Dying, Death, and Bereavement in Social Work Practice: Decision Cases for Advanced Practice

By Terry A. Wolfer and Vicki M. Runnion

Practitioners who work with clients at the end of their lives face difficult decisions concerning the client's self-determination, the kind of death he or she will have, and the prolongation of life. They must also remain sensitive to the beliefs and needs of family members and the legal, ethical, and spiritual ramifications of the client's death. Featuring twenty-three decision cases based on interviews with professional social workers, this unique volume allows students to wrestle with the often incomplete and conflicting information, ethical issues, and time constraints of actual cases. Instead of offering easy solutions, this book provides detailed accounts that provoke stimulating debates among students, enabling them to confront their own responses, beliefs, and uncertainties to hone their critical thinking and decision making skills for professional practice.

*Please note: Teaching Notes for this volume will be available from Electronic Hallway in Spring 2010.

To access the Teaching Notes, you must first become a member of the Electronic Hallway. The main Electronic Hallway web page is at https://hallway.org/index.php. To join, click Become a Hallway Member in the Get Involved category or point your browser directly to https://hallway.org/involved/join.php and provide the required information.

After your instructor status has been confirmed, you will receive an email granting access to the Electronic Hallway. Once logged on to Electronic Hallway as a member, click Case Search in the Cases and Resources category on themain web page. Enter "death, dying, bereavement"(without the quotation marks) in the search box, select "all ofthe words" in the drop down menu, and click Submit. The search process will generate a list of Teaching Notes for cases from Dying, Death, and Bereavement in Social Work Practice: Decision Cases for Advanced Practice.

• Language: English
• Publisher: Columbia University Press
• Release date: Jun 19, 2012
• ISBN: 9780231512626

Book preview

Mary Hylton and Terry A. Wolfer

AS THE MEETING AT PINECREST Intermediate Care Facility for the Mentally Retarded ended, hospice social worker Kathy Scott had more questions than before the meeting began. To judge by the expressions on their faces, her hospice colleagues were equally perplexed.

As she wedged her notebook into her briefcase, Kathy thought about Evelyn’s request. She was torn about whether or not the hospice should support Evelyn’s demand for termination of all life-prolonging treatments for her fourteen-year-old son, Timmy Jenkins. It had seemed to Kathy since her first meeting with Evelyn that Evelyn wanted Timmy to die. More than one family had expressed to her a readiness for a child to die in order to end his suffering, but this felt different. As Evelyn saw it, obtaining a Do Not Resuscitate (DNR) order and termination of antibiotics were steps toward facilitating his death. It was also obvious to Kathy that the Pinecrest staff did not share Evelyn’s wishes for her son.

Although hospice staff members often supported requests for the termination of life-prolonging treatments, Timmy’s situation was unusual. Although Kathy and her team members had agreed to assess his case, they had not yet determined whether to admit him to the pediatric program. After today’s meeting, Kathy wondered if Evelyn would still want to have hospice involved if they did not support her request. She also understood that if they did admit Timmy, they would have to decide to what extent they were willing to advocate on Evelyn’s behalf, given that Timmy was completely unable to participate in the decision.

Kathy looked at her hospice colleagues as they headed toward the door and thought, We have some difficult decisions to make.

Pinecrest Intermediate Care Facility for the Mentally Retarded

Pinecrest was one of four intermediate care facilities for the mentally retarded operated and regulated by the state since the 1920s. The imposing old four-story Gothic-style building, clearly separated from the neighborhood by its location high up on a hill, was surrounded by pine trees and a six-foot stone wall and accessible only by a narrow, winding, recently blacktopped road. The 120 residents were, almost without exception, profoundly disabled (although not in need of skilled nursing care on a regular basis), and most lived virtually their entire lives there. In contrast with common staff retention problems experienced in other nursing facilities, a majority of the staff at Pinecrest had worked there for more than 10 years and took pride in their longevity in a job that others rejected as too depressing or difficult.

Hospice of Springville

Hospice of Springville was the only hospice in the city of Springville, and was well regarded and well supported by the community. Local corporations and foundations had established a sort of rotating responsibility for funding the pediatric program, since in the early 1990s insurance companies were just beginning to recognize the need for hospice care for