News From the End-of-Life: Social workers discuss how to improve care

During a three-day summit, experts in social work and end-of-life care designed a social work agenda to improve care for the dying and their families. The agenda calls for organized professional leadership, standards of practice, and increased preparation at all levels of social work education.

"Our goal is to form a coalition of national organizations, institutions, and experts that can enhance and elevate end-of-life care training, education, practice, research, and policy within our profession and beyond, " said summit co-coordinator Susan Blacker, LCSW-C, of The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University in Baltimore.

The Social Work Summit on End-of-Life and Palliative Care, held March 20-22 at Duke University in Durham, NC, addressed the need for a formalized collaborative effort within the social work profession that focuses on end-of-life care and highlighted the importance of grief work to end-of-life care.

Leaders from national social work organizations, schools of social work, hospices, hospitals, government agencies, and end-of-life care advocacy groups attended the meeting on behalf of more than 30 organizations. The groups in attendance represented over 160,000 practicing social workers.

"The summit was an opportunity for the many prominent leaders in this field to sit down and design a comprehensive agenda for the future," said summit co-coordinator Grace Christ, DSW, of Columbia University School of Social Work in New York City. "One of our goals is to advocate for greater attention to grief work and the psychosocial dimensions of palliative care."

Grief work for sudden catastrophe

Often, limited attention is given to strengthening these areas in multidisciplinary education, practice, research, and policy development. Participants agreed that in order to more adequately reflect the breadth and depth of social work practice and patients’ and families’ needs, social work should encompass palliative care, end-of-life care, and grief work. Since the Sept. 11 tragedies, social workers have become more aware of the importance of standards of practice that include grief work for cases of sudden, traumatic or catastrophic deaths, Christ added.

Social workers often take the lead in providing essential emotional and social services to the dying and the bereaved, including counsel on advance directives, emotional support for the terminally ill, and assistance in locating health care and financial resources. Yet, social workers report gaps in end-of-life care education at the undergraduate, graduate, and post-graduate levels and lack of access to leadership in practice, teaching, research, and advocacy.

"By encouraging collaborative efforts between schools of social work, practice sites, and professional disciplines, we will reduce the professional isolation experienced by many social workers and strengthen professional practice of palliative and end-of-life care," said Blacker.

Additional priorities established at the summit included:

  • promoting advocacy, education, research, networking, and sharing of information between individual social workers and national organizations;
  • increasing social work research in palliative, end-of-life care, and grief work;
  • incorporating cultural sensitivity, life span variations, and interdisciplinary context throughout the end-of-life care educational curriculum;
  • increasing public awareness through an educational campaign regarding psychosocial dimensions of palliative care, end-of-life care, and grief work and the role of social work in this care.

"Social workers touch a broad array of areas within end-of-life care," said Christ. "Through practice, education, research, and policy development, we have the power to influence the culture of death in America."