Social work and end-of-life care

Social work is important in end-of-life care

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.

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Written by Malcolm Payne

10 April 2013 at 11:55 am

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