Journal of social work in end-of-life & palliative care
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Recognizing that seriously ill patients and their families utilize emergency departments (EDs) for distressing symptoms, changing goals of care, or at the end of life, palliative care and emergency medicine departments are partnering to enhance the care provided to patients with life-limiting illnesses and their families. A social work model for identifying patients with unmet palliative care needs in the ED is included to illustrate the process as well as specific psychosocial interventions that palliative social workers can provide in this environment. As increasing numbers of palliative and emergency medicine departments partner to both improve ED care for patients with life-threatening illness and initiate palliative care consults earlier in hospitalizations, palliative and ED social workers have an opportunity to join their physician and nurse colleagues who are making inroads in this important and growing area.
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J Soc Work End Life Palliat Care · Jan 2012
Interdisciplinary hospice team processes and multidimensional pain: a qualitative study.
Hospice teams may address multidimensional pain through the synergistic interaction of team members from various professional disciplines during regularly scheduled team meetings. However, the occurrence of that critical exchange has not been adequately described or documented. The purpose of this qualitative study was to explore two processes in team pain palliation: communication and collaboration. ⋯ In addition, structural influences inhibited creativity in pain palliation. There was no mutual understanding of the purpose for team meetings, no recognition of the need to reflect on team process, or common definition of leadership. Social work roles in hospice should include leadership that moves teams toward interdisciplinary care for multidimensional pain.
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J Soc Work End Life Palliat Care · Jan 2012
Exploring professional boundaries in end-of-life care: considerations for hospice social workers and other members of the team.
Hospice social workers and members of the interdisciplinary team develop close therapeutic relationships with patients and families as they journey toward death. During this process, situations can develop that challenge professional boundaries and blur the line between a professional and personal relationship. This article will examine professional boundaries within the context of hospice care through case studies identifying challenges that hospice social workers and members of the interdisciplinary team may encounter with recommendations for how to manage boundary concerns.
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J Soc Work End Life Palliat Care · Jan 2012
Bereaved parents' perspectives on pediatric palliative care.
This study's goal was to describe and begin to understand the experience of bereaved parents whose deceased child had received pediatric oncology services at a tertiary comprehensive cancer center. Focus groups were conducted with parents whose children were age 10 years and older at the time of death. Potential participants were contacted by mail and telephone. ⋯ Fourteen parents identified four major themes: standards of care, emotional care, communication, and social support. Bereaved parents discussed the challenges associated with institutional procedures and interpersonal aspects of care in anticipation of and following their child's death. The results of these personal narratives may be used to guide care plans and deliver pediatric palliative and end-of-life interventions.
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J Soc Work End Life Palliat Care · Jan 2012
Palliative care in the pediatric ICU: challenges and opportunities for family-centered practice.
The culture of pediatric intensive care units (PICUs) is focused on curative or life-prolonging treatments for seriously ill children. We present empirically-based approaches to family-centered palliative care that can be applied in PICUs. Palliative care in these settings is framed by larger issues related to the context of care in PICUs, the stressors experienced by families, and challenges to palliative care philosophy within this environment. Innovations from research on family-centered communication practices in adult ICU settings provide a framework for development of palliative care in PICUs and suggest avenues for social work support of critically ill children and their families.