Social work and end-of-life care

Social work is important in end-of-life care

Archive for April 2013

Domestic violence: there’s a lot of it about, it affects young people and it’s vital to intervene

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130412 Domestic violenceI came across an article about research on domestic violence, which contained some astonishing figures: or at least some people might think they were astonishing.

Dr Claire Fox said the research found that over half of the 1,203 Year 9 pupils had some direct experiences of domestic abuse, whether as victims, witnesses, or perpetrators. While on a date, just less than half of both girls and boys had been abused; a quarter reported carrying out abusive behaviour. Follow up focus groups revealed a range complicated attitudes towards domestic abuse by children, which went some way to explain the figures.

This document, rather stupidly I think, claims that compulsory education for school pupils in domestic violence will help to stop it. I rather think not, although I’m happy they should be more aware of it. My view is that if you want to stop domestic violence, then we all, and the public services, have to be prepared to intervene actively where you think it’s taking place.

But just look at the figures: that’s a huge proportion of young people who are experiencing domestic violence in their lives. Yet working on adult safeguarding in a hospice, I used to find people doubtful about the amount of domestic violence that was claimed to be going on. this also tells you very clearly that it affects young people in the families, which is an extra reason (aside from protecting the victims) why it’s important to do more about intervening and protecting the other people in the family. While I suspect they got these figures by a very broad definition of domestic violence, that not everyone would agree with, you only have to pay attention in your life to know that a good deal of it goes on.

Link to the article.


Written by Malcolm Payne

15 April 2013 at 11:21 am

Posted in children, family, social work

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Complete the statement: because of you, I… (bereavement exercise)

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130411 Because of youA commercial website sells keepsakes for bereaved people; perhaps a bit sentimental for some. But it offers a useful exercise for thinking about someone you have lost: complete the statement:

Because of you, I…

This is useful because it connects you to the person you have lost: you can turn a series of phrases into a poem, and it gives an example, written by a bereaved mother.

Link to the poem.

Written by Malcolm Payne

12 April 2013 at 11:00 am

Posted in bereavement

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Hospice care is a valuable social resource, not short-term specialist medical intervention

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130402 Personal experienceA journalist’s ‘personal experience’ column about end-of-life care for her father. It’s good to read these now and then, as it shows you how even well-informed people react when faced for the first time with negotiating their way through a major end-of-life illness. This is a Canadian one, in which a hospice admitted a man with bone metastases from an oesophagal cancer – so presumably there was actually a long history of treatment and care, with younger family members only really becoming involved towards the end.

Social workers sometimes do not get involved with wider members of the family who are not heavily involved in the care. Perhaps we should be looking to differentiate among the experiences of different members of a family, rather than concentrating on the ones who are doing most of the care. It might help us to pick up on future bereavement issues that otherwise do not get taken care of.

Another feature of this personal experience is how there was admission to a hospice for symptom control, but the patient then moved towards death and was never discharged. Margaret Reith and Caroline Lucas did an interesting piece of research on hospice discharges to nursing homes, in which they questioned to source of the assumption that hospice practice is all about short-term admissions for things like ‘symptom control’, thus forcing us to distress patients and their families unnecessarily by getting them to think about discharges to nursing homes, when the reality was that the patient was likely to remain in the hospice until death.

Do we tell people that they’re only coming in temporarily for a bit of some medical or nursing process, because we don’t like to say too clearly that they’re coming in to die? Or is it that the service assumption is too dominant that, in the UK at least, hospice is a short-term, specialist medical or nursing intervention? Instead, we should be accepting the social value of a nice hospice environment and good caring expertise when people are dying.

Link to the article.

130402 JSW coverLink to the Reith and Lucas article on discharges to nursing homes

and the citation:

Reith, M and Lucas, C. (2008) Questioning the Evidence for Service Assumptions: Audit of Transfers from a Hospice to Nursing Home Care. Journal of Social Work 8(3): 233-45.

Written by Malcolm Payne

10 April 2013 at 11:55 am

Mark Twain’s reason for not fearing death

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Written by Malcolm Payne

8 April 2013 at 12:17 pm

Posted in death and living

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