Holistic end-of-life care in social work

Authored by: Cecilia L. W. Chan , Candy H. C. Fong , Y. L. Fung

The Routledge Handbook of Social Work Theory

Print publication date:  July  2019
Online publication date:  June  2019

Print ISBN: 9780415793438
eBook ISBN: 9781315211053
Adobe ISBN:

10.4324/9781315211053-42

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Abstract

End-of-life social work interventions often focus on grief, anxiety, fear of death, pain and symptoms associated with the end of life, pathological adjustment to loss, problem behaviours, and subsequent co-morbidity and mortality (Christ, Messner, & Behar, 2015; Altilio & Otis-Green, 2011). Medical models are often taken as a core theoretical framework where sickness, discomforts and death are described as maladjustments or functional pathogenesis or seen as failures of medical intervention. Likewise, palliative care social work is heavily influenced by social work practice in hospital settings under the leadership of medical specialists in oncology, cardiology, nephrology, rheumatology, geriatrics and paediatrics. When patients are given an end-stage diagnosis, critical issues of physical care in the home, family adjustment to caring tasks, sudden loss of income and increases in health spending, anticipatory death anxiety and grief and shattered dreams and hopes can put the extended network of family and close friends into chaos. Dying is not an individual matter; it is a family and collective issue, which can be framed by a public health framework (Kellehear, 2005). Family members suffer from high emotional and practical distress but are often neglected by service providers. With high levels of unmet needs, especially on the psychosocial and spiritual aspects, there is a call for collective actions in curriculum design, training and standard setting in palliative and end-of-life social work and transdisciplinary teams (Otis-Green et al., 2009).

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