Journal of Social Work in End-of-Life & Palliative Care最新文献

Medical Aid in Dying (MAID) is legal in Washington State, and most individuals who pursue it are enrolled in hospice care. Despite legalization, many hospices omit MAID from their business websites, leaving patients and families without clear guidance for decision-making. This qualitative case study used exploratory document analysis, guided by the READ approach, to examine how Medicare-certified hospices in Washington communicated, or obscured, their stance on MAID through website content. Only 60% presented any position, policy, or related services online. The analysis assessed clarity, accessibility, and interpretive burden from the perspective of a prospective patient or caregiver. Four typologies emerged, Silent, Compliant, Restrictive, and Affirming, reflecting approaches that ranged from withholding all mention of MAID to providing clear, patient-oriented information. Findings suggest that public communication is not a neutral act but an ethically consequential one. When organizational silence prevails, social workers often bear the burden of interpreting policy and guiding patients with limited institutional support. Positioned at the intersection of ethics, advocacy, and care coordination, social workers are uniquely equipped to promote transparency and patient self-determination. A practice-ready toolkit is provided to support social workers in assessing hospice messaging and advocating for accessible, values-consistent communication in legally authorized settings.

The COVID-19 pandemic caused many hospice and palliative care services to reconfigure existing services and invent new ones using technology and remote working. Workloads increased in response to demand and healthcare professionals risked professional burnout, stress and emotional exhaustion. The aim of this study was to conduct secondary analysis of international survey data from palliative care social workers regarding the support received during the COVID-19 pandemic. A cross-sectional online survey-based design was used. Social workers in palliative care were invited to participate via members of international palliative care Social Work networks. The findings are based on data from 278 respondents from 21 countries. Most reported online team meetings, supervision and peer-led group supervision as the main support strategies during the pandemic, yet many indicated they had no time during the pandemic to access support. With hindsight, 43.5% of respondents said they would have done things differently during the pandemic. Most regretted implementing social distancing measures, due to the social isolation, moral distress and impact on grieving relatives. Managers need to help social workers prioritize self-care and proactively engage in support strategies, including supervision, peer-led group supervision and have a better work-life balance that allows time to switch off from work.

Palliative care is provided to chronically ill patients to offer symptomatic relief from their disease, but it is not a curative treatment. A range of strategies are employed to alleviate symptoms and improve quality of life, among which horticultural therapy has emerged as a possible option. Horticultural therapy has been shown to provide diverse benefits, including creating a calming environment that provides comfort and emotional support for palliative care patients. Patients experience symptom relief and perceived pain reduction through engaging activities that distract from discomfort. Those with mental health disorders also report decreased symptoms after participating in horticulture therapy. It also encourages healthier and proactive lifestyle through physical exercise and a more positive outlook on life, however, participants should be cautious of potential risks, such as dehydration and fatigue. This therapy can result in reduced cortisol and increased serotonin levels, indicating lower stress and improvement of cognitive function. Moreover, horticultural activities enhance social well-being by fostering interactions and strengthening social bonds among participants. Horticultural therapy benefits patients' senses by providing an immersive experience with diverse colors, textures, fragrances, and lush landscapes. Through the interplay of these mechanisms, horticulture therapy holds strong prospect of emerging as valuable addition to palliative care.

Bereavement support is a foundational element of palliative care social work, yet practice approaches and support strategies remain varied. This scoping review was initiated in response to a Canadian children's hospice's interest in expanding its bereavement services. The aim was to identify and critically reflect on assessment strategies and professional approaches used with bereaved children, youth, and adults, and to consider how these align, or diverge, from the values and practices of palliative care social work. A review of evidence syntheses published between 2015 and September 2024 was conducted across four databases: MEDLINE, Embase, PsycINFO, and CINAHL. Seventy-one articles met inclusion criteria, identifying over 400 distinct assessment tools and a wide range of support approaches. This review also highlighted gaps in the literature, such as methodological limitations (risk of bias, lack of control groups, limited follow-up), conceptual ambiguity, and challenges in applying evidence to practice. Viewed through a palliative care social work lens, the findings underscore the need to understand grief as a uniquely human experience requiring systems of support. Expanding bereavement care involves individual service delivery in addition to building cohesive programming and integrated systems that acknowledge and support grief across contexts.