Social workers need more training in talking about death

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Councils could save money from end-of-life care packages by giving social workers more training in talking to people nearing death, a study reveals.

The National End of Life Care Programme report found that, if conversations about end-of-life care were broached earlier by social workers, costly packages could be avoided.

“Social care costs for people at the end of life can escalate in the last few weeks because social workers are anxious and feel they have to provide bigger care packages,” said Tes Smith, the programme’s social care lead.

The report was based on 12 pilot sites, each of which conducted a local training needs analysis and developed plans to address gaps. The study found most staff working in adult social care had a role to play in supporting people at the end of life.

“Because people didn’t understand that they were delivering end-of-life care, they weren’t participating in the training that is there,” said project manager Katie Lindsey. Much of the training had a heavy health focus, which discouraged social care staff from accessing it.

“There’s an assumption that the social care workforce has communication skills training and doesn’t need any more, but generally people said that they do,” she said.

Lindsey added that personalised end-of-life care could be delivered only if staff had the confidence to start conversations early about what was needed.

The programme proposes that social care bodies consider including end-of-life communication skills in core professional training.

CASE STUDY: Kate Fellow, hospital social worker

Kate Fellow took part in end-of-life care training at the hospital where she works in Lincolnshire. Formerly unaware of what other professionals had to deal with emotionally when working with clients at the end of life, she has become more respectful of the pressures, she admits.

She was now more focused on maintaining respect and empathy in dealing with these clients, factors that could slip as social workers fell into a routine, Fellow said.

Her work with clients has also been enhanced. “I give the service users more time in my working day for them to tell their stories for their assessment,” she said.

Fellow said the training had wider applications than communicating with those who need to plan end-of-life care. “As social workers in an acute hospital setting, the majority of our work is about people who are not necessarily going to die, but are having a loss,” she said. Those losing independence or dealing with disability for the first time also benefit from a more sympathetic approach, she added.

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