Social workers

How social workers address palliative care

Social workers help people with a life-limiting condition and their families by assisting with practical difficulties around social, financial and legal matters and by providing supportive counselling to assist adjustment to grief and loss.

Scope of practice

Social workers support people to make change in their life to improve their personal and social wellbeing. They have knowledge of human behaviour and development, life cycle stages, families and social networks, disability and health, including mental health. Social workers may counsel people or be involved in advocacy, community engagement and social action to address issues at both the personal and social level. [1,2]

The Scope of Social Work Practice is available on the Australian Association of Social Workers (AASW) website.

Social workers may have roles of advanced or extended scope of practice which reflect a level of expertise within or beyond the established contemporary scope of practice. [3]

Role in palliative care

Palliative care provides a support system for people living with a life-limiting condition to live as actively as possible, with dignity, for as long as possible. It is active and supportive care that seeks to maximise quality of life. [4] It is useful well before death and not limited to care of the dying. [5]

In helping people with palliative care needs, a social worker [5-8]:

• is led by the person’s situation and their sense of what is important to them to co-create realistic goals and expectations in the face of decline and impeding death within the context of a therapeutic relationship
• enables the person to make decisions and exercise choice in their care and decision-making around this
• strengthens people in managing the emotional, psychological and social consequences of what is happening to them
• helps friends, families and partners to feel involved in care and decision-making as appropriate
• enables people to make the best possible use of relevant and available community resources that will help them
• connects the person, family or carers with financial support services to assist with management of financial issues
• can help the person to identify others who are important to them and highlight relationship issues
• can empower the person and those close to them to work towards completion of any unfinished business and say their goodbyes
• along with the pastoral carer, may help to address spiritual pain by recognising concerns, providing comfort and helping to relieve isolation
• provides the person with information and support during advance care planning
• may help the person address issues of sexuality or sexual health and resolve sexual problems
• may advocate for the person’s wishes to the palliative care or healthcare team
• liaises within the care team to promote best outcomes
• can provide grief counselling of pre-bereaved or bereaved family members including those experiencing complex bereavement
• can assist with accommodation or placement such as residential aged care, respite care and supported accommodation.

Social workers may work in palliative care as only part of their role or have a palliative care caseload with a specialist role. This may be a member of a multidisciplinary team or a sole practitioner.

The National Association of Social Work in the US has identified Standards for Social Work Practice in Palliative and End of Life Care (120kb pdf).

Association of Palliative Care Social Workers - UK (APCSW) and The British Association of Social Workers (BASW) has published The role of social workers in palliative, end of life and bereavement care (8.13MB pdf) (2016)

British Association of Social Workers has published BASW Position Statement – Social Work Support to people who are dying (116kb pdf) (2016)

The RACGP aged care clinical guide (Silver Book 2019) recognises the role of allied health professionals in team care arrangements for a proactive person-centred approach to palliative care. [9] Palliative Care Australia also recognises the importance of access to information and support from a diverse range of allied health services for patients, families and carers. [10]

The role of allied health in palliative care is to provide the person with as much therapy time as possible. The goal of allied health in palliative care is around maintaining and improving functional ability. There may be a blurring of roles across allied health professions in palliative care more than in other care contexts.

Allied Health workers provide care in all practice settings. For further information on the specific area of practice go to Practice Settings.

Practice support

Useful evidence-based information and resources on rehabilitative palliative care are available from Hospice UK.

Using Evidence

Although social workers are familiar with evidence and evidence-based practice through their training and continuing professional development (CPD), keeping up to date can be time-consuming.

CareSearch provides the tools to help find and use evidence. This includes PubMed searches on a multitude of topics and sections dedicated to Searching for Evidence and Using Evidence in Practice.

For support in applying evidence in practice, check out the Journal Club Basics page on CareSearch which provides information on the benefits of and practical pointers in setting up or joining a journal club.

Guidelines

The AASW Practice Standards 2013 outline the practice expectations of all social workers. They are designed to guide social workers to ensure they fulfil their professional practice responsibilities.

Guidelines specific to social work and palliative care in Australia have not been published, however, the Palliative Care Service Development Guidelines 2018 (332kb pdf) provides an overview of social work (as part of allied health) in palliative care. [10]

Resources for Patients, Carers and Families

Social Workers have an important role in supporting patients, carers and their families with information. The CareSearch Resources for Patients, Carers & Families provides links to useful information including fact sheets and printable resources Social Workers can download and share.

Education

The National Palliative Care Strategy 2018 lists as a priority the ability of medical, nursing and allied health graduates to identify and address people’s palliative care needs (Priority 2.1, p15). [11] This is highlighted in the Essential Elements of the National Consensus Statement: essential elements for safe and high-quality end-of-life care which also recognises the importance of the role of an interdisciplinary team. [12]

Courses

CareSearch lists a collection of Palliative Care eLearning resources for allied health for independent learning.