Social work and end-of-life care

Social work is important in end-of-life care

Archive for February 2014

Simple information on cancer spread

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20140224 Cancer choicesI came across a useful article for lawyers who may be dealing with claims for medical negligence; many social workers might find it of interest, because it explains simply how cancer develops and the stages of treatment and care.

Link to simple article on cancer.

How cancer spreads is broadly predictable, depending on your age. The political point is that the government is quick to blame slow referrals for diagnosis to what is claimed to be the UK’s poor results on outcomes of treatment for cancer. There is something called a TNM (Tumour – lymph Node development – Metastases) score, which indicates how far the cancer has spread – more spreading means less likelihood of successful treatment. The spread of the tumour is measured on a 1-4 scale – 4 being the widest spread. After that, cancer spreads to lymph nodes, from which it moves on to other organs in the body.

As the article says, doctors are supposed to follow the NICE (National Institute for Health and Clinical Excellence) guidance on cancer treatment, and there is also NICE guidance on how a cancer service should be run. Unfortunately, these are written for doctors so they are largely incomprehensible, but here’s a link:

NICE Cancer website

The best place for general guidance about medical conditions for normal people is the NHS Choices website

NHS Choices Cancer website.


Written by Malcolm Payne

25 February 2014 at 11:21 am

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Seeing beauty in people gives them dignity – a good principle for good practice

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140222 Nursing and public healthBecause I’m involved in international social work, I often receive publications from foreign lands, although equally often they are in foreign languages which I don’t understand, or in the English as written by people who don’t quite get it right. One editorial board I contribute to is for a journal published from Wrocław in Poland called Nursing and Public Health Quarterly (well actually Pielęgniartswo I Zdrowie Publiczne but I thought it would be unhelpful to provide a non-translated title). I originally got involved, because the School of Public Health in Wrocław is very involved in palliative care.

This quarter’s papers include a really interesting brief paper, with an English abstract, which argues that beauty is a mystery, but that seeing it in people accords them the greatest possible human dignity. The writer has a set of questions for his nursing/medical students: they have three minutes to answer each, so he gets an unconsidered response. They are:

  • What is good?
  • What is beauty?
  • What is freedom?
  • What is love?
  • What is dignity?

I think these are a good set of questions to ask beginning practitioners in health and social care, to get them to think about the objectives and values inherent in their work. In fact, we could all ask ourselves these questions regularly.

You can read the abstract here.

If you can read Polish you can go the the journal through this link; its articles are online – there are also occasional English articles.

Written by Malcolm Payne

24 February 2014 at 11:03 am

Think about the social and psychological needs of employees who survive cancer

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I came across a useful discussion, on an employment law website, of returning to work after having cancer; many people do, some people don’t. But employers need to focus on the psychological and social (‘softer’) changes that cancer survivors make in their lives, as well as making changes in their employee’s lives that respond to the physical problems created by their bout of cancer. This will become increasingly important as people’s working lives extend beyond their early sixties and as cancer is increasingly seen as a survivable illness, rather than a death sentence.

Link to the article140220 working with cancer

This article is written by an organisation, Working with Cancer,  concerned with helping people, through providing coaching for individuals and information more widely, return to work successfully after a period of cancer. They have a useful website.

Written by Malcolm Payne

20 February 2014 at 8:56 am

Hymns for a social worker’s funeral

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Attending a friend’s funeral last Friday, I was stimulated to think again about the hymns a social worker might want sung at their funeral (Planning my own funeral is only an occasional activity, because my wife thinks that it’s the people left behind who should organise funerals for their benefit).

My current favourite is ‘For everyone born, a place at the table’, with its uplifting refrain seeking justice for all. Link to the hymn on The Hymnary.Org.

Link to information on the hymn text writer, New Zealander, Shirley Erena Murray.

Among other possibles are Sydney Carter’s ‘When I needed a neighbour, were you there?’

Link the the hymn on The Hymnary.Org

Link to information on the hymn text writer, Sydney Carter, whose hymn ‘One more step along the way I go‘ is also a useful possibility. It is about going on a journey, and has a bouncy optimistically hopeful tune about the future.

Of course, many people choose music for their funerals that the largely non-churchgoing population either know or can pick up quickly. I’m afraid Murray’s hymn is quite difficult musically, but for its social justice sentiments, well worth it. A little while ago I went to a funeral and for the first time ever was presented with an order of service containing printed music. It turned out that the person who died was a choir member, and, aside from a good rendering of an anthem, for the rest of the funeral many of the large congregation could sing the four-part harmony. A non-musical friend said it was like standing in the middle of a choral society and I must say was very inspiring. It reminds you why music is so important for many religions and why religious music has such a life outside churches.

Written by Malcolm Payne

16 February 2014 at 4:56 pm