Social work ‘too often missing from end-of-life care’

Social workers have a vital role in end-of-life care but they often struggle to perform it because of cuts, workloads and a lack of confidence, says a report from the National End of Life Care Programme.

By Mithran Samuel on July 19, 2012 in Adults

Social workers' therapeutic and listening skills are crucial to end-of-life care, says the report

Council social workers have a vital role in end-of-life care but are often failing to perform it because of cuts, high workloads and a lack of confidence. That was the conclusion from a guide published today by the National End of Life Care Programme and The College of Social Work, designed to improve the quality and impact of social work at the end of life.

End-of-life care practice tips for social workers

Enable the individual and their family to talk about their end-of-life wishes when ready and establish their needs, aspirations and concerns now and in the future;

Enable families to access practical help and resources and advocate for them in doing so where necessary;

Liaise with care providers to ensure smooth transition between settings and act as a constant point of contact for families during transfers;

Use regular telephone contact to pick up concerns and avoid crises, to enable people to stay in their preferred place if possible.

Source: The route to success in end of life care, National End of Life Care Programme

Social workers’ skills in advocacy, listening, helping people adjust to changing circumstances and working with the whole family and their human rights value base made them a vital ingredient in good end-of-life care. However, the report said, cuts, high workloads and a lack of confidence in their abilities in this area meant council social workers’ contribution to end-of-life care was often lacking and it was seen as a luxury.

“We urge social workers never to shy away from the subject of end-of-life care. It is here that their advocacy skills come into their own, helping people to find a path through an unknown, frightening terrain where they would otherwise feel utterly disoriented,” said Professor Corinne May-Chahal, interim co-chair of The College of Social Work.

The guide provides tips for practitioners and managers and good practice case studies in areas including discussing end-of-life wishes, assessment, care co-ordination and care in the last days and after death. It calls for managers to help social workers contribute to end-of-life care, including by providing appropriate training. Specialist palliative care social workers – who are often employed by hospices – are an important source of training and advice for council practitioners, as well as people they could refer clients on to where appropriate, says the guide.

“[Social work involvement] can help enable people to die in their usual place of residence, with their quality of life maintained to the end, which is what most of us want, said professor Margaret Holloway, social care lead at the National End of Life Care Programme.
“We know that when given small amounts of end of life care training and with the support of their managers, social workers have shown that they have a significant contribution to make.”

How specialist social workers can train mainstream counterparts in end-of-life care

Social workers at Southwark and Lambeth councils in London gained confidence and skills in end-of-life care as a result of a programme of training from specialist practitioners at St Christopher’s Hospice in London, in a National End of Life Care Programme pilot.

As a result of the training, social workers were more likely to have end-of-life conversations in assessments, where appropriate, more confident in dealing with health professionals on palliative care issues and spent more time preparing service users for emergencies.

Read the full story on the pilot.

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