Journal of social work in end-of-life & palliative care
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J Soc Work End Life Palliat Care · Jan 2006
Calling the question of "possible dying" among nursing home residents: triggers, barriers, and facilitators.
Glaser and Strauss reported decades ago that in order for a person to be treated as dying, he/she must be defined as dying. Defining nursing home residents as "dying" can be complicated because most residents are in advanced old age with multiple chronic conditions. Using a social construction theoretical framework, this study looks at the step before the declaration of dying, that is, the consideration of the possibility of dying. ⋯ The paper also reports barriers (family, staff, and disease process) and facilitators to calling the question of possible dying, including families having a sense of treatments they would like to avoid and having the opportunity to talk through options. Findings are discussed in light of basic assumptions of social construction. Implications for social workers include helping residents, families, and staff anticipate and address the possibility of dying, and to reflect these discussion in care plans, as well as the need to be available to help residents and family members with psychosocial issues related to living and dying in the nursing home setting, including the profound issues that can be provoked or exacerbated by resident health status decline and possible dying.
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J Soc Work End Life Palliat Care · Jan 2006
The impact of prison hospice: collaboration among social workers and other professionals in a criminal justice setting that promotes care for the dying.
This study reports on a qualitative national telephone survey with coordinators of 14 prison hospice programs in 11 states. The rationale behind the survey was to learn about interdisciplinary collaboration between social work and criminal justice, using prison hospice as an exemplar of this collaboration. In addition to learning that all prison hospices in the study operate using an interdisciplinary team model and that most report high quality collaboration on the hospice team, the following additional five themes emerged: administrators and wardens are very supportive while correctional staff provides mixed support to team and program; greater collaboration with those outside prison hospice is critical; collaboration through prison hospice has a positive impact on dying prisoners; collaboration through prison hospice has a positive impact on prisoner volunteers; and, collaboration through prison hospice has a positive impact on the entire culture of the prison.
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J Soc Work End Life Palliat Care · Jan 2006
End-of-life care preferences of older adults and family members who care for them.
Using data from a series of in-depth semi-structured telephone interviews with family caregivers (N = 110), this study explored preferences for end-of-life care and the types of plans made. Caregivers provided rich descriptions of care receivers' perceived preferences for care at six weeks (post-patient discharge due to hip fracture or stroke), as well as their own preferences at one year and at five years. ⋯ A fourth theme, impact of the caregiving experience, also emerged from the caregivers' responses in terms of their own preferences for care. The findings are discussed in terms of the recently proposed national agenda for social work research in palliative and end-of-life care.
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This paper reports on the last of three National Hospice and Palliative Care Organization initiatives to move hospice and palliative care social workers into the patient/family outcomes arena: the development of the Social Work Assessment Tool. The experience of a team of practitioners and researchers is described, including results of two pilot studies and subsequent SWAT revisions. The major focus is on the current model performance improvement project, in which 19 social workers from 14 hospice and palliative care programs used the SWAT with 101 patients and 81 primary caregivers for a median of 44 days. ⋯ Qualitative interviewing of the social workers indicated some lack of readiness in the field to conduct quantitative outcomes measurement. Additional measures are needed in addition to the SWAT, including qualitative measures, and measures of mezzo and macro practice. Participants indicated that the SWAT was appropriate for use with economically and culturally diverse clients.
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J Soc Work End Life Palliat Care · Jan 2006
"They don't want to hear us": Hispanic elders and adult children speak about end-of-life planning.
This study used focus groups to understand Hispanic elders' and adult children's concerns about end-of-life planning. Ten older persons participated in the elders group, and ten adult children in a separate group. ⋯ Communication regarding end-of-life planning was of particular importance to both elders and adult children. The most striking indication of the challenges in communication about end-of-life issues is the insistence by both the elders and the adult children that their children/ parents do not want to have these discussions.