One of our aims is to promote the lively exchange of news, views and experiences amongst our members.
Below are a selection of blogs written by our members along with some of the latest postings from others across the palliative care and wider social work field.
If you’d like to submit a blog post then please send it through to firstname.lastname@example.org
How Covid 19 has really challenged my ethics, morals and ways I practice
Written by Wendy Ashton, Eden Valley Hospice – August 2020
As a palliative care social worker in a Hospice, Covid 19 has really challenged my ethics, morals and ways I practice. Hopefully for the better in the long term.
I work in a small Hospice that covers a vast rural community and work as a full time Palliative Care Social Worker and Family Support Team Lead. I work with people with at end of life who have complex needs and aim to make the time that people have left as happy and content as possible. I think Hospice staff are a ‘Huggy’ lot and we work well as a multi-disciplinary team. A large part of my role involves working with families and friends as well as clients.
When Covid appeared I found myself being based on the ward in a small office wearing scrubs. We chose our own colours but the teal I chose turned out to be mint green! What a laugh. The purpose of this is to reduce footfall around the Hospice and contain the clinical staff – which I was one of – in the clinical area. It was a bit scary at first as we had to get used to wearing aprons, gloves and masks when seeing patients. It all seemed very depersonalised and a tad out of my comfort zone. The High School Musical song ‘We’re all in this together’ springs to mind frequently.
I have written about a few examples of adapting to working within Covid restrictions to share that we can still achieve person centred care in an empathetic and positive manner.
Often, a patient is too unwell to return home and chooses to die at the Hospice. A last wish is to see home for one last time and we can initiate this with a carer and transport for an hour at home. It is tricky to organise, but it is worth it when you see the joy on that patient’s face when they return after seeing home for the last time. Unfortunately, this was not an achievable goal with lockdown. However, I am not one to give up so after speaking to the patient’s husband we set up for him to video the house room by room and include the cats on it too. He did this and returned with it on his phone. After a bit of IT help we downloaded 2 short videos onto a laptop that we left in the patient’s room. She watched the clips with animation showing staff her beautiful home that she was so proud of. The cats (too feral to visit apparently – we had suggested) also made an appearance and the patient was ecstatic to see them. She watched those clips daily for a couple of weeks before she became too unwell to watch. A positive and happy outcome. If you can’t go home, we will bring home to you.
Another day was when a patient was dying and was Covid +. One family member was allowed to see her and say goodbye with full PPE on but others were upset they could not say goodbye. I set up a WhatsApp call and family came on to say their goodbyes to her. Although the patient was unresponsive, hearing is the last sense to go so we truly believe she died knowing that all her loved ones said goodbye before she died. We had volunteers knitting hearts for the Hospice and the patient kept one and the family were sent matching ones that were bagged for the quarantined period prior to sending out.
As a social worker I have utilised facetime and whatsapp to connect family and friends. We have had family/MDT meetings in the gardens sat 2 metres apart and we have given lots of virtual hugs and hands on shoulders to comfort. It has been difficult at times trying to make a difference at end of life, but I feel we have been successful within our restrictions and limits.
I have had my heart-breaking moments when you cannot initiate change. A lady in her 50’s was troubled constantly in her last week of life. When I asked her what it was and could I help she replied that she was struggling to decide which 10 people could go to her funeral. How on earth can you answer that? I could not do anything except listen. Often that helps.
A good quality of life is so important even if it is only for a day or two. I love my job and hope that we can continue to work to achieve dreams and happiness at end of life with our clients and families. I know I will keep on trying. Social Workers play such a valuable role at end of life for both clients and families and friends.
My Journey into Palliative Care Social Work
Written by Katy Di-Lena, LOROS Hospice – November 2019
I have been a qualified Social Worker for just over four years now and I must say, what a journey it has been!
I always knew Social Work was my calling, the very moment I attended the Social Work MA open day at The University of Leicester where I studied my MA in 2013 I was hooked.
I am very proud to be part of a profession that is able to challenge the status quo, challenge injustice and inequality and where the promotion of human rights is at the very core of what we do. This I would argue is a rarity in the Society that we will live in today which is marked by ever present and growing societal ills most notably racism, poverty and sexism to name the very least.
I began my Social Work career with Nottingham City Council’s Adult Mental Health Social Work Team where I completed my ASYE. Working in Adult Mental Health services for a year was such an interesting and challenging area of work; in fact, I would say it has made me the very Social Worker that I am today enabling me to build the foundation skills that are key as a Social Worker most notably emotional intelligence and emotional resilience.
Since then I have worked with Leicestershire County Council for two and a half years working predominantly with adults with Learning Disabilities. Although I enjoyed this work and found it highly rewarding, working as a local authority Social Worker equally had its challenges. In a world driven by funding cuts, increased bureaucracy and red tape, I began to feel that my Social Work values were being tampered with. You see I am not just a Social Worker by title, my Social Work values are at the very core of my being and to not be true to my Social Work values, I was not being true to myself. What are these values you ask? Advocacy, the promotion of human rights, anti-oppressive practise, strengths-based practice, equality and diversity, social justice; they are what I and many other Social Workers like me live and breathe. These core values are the very reason I and many others entered the profession. My inability to truly incorporate these core values into the very essence of my practise as a result of the ever growing bureaucracy and red tape made me question whether I could carry on in a profession which I cared so much for, but felt so limited to what I knew I was truly capable of. This is because the inability to do so caused me great pain.
So, I contemplated alternative careers routes, Counselling perhaps or maybe a Disability Officer? But then I knew this was not quite enough. Then something wonderful happened. After months of looking for alternatives my dream job was there, staring at me right on a computer screen: ‘Loros Social Worker’, a role for a Hospice Social Worker at Loros Hospice in Leicestershire. Could this be I asked myself? Adrenaline began to pump through my body, I could not believe the job that I had wanted for four years had become available!
I visited Loros as a student: I was overwhelmed by the sincere and caring atmosphere that it poured out and I knew I needed to be a part of it. So here I am four years on and in my dream Social Work job as a Palliative Care Social Worker!
My core values are finally in harmony with my job role; I am able to adopt the person cantered and relationship based Social Work that I always craved on a daily basis. Loros is a wonderful place to work; all of the MDT work so closely together to support the patients as best we can, looking at their holistic needs. I feel the Medical and Social Model at Loros are equally respected which is so refreshing. As the Loros Social Worker my role is varied, supporting with benefits, the needs of Carers and leading on Safeguarding and Mental Capacity and DoLs are some of the skills I have adopted within the role to name a few. What is most fulfilling about my role and the Hospice’s role as a whole is that we always start with the question what is it that the patient needs and what can we do as a team to support this? That to me is the very essence of ‘true’ Social Work and how blessed I am to be a part of this. I cannot believe I almost contemplated leaving the very profession I was called to.
Support with financial issues
Written by Jonathan Pearce, Family Support Team, Hospice of the Valleys – November 2019
Having to hear bad news about your own or a loved one’s health can be difficult, and that news has a range of significant consequences that can have an enormous impact. Support with the financial consequences of living with, and dying from, a life limiting illness, has always been an integral part of the holistic approach that the Family Support Team at our hospice provides. This support also extends to the bereaved relatives that we support.
Within Blaenau Gwent, a snapshot of the picture of health compares less favourably to most parts of the rest of Wales, and the U.K.This means that our Family Support Team are keen to inform, enable and empower the people that receive our service to identify what matters most to them, and provide a level and type of support that suits their circumstances.
During the year April 2018 – 19, we supported people referred to our service, including bereaved relatives, to generate an annual income of £650,000. The rapport, trust and confidence in our service is something we work hard at. We want to remain recognised as a professional, conscientious and enabling service when supporting people to navigate the benefits system, and sourcing further support that have financial implications. This may involve liaising with other services, such as the Local Authority.
Michelle Llewellyn, one of our 2 Welfare Rights Advisors and I have recently returned from the All Wales Palliative Care conference. The presentation was entitled ‘I cannot afford to be Ill! The impact of financial support in palliative & bereavement care.’ The presentation demonstrated the work of our Family Support Team (all 5 of us!) in achieving an income totalling £1 Million for the period April – September 2019, and was a great opportunity to inform other palliative care professionals of the difference that they can make. It also demonstrated the power of telling stories.
We support people with all kinds of benefits, and to date (September 2019) we have supported people with the following;
• Personal Independence Payments totalling £177,166.16
• Universal Credit claims of £170,718.42
• Attendance Allowance of £228,943
• Claims for bereaved relatives totalling £175,851.26
• State Pension claims of £69,635.53
• Pension Credit claims of £11,239.28
We also assist people to save money by ensuring that they are on the correct utility tariffs. We have supported over 100 Lasting Power of Attorney applications, saving people at least £36,764 (based on solicitors fees locally), and council tax reductions totalling £45,245.84, of which £14,877.75 due to the Severe Mental Impairment exemption.
We have been told that the impact of providing support with financial concerns has been invaluable, and we are keen to continue and develop our service, to meet the needs of people who need it most. This occurs in an area with a history of inequality and a gap that continues to increase.
A day in the life of…but not a typical day
Written by Jonathan Pearce, Family Support Team, Hospice of the Valleys – November 2019
On Tuesday 23rd July 2019, armed with a bottle of water and a bag of mints, I began my journey to the University of York. My abstract to present at the 9th International Conference on Social Work in Health and Mental Health had been accepted. The 5-hour journey, aided by a couple of rest stops, was certainly helped by the air conditioning; the weather outside being scorchio.
My presentation title was, ‘Palliative care social work in Blaenau Gwent- What’s going well, and what lies ahead?’
I was hoping to highlight the work of the Family Support Team that I am proud to be a part of, and demonstrate the breadth of inequality and the pressing needs of the community that we serve.
Due to the anticipation of an international audience,(there were about 15 different nationalities in the room), I began with a visual description of Wales, where we are, and what we are famous for (i.e. Dragons, mountains and sheep). The introduction, and its rather muted response, made me reflect quite quickly that humour differs greatly around the world.
The presentation content demonstrated the range of expertise, knowledge and skill that our team offer, including help with financial issues, emotional support, planning, carer and bereavement support. This was achieved with a combination of statistics and stories. There is nothing as powerful and impacting as a story. It was nice to have some positive feedback, particularly from some wonderful social work, colleagues from Hong Kong, and BASW Cymric have arranged an interview following my recent and relatively new tweeting activity.
I also enjoyed a number of other presentations focussing on health inequalities, bereavement, and hospice care from around the globe.
I have been a palliative care social worker for 11 years now. No 2 days are ever the same, but this one less typical than most. It was a pleasure to present, representing a team, service and organisation that I am very proud of being a part of.
The Other Side
Written by Wendy Ashton – Hospice Social Worker, Eden Valley Hospice & Jigsaw, Cumbria’s Children’s Hospice – Carlisle – September 2018
In September 2018 I suddenly found myself on ‘the other side’ of palliative care.
My sister called to let me know that the ‘gallstones’/’kidney stones’ was actually bowel cancer with liver and lung mets. She also appeared to develop Tourette’s syndrome during our conversation. “It’s not curative” she informed me. But with my experience of working in palliative care for over eight years I sort of knew that already.
It was hard trying to listen to her explain the treatment options without saying to her ‘but it’s just a matter of time, sis’. My head went into overdrive. The mets were causing the pain, not the bowel cancer. Was she constipated? Had she thought about quality of life? She was always the ‘pathetic one’ who couldn’t watch Casualty with me or stand to have injections. She could never have worked in the health sector like me. For goodness sake she’d only got her ears pierced the once because it hurt.
My heart was in my boots and tears were flowing down my cheeks, but you can’t see down phones can you? I stayed calm and agreed with her that life is cruel and hers will be probably shorter than mine. But hey – any of us could be run over by a bus or drop down dead at any time. Oddly that scenario didn’t help.
The plan following her oncology appt was to have some chemotherapy at the Hospital that had diagnosed the cancer. She could have gone to a Cancer Care Specialist Centre in the neighbouring city as that was actually her catchment hospital. I talked to her – probably as a professional – about how this is a great unit and they do all sorts of wonderful stuff. As a sister I thought, “you have to go for the best because I don’t want you to die just yet”. However, her trust was in the diagnosing unit so I respected this and shut up.
I tried really hard over the next few months to be her sister and not let my knowledge and experience intervene. It is so, so hard……
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