Social Workers' Roles in Addressing the Complex End-Of-Life Care Needs of Elders with Advanced Chronic Disease

Abstract

This study examined social workers' roles in caring for low-income elders with advanced chronic disease in an innovative, community-based managed care program, from the perspective of elders, family, team members, and social workers. The results are drawn from a larger longitudinal, multimethod case study. Sources of data include survey reports of needs addressed by social workers for 120 deceased elders, five focus groups with interdisciplinary team members, and in-depth interviews with 14 elders and 10 of their family caregivers. A thematic conceptual matrix was developed to detail 32 distinctive social work roles that address divergent needs of elders, family, and team members. Distinctive perceptions of social workers' roles were identified for the different stakeholder groups (i.e., elders, family caregivers, team members, and social workers). Findings from this study may inform supervisors and educators regarding training needs of those preparing to enter the rapidly growing workforce of gerontological social workers who may be called upon to care for elders at the end of life. Training is particularly warranted to help social workers gain the skills needed to more successfully treat symptom management, depression, anxiety, agitation, grief, funeral planning, and spiritual needs that are common to the end of life.

KEYWORDS:

• social work role
• interdisciplinary teams
• perceptions
• managed care
• long-term care

Acknowledgments

This study was supported through a grant from the John A. Hartford Foundation. Much appreciation is extended to the older adults and family members who graciously shared their experiences and perceptions, and to the Care Wisconsin Partnership Program team members who participated in the focus groups. Special gratitude is extended to the social workers who additionally completed the surveys of deceased participants.

Notes

Note. ^*Percentages calculated based on total number of needs considered important to care of elder at end of life (i.e., only those actually addressed by the teams—see column 1).