As life meets death : How does the hospice social worker, through her knowledge and skills, help in a person's process of dying

Abstract

This study seeks to explore and understand the experience of the dying person and the hospice social worker's role throughout the experience. Five persons who are clients of the Malta Hospice Movement participated in in-depth interviews, the content of which was subsequently analysed according to the grounded theory method. The findings provide evidence that the hospice social worker is beneficial to the terminally ill persons. The hospice social worker helps through fulfillment of the clients' social needs, an intrinsic part of the care aimed at bringing safety and security to the dying person. The social worker also provides emotional support, mainly through the acknowledgement of the multiple losses which are experienced by the dying person. From the study, it emerged that the cornerstone of the social worker's role, as identified by the participants, is two-fold. Empathy and genuine concern for the well-being of the client and providing concrete, practical solutions that mitigate the difficulties encountered by a terminally ill person are pivotal to successful social work intervention. This period in a terminally ill person is considered an opportunity for evaluation and reassessment of one's life and its priorities and often it is the social worker's expertise that can provide direction and help the client identify and resolve key issues. Throughout the study, it was found that there exists an underlying concern regarding a conspiracy of silence surrounding cancer and death. The participants are aware of the intentional avoidance of terms such as 'cancer', 'terminal illness' and 'death' on the part of their own family and professionals alike. The participants feel that this attitude unfairly deprives them from acquiring the necessary medical information which helps them understand and cope with their illness. The lack of honesty is also felt to be an added burden to the participants as, in their struggle to come to terms with their new reality, they find they are stonewalled by the very people they expect help and understanding from.