In recent years social workers have produced some excellent textbooks in health and health and aging including several specifically addressing palliative care and grief and loss. Many chapters in these books have been used throughout the health resource reviews. These handbooks and texts are a great resource for social work students and practitioners who are seeking to familiarize themselves with state-of-the-art social work practice and research in a broad range of important substantive areas in health and aging.
The Handbook on Social Work in Health and Aging is a very comprehensive, highly readable, and authoritative handbook on a broad range of topics in health and aging. It reviews the major practice, education, research, and policy issues with older adults. The editorial committee and the authors of individual chapters are the leaders in the field of health and aging. Most authors have been integral to the development of the highly successfully Hartford Geriatric Initiative; therefore, it is important for students to become aware of their work. The literature reviews are extensive, documenting the evidence base and major conceptual frameworks used in practice and research. Many relate to topics, such as advanced chronic illness and long-term care that are integral components of hospice and palliative care. This is a tremendous resource for students and faculty seeking an up-to-date synthesis of research literature in specialty areas related to health and aging.
This book is an excellent compendium of curricula resources and course syllabi for social work classes in palliative care, grief, and loss across the lifespan. It is divided into courses for BSW and MSW in end-of-life care, palliative care, grief and loss, across the lifespan, and other specialty areas. The presentation of material varies quite a bit across sections, but there is something for everyone here: classroom exercises, assignments, videos, selected client book lists, self-reflection outlines, class evaluations, bibliographies, a timeline of major historical events people have experienced, and much more.
Social Gerontology: A Multidisciplinary Perspective is a classic text in the field of social gerontology that is comprehensive, highly readable, theory- and evidence-based, and full of pictures, charts, and graphs that make it very popular with students working with older adults. It takes a strengths-based and resiliency approach to the topic utilizing an active aging framework and incorporating international information as well as U.S. data in the demographics section. The second section focuses on the biological and physiological context of social aging, and presents detailed discussions of the major chronic illnesses now experienced by older adults. The third section addresses the psychological context of social aging including cognitive changes, mental health issues, love, intimacy, and sexuality. The fourth section covers the social context of aging that includes social theories, social supports/networks, opportunities for caregiving, productive aging including paid and nonpaid roles and activities, death, dying and bereavement, and resilience in race and gender. The fifth section addresses policy initiatives to improve the social problems identified. This text is up to date, authoritative, detailed, and comprehensive with relevance to health, illness, and loss woven throughout many sections. A great resource for bibliography and data for student papers in a variety of specialty areas for older adults and health.
This article presents a model for communication and decision making between physicians and their patients that takes account of where they are in the disease and treatment process and the patient and families’ preferences and values. Their model incorporates degree of predictability of outcome and likelihood of the patient continuing acceptable quality of life. They review previous approaches to decision making: i.e. paternalism, and autonomy which have proven inadequate in the face of multiple medical possibilities for extending life, even with often unacceptable suffering. They suggest a shared decision making process that elicits and takes account of the physicians own reactions as well as patient and family preferences.. This model has application for social workers and other health professionals as well as providing insight into the physicians’ challenges in managing communication over the course of an advancing illness.
This article, written by a physician, describes the current understanding of key symptoms that permit a diagnosis of the dying process. This is an important knowledge base for social workers in health care so that they can fully incorporate the biological aspects in their discussions with patients and families and in their assessments. The author describes key symptoms of dying that include pain, breathlessness, secretions, and restlessness, and reviews how they are currently managed in palliative care. Importantly he discusses the ethical issues confronted in using opiods and sedation to relieve the patient of symptom distress and pain while maintaining life. The “principle of double effect” is reviewed. This principle suggests that an action (medication) which causes a serious adverse effect that has been foreseen, even death, is morally allowable if the intention behind the action was to do good (eg. relieve pain and suffering) and not to harm the patient. Reviewing different opinions about this principle, the relationships to euthanasia and assisted suicide are important to an optimal social work health practice knowledge base in palliative care.
Communication has increasingly been found to be a core of emotional support during treatment of life-threatening illness, especially advanced illness. Communication skills are presented as discrete learned behaviors. While this article is aimed at physicians who have a specific area to discuss with patients, it highlights for social workers the critical transitions in the advanced illness process and communication challenges faced at each point. Often social workers are asked to participate in these discussions and to follow up with the family afterward to provide clarification and support for next steps. For example the authors discuss changing the goals of care and talking about prognosis and talking about death and dying. Regarding treatment, they review withholding and withdrawing life-prolonging medical treatments, questions of whether the patient wants to be resuscitated (DNR orders), stopping palliative chemotherapy, dealing with inappropriate treatment requests. In all of these areas they discuss various misunderstandings patients have about these complex medical issues and suggest ways to explain or clarify them to patients and family members.
Finally they review what the patients experience during the process: information needs, a wish to deny or protect themselves from harsh realities, disappointment when treatment is unsuccessful, prolonged sense of hopelessness without being able to substitute realistic hope, dealing with despair and anger. Other communication problems involve groups: confusion or conflict within families, differences between members of a multidisciplinary team. The authors address physicians’ reluctance to “share” the patient with other specialists or ask for help by referring to another discipline. They conclude by emphasizing the importance of core techniques of communication: being mindful of the emotional impact of the situation, adjusting to different communication needs of different individuals, maintaining a collaborative approach with patients, and trying to understand the situation as the patient and family perceive it.
« Back to page Section 4.1 Suggested Readings
CSWE Gero-Ed Center
A program of the Hartford Geriatric Social Work Initiative1701 Duke Street, Suite 200 Alexandria, VA 22314P: +1.703.683.8080 F: +1.703.683.8099 E: firstname.lastname@example.org