This paper review synthesizes and criticizes the existing literature regarding the role of social workers in a broad range of decisions associated with end of life. Over the last few years, social workers have been singled out as important players in assisting individuals with terminal illnesses make their own end of life decisions (Beresford, Adshead & Croft, 2007; Pockett, Walker, Kashmira, 2010; Watts, 2013). Alongside medicine, nursing, including a wide array of other complementary and clinical remedies, social workers increasingly offers psychosocial, including practice backing to individuals approaching their end of lives. As argued out by Watts (2013) dying and death involves transformation and loss, and for a significant number of individuals coming to their end of lives, the experience may be overwhelming and as such, they increasingly demand assistance with the aim of coping and managing their feelings, including helping them come into terms with this important transition. Since loss is in most cases social and personal, the focus of social workers in matters associated with decisions linked to end of life includes social and family network responses to the end of life.
Comforting (Palliative) Care Social Work
The core focus of comforting care social work entails assisting individuals deal with important existential queries closely connected to facing one’s mortality, including managing the dying process and coping with severe or serious illness. Watts (2013) points out that since within most societies and cultures, initiating discussions increasingly continues to be a taboo and therefore avoided, this is in most cases emotionally difficult and challenging work that consists of both community and personal components. Moreover, comforting care social work involves intricate ethical dilemmas closely associated with decisions of end of life since social workers in most cases play an integral role as a link between healthcare providers, families and patients(Mathieu, 2012, Pockett, Walker, Kashmira, 2010; Watts, 2013). The core attributes associated with comforting care social work includes facilitating psycho-educational support groups, leading a broad range of community education workshops, advocating on behalf of the family and patient, including promoting and facilitating advance care planning. Other characteristics associated with comforting care social work encompass intervening in crises, psychotherapy and counseling for families, couples, and individuals, and mediating conflict between service organizations, interdisciplinary team, between clients, and within families. The list is not exhaustive since there is a broad range of manners workers increasing support individuals facing death, including their families.
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In most cases, social workers increasingly come across individuals who are undergoing bereavement, death, and experiencing loss. Mourning, end of life, including good comforting care depends on a wide array of informal and formal support. It is estimated that approximately a half million individuals in the United Kingdom die each year (Association of Palliative Care Social Workers (APCSW), 2017). Existing literature has demonstrated that individuals with life-limiting diseases such as cancer are increasingly living with more intricate needs than before (Beresford et al., 2007; Connor, 2009; Mathieu, 2012, Pockett, Walker, Kashmira, 2010; Watts, 2013). While some deaths are unpredictable, others are expected or sudden. Previous studies have shown that a significant number of individuals, particularly older individuals are not identified or recognized as dying in time to initiate a broad range of measures aimed at providing the support they would need (APCSW, 2017). In the UK, 75% of bereaved individuals do not support they increasingly need (APCSW, 2017). Countries such as United States, Canada, Australia, the UK and other countries across the globe are diverse and individual experience; beliefs, culture, and background influence the experiences, wishes, and preferences around bereavement, dying, and death.
Social work expertise complement the skills and knowledge of others such as inherent wisdom of communities, doctors, chaplains, advocates, psychologists, counselors, physiotherapists, occupational therapists, and nurses. The role played by social workers in end of life decisions encompass using legislation with the aim of ensuring the rights of individuals who do not possess the ability and capacity to make decisions on their own, and assisting individuals select what happens to their body following their deaths(Beresford et al., 2007; Connor, 2009; Mathieu, 2012). Comforting care social workers also play a critical role in assisting individuals increasingly select where to die, including identifying how to make this take place if possible. Moreover, comforting care social workers assist individuals to express what is significant to them, including employing a broad range of existing legal powers and tools such as lasting powers of attorney, emergency healthcare plans, advanced decisions to refuse treatment, and advanced statements so that the wishes of dying people are recognized and respected.
Conclusion
Within palliative care, including end of life setting, social workers assist individuals express what is significant to them, help people talk openly regarding bereavement and dying and making choices, provide bereavement support such as signposting, storytelling, art groups, counseling, and group, and supporting families who are involved in the dying process of their patients. Additionally, comforting care social workers work in partnership with individuals who possess lived experience of bereavement, dying, and death so that individuals can learn directly from this experience. Social workers also advice employers, leaders, funders, and commissioners regarding bereavement, end of life, and good comforting care, including ensuring individual’s social, cultural, religious, and spiritual needs are increasingly acknowledged and addressed.
References
Association of Palliative Care Social Workers. (2017). The role of social workers in palliative, end of life and bereavement care . London: APCSW
Beresford, P., Adshead, L., & Croft, S. (2007). Palliative care, social work and service users: Making life possible . London: Jessica Kingsley Publishers
Connor, S.R. (2009). Hospice and palliative care: Essential guide . London: Routledge
Dominelli, L. (2010). Social work in a globalization world . Cambridge: Polity Press
Mathieu, F. (2012). The compassion fatigue workbook . Taylor & Francis
Pockett, R., Walker, E., Kashmira, D. (2010). Last orders: Dying in a hospital setting. Australia
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Watts, J.H. (2013). Considering the role of social work in palliative care: Reflections from the
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