, and improve their understanding regarding how to best proceed as facilitators. This paper studied a peer supervision group of experts-by-experience facilitators to demonstrate the dynamics of mutual aid that characterized the group’s functioning.     

Open Mic: reciprocity,parallel process,and mutual aid in a discussion group for faculty working with adult students

ABSTRACT

This article describes Open Mic on Mentoring Practices, a mostly online and occasionally in-person discussion group for faculty and professionals at a geographically dispersed public college serving adult students. The evolution, purpose, membership, and themes present in the group discussions are explored. Specific group dynamics of Open Mic follow, including the role of parallel process, mutual aid and reciprocity, are addressed, with attention to their relevance for adult learners. Finally, the paper ends with a discussion of challenges, surprises, and recommendations for replication or adaptation of Open Mic groups.     

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.     

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.     

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.     

“Res Ipsa Loquitur” … It Speaks for Itself … Social Work—Values,Pain, and Palliative Care

Abstract

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.     

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.     

Facilitating Arts-Based Mindfulness Group Activities with Vulnerable Children: An Example of Nondeliberative Social Group Work Practice

ABSTRACT

This article discusses the process of facilitating arts-based mindfulness group work and activities with vulnerable children age 8 to 12 years who were involved with the child welfare or mental health systems. Specifically, it delineates connections between our group program and Norma Lang’s nondeliberative social group work practice. Importantly, in working with vulnerable children, the authors purposefully fostered the development of mutual aid, creativity, and strengths and recognized that each group had a life of its own.     

Examining the Structure and Dynamics of Kinship Care Groups

ABSTRACT

In the fall of 2006, a self-administered Internet survey was made available to all kinship care group facilitators listed in the 2006 New York State Office for the Aging's directory for kinship care providers. The survey sought facilitators' views on the purpose and structural aspects of the groups and to understand whether and how mutual aid processes were occurring. A purposive sample of 16 participants (53% response rate) completed the online quantitative survey that included space for qualitative comments. Findings revealed that 75% of participants facilitated a kinship care group in the past 5 years, and they believed their group purposes primarily included support and growth. Additionally, participants reported that all mutual aid principles occurred in their groups, with the supportive mutual aid interventions occurring more frequently than the challenging ones. Finally, themes from open-ended responses included 1) an enhanced sense of solidarity developed among group members, 2) the importance of facilitators' show of compassion for group members, and 3) facilitators' need to have a working knowledge of and ability to maximize available resources. Implications for serving the needs of kinship care providers through groups and other practices are addressed.     

Mutual Aid During a Pandemic: A Group Work Class Example

ABSTRACT

The pandemic of 2020 had faculty pivoting quickly from face-to-face to remote teaching. Many of us had to manage this herculean task with little know-how and within a short time-frame. Best practices were unclear given the highly individualized circumstances in which students were now living. Group work within an educational framework is possible and can help students effectively manage the stresses resulting from sudden crisis situations. The key to group work as practiced by social workers is mutual aid and it was this process that emerged in an online class for undergraduate students. It was not planned yet evolved in large part due to students’ capacity for caring, empathy, and connection.     

A Good Death for Residents of Long-Term Care

Abstract

Little research has been done on the topic of end-of-life care in long-term care settings to identify important themes regarding end-of-life care structures, processes, and outcomes. This study utilized data gathered in a stratified, random sample of 437 family members of residents who died in 31 nursing homes (NHs) and 199 residential care/assisted living facilities. Structural components of care including staffing adequacy, training, and consistence as well as facility environment and size were important factors for family members interviewed. “Being there” and manner of care delivery (e.g., staff attitudes/empathy) were major elements in the process of care. These factors were mentioned more than direct care, Hospice, or resident preferences. Family members identified themes of [dying at] home and being comfortable and clean as important outcomes of care. These identified structural components, processes, and outcomes have implications for the role of social workers in these settings despite that social work support is notably absent in these findings.     

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.     

“We Just Happen to Live Here”

Abstract

This article is written more like a conversation with the reader rather than a strictly academic piece. The purpose is to share from a more personal perspective the unique circumstances and challenges faced by two social workers in Oregon as they grappled with the Death with Dignity Law. The law has been in effect for six years and a May 2004 decision from the Ninth U.S. Circuit Court allowed the law to remain a legal end-of-life option. Each writer has a unique voice on the process of social work involvement in practice, research, and policy since the law was originally passed in 1994.     

It Is Not Always Easy to Sit on Your Mouth

ABSTRACT

This paper describes the use of small groups in an after-school tutoring program for children, ages 5 to 12. Five group work principles are emphasized: (1) beginning where the group members are and drawing upon their interests; (2) enhancing mutual aid among group members; (3) taking the stages of group development into consideration when planning activities; (4) using the leader's role in ways that encourage and are helpful to group members; and (5) believing that members have something valuable to contribute to the group. Incorporation of group work principles into academic enrichment programs, rather than reliance solely on one-to-one tutoring, is urged.