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Personal and professional values in social work
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Thanks in part to the scientific and technological advances of todays’ society, enhanced medicinal treatment options are helping people battle illnesses and diseases and live longer than ever before. Despite these advances, however, many people with life threatening illnesses have needs and concerns that are unidentified and therefore unmet at the end of life, notes Arnold, Artin, Griffith, Person and Graham (2006, p. 62). They further noted that when these needs and concerns remain unmet, due in part to the failure of providers to correctly evaluate these needs, as well as the patients’ reluctance to discuss them (p. 63, as originally noted by Heaven & Maguire, 1997), a patient’s quality of life may be adversely affected. According to Bosma et al. (2010, p. 84), “Many generalist social work skills regarding counseling, family systems, community resources, and psychosocial assessments are relevant to working with patients and families with terminal illness”, thereby placing social workers in the distinctive position of being able to support and assist clients with end of life decisions and care planning needs. In fact, they further noted that at some point, “most social work practitioners will encounter adults, children, and families who are facing progressive life limiting illness, dying, death, or bereavement” (p. 79). Caring for an individual who is facing a life threatening illness is often completed by a multidimensional team, including doctors, nurses, therapists, and caregivers, as well as family members. Social workers are an integral part of this team, since they are usually the healthcare workers that are involved in the evaluation and assessment of patients and their family members’ needs and concerns at the end ... ... middle of paper ... ...icine, 24(1), 79–87. Retrieved from the Walden Library databases. Christ, G., & Blacker, S. E. (nd). Social Work’s unique Contribution to Palliative Care. Council on Social Work Education, CWSE Gero-Ed Center, National Center for Gerontological Social Work Education. Retrieved from http://www.cswe.org/CentersInitiatives/CurriculumResources/MAC/Reviews/Health/22739/22741.aspx. Code of Ethics of the National Association of Social Workers (2008). Retrieved from: http://www.socialworkers.org/pubs/code/code.asp NASW Standards for Social Work Practice in Palliative and End of Life Care. (2014). Retrieved from https://www.socialworkers.org/practice/bereavement/standards/standards0504New.pdf. Wesley, C. A. (1996). Social Work and End-of-Life Decisions: Self-Determination and the Common Good. Health & Social Work, 21(2), 115. Retrieved from the Walden Library databases.
End-of-life care in the United States is often fraught with difficult decisions and borne with great expense. Americans are often uncomfortable discussing death and
The Public Health Imperative measures the quality of life of an individual during times of severe chronic illness. This health imperative is characterized by: the potential to prevent suffering caused by the illness, major impact, and high burden. In the recent past is has become evident that care for older people, who have potential to become terminally ill, must be focused on. The types of patients may also lose the capability to make some of their most important decisions which include actions made by health professionals that are related to their end of life situation. Luckily actions were made to identify certain priorities pertaining to the public health and end of life issues. These priorities were established by the National Association of Chronic Disease Directors and the Healthy Aging Program at the Centers for Disease Control and Prevention. These end of life health priorities which address short-term, medium-term and long-term needs are also called advanced care planning. It can be concluded that communication between professionals and among families about the patient can enhance the effectiveness of advanced care planning.
When a patient receives a terminal or life-altering diagnosis, the subsequent life changes are not limited to the medical challenges. Patients encounter the physical trauma of the medical diagnosis while also experiencing psychological difficulties, social changes, and even existential concerns. In Oregon Health Authority research, 91 percent of those who were assisted with suicide cited loss of autonomy as their motivation to end their lives, and 71 percent cited loss of dignity as their motivation. Only 31 percent cited inadequate pain control. These needs require different forms of care. Palliative care seeks to take into consideration every facet of the patient’s situation—with professionals who can attend to all aspects of the patient’s needs. (Anderson, R. 2015).
The care of patients at the end of their live should be as humane and respectful to help them cope with the accompanying prognosis of the end of their lives. The reality of this situation is that all too often, the care a patient receives at the end of their life is quite different and generally not performed well. The healthcare system of the United States does not perform well within the scope of providing the patient with by all means a distress and pain free palliative or hospice care plan. To often patients do not have a specific plan implemented on how they wish to have their end of life care carried out for them. End of life decisions are frequently left to the decision of family member's or physicians who may not know what the patient needs are beforehand or is not acting in the patient's best wishes. This places the unenviable task of choosing care for the patient instead of the patient having a carefully written out plan on how to carry out their final days. A strategy that can improve the rate of care that patients receive and improve the healthcare system in general would be to have the patient create a end of life care plan with their primary care physician one to two years prior to when the physician feels that the patient is near the end of their life. This would put the decision making power on the patient and it would improve the quality of care the patient receives when they are at the end of their life. By developing a specific care plan, the patient would be in control of their wishes on how they would like their care to be handled when the time of death nears. We can identify strengths and weakness with this strategy and implement changes to the strategy to improve the overall system of care with...
Palliative care is a type of expert medical care designed to improve all aspects of a patient’s life and address all of said patient’s medical, physical, emotional and social needs, among others. It is typically used to help terminally ill and disabled patients, those often more prone to consider PAS. It is specialized to each patient and the kind of specific treatment his or her illness requires, and is designed to help patients live as long as possible and improve their quality of life. David Jeffrey, author of Physician-Assisted Suicide: A Palliative Care Perspective, states, “Over 90% of doctors working within palliative care oppose euthanasia and PAS” (Jeffrey 6). Palliative care doctors are those most exposed to PAS, and who have the most experience in dealing with it. The most informed experts on PAS oppose it, because such an exceptional alternative—palliative care—is available. With recent improvements in palliative care, the legalization of PAS is unnecessary and irrelevant now more than ever. The Annual Summary of The World Health Organization Expert Committee states, “With the development of modern methods of palliative care, legalization of euthanasia is unnecessary. Now that a practical alternative to death in pain exists, there should be concentrated efforts to implement programs of palliative care, rather than yielding to pressure for legal
The purpose of this essay is to analyse various theories on ageing, death, dying, and end of life issues from different perspectives such as: biophysiological theories, psychosocial theories; and taking in consideration the cultural, historical, and religious implications around the aforementioned life stages. One will also discuss important issues relevant to social work practice such as dignity, autonomy, and their relationship with the concept of a successful ageing and a good death. One considers these areas important since they upheld anti-discriminatory practice and may perhaps promote the development of personalised care pathways, as well as fair and justifiable social policies.
One key agency involved with patients suffering from a terminal illness is Macmillan Nurses, who provide specialist care for those suffering from a terminal illness both directly and indirectly, their role varies from administration of specific medicines which can help improve a patient’s wellbeing in their last few days to providing advice and support to the patient and their significant others (Skilbeck et al. 2002a). However, the role of Macmillan Nurses has been called into questions due to constant changes in policies relating to palliative care and improved access to palliative care services, it has been argued that they are not keeping up to date with changes and further training is needed to improve their skills and clarify their scope of practice in the community (Skilbeck et al. 2002b). Along with Macmillan Nurses there is also the role of a Hospice in some terminally ill patients care. A Hospice usually provides residential care for those requiring advanced and ongoing medical treatment, they can provide nursing care, medications and psychological and emotional to support to patients as well as supporting the patient’s significant others (Macmillan
It can be hard to define the role of a social worker when it comes to end of life care. On the other hand, the role of nurses, home caregivers, and physicians is readily discernable. Because of this many hospice programs, in an effort to save costs, tend to reduce the number of social workers and increase the number of nurses/caregivers/physicians. Not only is this detrimental to the hospice patients and overworked social workers, but also in fact studies show that having fewer social workers actually increases costs. If the U.S. hospice industry would properly evaluate the benefits that social workers bring to hospice care, they could not only reduce their costs, but
Many elderly and terminal ill patients may argue the fact that they have a “right to die”. Many patients have the idea that they have the right to decide when to prematurely end their lives, to prevent any suffering and continuous burdens on their family. Many terminally ill patients suffer from severe depression and thus trigger a desire for death. Patients in a persistent vegetative state or chronic illness do not want to be a burden on their family members. Euthanasia can be considered as a way to upheld the ‘Right to life’ by honoring ‘Right to die’ with dignity (Math & Chaturvedi, 2012). For instance, in the Nancy Cruzan case, the young lady was in a persistent vegetative state for 4 years. Her life was maintained by artificial hydration and nutrition. The US Supreme Court decided not to allow discontinuation of the treatment since there was no clear and convincing evidence that she would want her treatment to be discontinued. However, the court stated that individual states could not ignore the expressed wishes of patient when satisfactory evidence was presented (Chao & Chan, 2001). Aside from the patient the caregiver may file for a similar request to identify alternative options to preserving the life of the patient. The caregiver tends to carry a large burden which involves financial obligations, emotional,
Each worker strives to ensure the patients are taken care of and that their needs are meet. The Social Worker truly shows the use of the NASW in this seating. There are times that they must make an ethical decision based on the best interest of the client. There are many clients that feel they are able to go home and care for them self’s but truly are not. The Social Worker along with the doctor and other staff members make the difficult decision of taking the individual’s right away making them a ward of the state or putting them in other necessary
Palliative care encompasses advanced care planning, legal issues, and ethical decisions which help ensure that the patient maintains their autonomy (Buttaro, Trybulski, Bailey & Sandberg-Cook, 2016). The problem of advanced planning should be discussed with every adult patient with the first exam and then yearly. (Buttaro et al., 2016). Knowing what the patient’s wishes are and having affairs in order is important for every family to have a plan for when the time comes. The Terri Schiavo court battle that brought patients’ rights for an end of life, palliative care and persistent vegetative states and how life and death are determined (Caplan, 2015). There is no standard to how the end of life decisions is made and living wills, and advance directives are not common place for everyone (Caplan, 2015). Palliative care can offer the patient and their family an improved experience in end of life care with patient-centered care (Buttaro et al., 2016). The beginning is understanding what the patient's wishes, which is best achieved with the patient before any disease processes make the patient unable to participate (Buttaro et al., 2016) are.
These challenges are due to the Medicare benefit, workforce issues, and access and quality of the services. Medicare’s regulations state that hospice is only offered to those near death (six months or less to live) and that the admitted patients stop the treatments with the purpose of curing the illness. The purpose of these restrictions is to keep costs low, but there is also the ethical responsibility of hospice to provide the best end-of-life care possible for patients and their families. Another issue with hospice and palliative care is the lack of workforce while this field is growing. Currently, social workers provide the majority of psychological services, but psychologists and psychiatrists are also needed for effective psychosocial care. Since hospice and palliative care is now recognized as a sub-specialty, there is hope that this will increase physicians entering this medical field. Spiritual and religious services are other areas within hospice and palliative care that needs expansion. “If current projections are correct, then more than twice as many hospice professionals and volunteers will be needed in the next 20 years to meet the unmet need for palliative care and the growing numbers of older people in our society” (Connor 98). The last problem with end-of-life care programs is the access and quality. For example, African Americans are 7% less likely to receive hospice
King, K. & Klawitter, B. (2007). End of Life Counseling: Advanced Counseling Skills, Third Edition (pp. 244-262). Baltimore, MD. Lippincott Williams & Wilkins.
Social work is of great significance worldwide aiming to bring about social change and development, cohesiveness within the society, empowerment and liberation of people, particularly those who are in need (International Federation of Social Workers & International Association of School of Social Work (IFSW & IASSW), 2014). The basic functions of social work includes Restoration, Provision of resources and Prevention. A Social Worker can be defined as an individual who is trained and qualified in the field of Social Work. He/she works with vulnerable people in an effort to bring about change in them and develop their social functioning. This is done in hopes of the individual meeting their social needs, identifying and finding solutions for
The social work profession is defined as “a practice-based profession and an academic discipline that promotes social change and development, social cohesion, and the empowerment and liberation of people (ISFW, ‘Global Definition of Social Work’, 2016).” The definition may be true about the profession but it is more in depth than just that. To me, the profession’s primary focus is to help others through life as much as we can while letting them make their own choices and guiding them. In society, social workers are utilized in many different nonprofit and government roles. They serve the community in many different ways from monitoring parent visits to helping people through mental illnesses. Human beings are so complex and things that happen