Transcript Project on Death in America

Project on Death in America
Katherine Walsh-Burke, Ph.D, MSW
Social Work Leadership Development
Grant Recipient, 2000-2002
Cohort II
Sponsoring Organization
Collaborators
 Katherine Walsh-Burke, Ph.D.,MSW ,
Springfield College School of Social Work- Springfield, MASS.
 Cleora Roberts, Ph.D.,MSW
University of Southern Florida School of Social Work- Tampa, Florida
 Karlynn BrintzenhofeSzoc, Ph.D.,MSW
Catholic University of America School of Social Work- Washington, D.C.
 Susan Hedlund, MSW,.
University of Oregon School of Health Sciences- Portland, Oregon
Education in End of Life Care
for Social Workers
A Documented Need

Social Work Education for Practice in Health Care - Final
Report A project of The New York Academy of Medicine.
(Volland, 1999)

Advancing Social Work Practice in End of Life Care
Christ, G. and Sormanti, M. Social Work in Health Care (2000)

A preliminary Investigation of a Course on Grief, Death and
Loss
Kramer, B. (1998) Journal of Social Work Education.
Problematic Aspects of Existing Continuing
Education Programs
 Cost
 Time away from work
 Lack of SW content in courses
 Limited time devoted to training in
new skills
 Content not sufficiently advanced
Christ and Sormanti ( 2000)
Advantages of Internet-based
Continuing Education
 Online education is Cost-effective
 Online education is Time-effective
It is accessible to professionals in
remote and rural locations
 It allows maximum use of web resources
 It affords privacy to the adult learner
 It brings experts to learners at a distance

What Online Courses Offer
 Integration of reading and discussion at
peak learning times for individual students
 Ready access to relevant web based
resources through links
 Audio and visual stimulation
 Immediate feedback on mastery of content
 Capability for rapid updating and
modfication
Quality of Professional Training
Key to Quality of EOL Care
Policy re the end of life and the professional
practice it guides should:
1. Respect the dignity of both patient and
caregivers;
2. Be sensitive to and respectful of the patient's
and family's wishes;
3. Use the most appropriate measures that are
consistent with patient choices;
Quality of Professional Training
Key to Quality of EOL Care
4. Encompass alleviation of pain and other
physical symptoms;
5. Assess and manage psychological, social, and
spiritual/religious problems;
6. Offer continuity (the patient should be able to
continue to be cared for, if so
desired, by his/her primary care and
specialist providers);
Quality of Professional Training
Key to Quality of EOL Care
7. Provide access to any therapy which may
realistically be expected to improve
the patient's quality of life, including alternative
or nontraditional treatments;
8. Provide access to palliative care and hospice care
9. Respect the right to refuse treatment;
End of Life Care
10. Respect the physician's professional
responsibility to discontinue some
treatments when appropriate, with
consideration for both patient and family
preferences
11. Promote clinical and evidence-based research
on providing care at the end of life.
Www.milbank.org/endoflife/index.html
Year One: August- September
 Reviewed
existing curriculum in
MSW and Continuing Education
Programs for Social Workers in
End of Life Care
 Conducted web search of
online courses & programs
 Created file of web links
September- October 2000
 Reviewed
existing PDIA SW
leader surveys
 Designed AOSW survey
 Conducted random sample
survey of 250 AOSW members
on continuing education
content and format preferences
Randomized Sample of 250
AOSW Members (n=140)
Access to Internet
98.4% Yes
1.6% No
Interest in On-Line Course
62% very interested
32% somewhat interested
Interest in Receiving CEU’s
84% very interested
Course Format Preferences
Format
% High Preference
Self-Directed
Time-limited
Interactive
Facilitator Led
Audiovisual
77.7
49.5
28.6
30.3
67.3
% Low Pref
22.3
50.5
71.4
69.7
32.7
Content Preferences
Ranked in Descending Order
1.
2.
3.
4.
5.
6.
7.
8.
End-of-Life Decisions
Family Counseling Techniques
Ethical Dilemmas
Management of Depression
Management of Anxiety
Techniques for Counseling Individuals
Bereavement- Adult
Spiritual Distress
November - December
•Online Courseware options identified
Blackboard.com
Ecollege
Intralearn
Web CT
•Demonstration courses reviewed
•Consultation with Other SW faculty
teaching online
•AOSW SW faculty collaborators
identified and topics assigned
January- February

Proposals solicited
Ecollege, Blackboard.com, WEB CT
Dynamic Learning (Costs range from @
$6,000 to $25,000)
 Recommendations
reviewed
by AOSW Board
 Contract negotiated with
Dynamic Learning Online
January - April
 Six modules of the
first course
collaboratively constructed
CEUs secured from NASW
Presentations at CSWE, AOSW,
APOSW
First Course Content
 Counseling Individuals at EOL
 Counseling Families facing EOL
 Assessing Anxiety and Depression
 End of Life Decision making
 Spirituality
 Bereavement
INTRODUCTION
PURPOSE OF THIS COURSE
Psychosocial care is an essential component of End of Life Care. Social workers are
the practitioners who most often provide psychosocial care in health and mental health
systems. In doing so, they assist individuals in coping with psychological, social,
emotional and spiritual issues. Social work education provides social workers with the
theoretical understanding and practice skills to assist individuals with a complex array of
issues they encounter through the life span. Yet recent studies indicate that social work
education programs do not always adequately prepare practitioners for the range of
specialized skills that enable them to address the psychosocial needs of individuals at the
end of life1.
This distance learning course is designed to bring the resources of the professional
literature and the World Wide Web, as well as the expertise of skilled practitioners in the
arena of End of Life care to practicing social workers. This course will better prepare you
to deliver to your clients care that meets the evolving standards of the profession.
Course Demonstration
Www.aol.com
Www.dynamic-online.com
Lesson 3 Topic 3
Family Screening and Assessment
Lesson 3
Topic : Family Screening and Assessment Tools:
Many screening and assessment tools have been
developed for families. These are used by social workers
in both clinical and research contexts. In the clinical
context they may be used to screen and identify families
at risk. In the research context, they help identify common
experiences and are sometimes used to assess the impact
of intervention. The following are just a few instruments
which are reviewed on a helpful website put together by
http://www.chcr.brown.edu/pcoc/toolkit.htm
Lesson 3 Topic 3
Family Assessment Tools
The Genogram is a graphic depiction of family composition and
history. In relation to End of Life care, it is important to list previous
losses the family has sustained and the reasons for the deaths.
Cons ruction of the Genogram in the context of a family meeting can be
considered both an assessment tool and an intervention technique as it
initiates communication among family members about losses and their
meanings
A template that can be downloaded to construct a genogram can be
found at the following site
http://www.aafp.org/fpm/20010300/49focu.html#box_b
Lesson 4 Topic 4
Psychiatric Consultation
Patients who are significantly depressed or experiencing severe anxiety and who are
not responding to counseling or other psychosocial interventions should be discussed with
psychiatric colleagues. There is a risk of suicide for those experiencing depression in the
context of a life-limiting illness and suffering can be alleviated through appropriate
intervention. Psychiatric referral may be advisable to address the pharmacological agents
for treatment of depression or anxiety.
There are a variety of anxiolytic (or anti-anxiety) medications that can be
helpful in alleviating anxiety. These include Buspar and Xanax, as well as
several others. For usual dosages and information about other treatment
approaches, click on the links below.
http://www.cancernetwork.com/handbook/images/depression%20t2.gif
http://www.aafp.org/afp/20001001/1591.html
http://www.psych.org/clin_res/pg_panic.cfm
http://www.oncolink.upenn.edu/pdq/305966.html
Promotion of Course to Social
Workers
 Newsletters
AOSW, APOSW, ONS, NAHPC,
 PDIA SW Leaders’ Organizations
 Online Educational Listings
 Related Web Sites
About.com (Social Work Site)
Year Two: July 2001-June 2002
First Course content and
format to be evaluated
First course to be updated and
modified per evaluation
findings
Year Two Continued (2001-2002)
Review literature, curriculum and
Internet Resources on designated
special topics in End of Life Care
Expert Collaborators design
continuing education course on
Special Topic in End of Life Care for
Social Workers per Survey results
Year Two Continued (2001-2002)
 Review existing continuing education
curriculum for allied health care providers
on psychosocial aspects of End of Life Care
 Identify interdisciplinary continuing ed
needs
 Authors and topics determined for
Interdisciplinary course
Year Two Conclusion (2002)
Courses are evaluated
Decisions are made re future
continuing education offerings
online
Mentor other social workers in
developing online courses