THE ROLES OF SOCIAL WORKERS IN THE FIELD OF CANCER
Social workers are the primary providers of psychosocial services in cancer treatment centers around the world. With their expertise in cancer and its psychosocial impact on patients and their family/community, social workers have training in dealing with psychosocial issues such as anxiety, family relationships, changes in lifestyle during and following treatment. Social workers are also there to help patients with re-integration in to the workforce and to cope with fears about recurrence and death which are stressors experienced by many cancer patients. Social workers can assist with practical needs such as employment and financial stressors caused by the illness. The social worker is an important link in the chain of communication that takes place in a busy hospital. Social workers accompany patients through all phases of the illness trajectory including diagnosis, treatment, live after cancer, and supportive∕ palliative care. The following sections describe the role of the social worker in more detail along the treatment trajectory:
3. Palliative Care
During this phase, as a new patient, patient and his/her family may be in a state of upheaval. The uncertainty that accompanies the news of a diagnosis can have a ripple effect on family life, employment and financial situation, and emotional state. Social workers will evaluate situation in order to understand the full impact of the illness on patient and those around him/her. During this time, patient and his/her family will receive information about illness, assistance with how to negotiate time away from work responsibilities, information about medication programs and community and financial resources. The patient will need support both from your social network as well as from health care team. The social worker is well placed to be a bridge for good communication with the health care team.
Social workers are trained to assess how the patient is coping and provides illness adjustment counseling to him/her and loved ones including young children. Social workers will also screen, monitor and refer patients to appropriate services if they are identified as dealing with depression, anxiety, or anticipatory grief. Particular attention is given to assess whether there are other stressors happening in his/her life during the time of diagnosis such as family conflict, abusive relationship, etc. Doing so can help social workers provide support needed to make living life with treatments somewhat easier.
During this phase the social worker’s goal is to monitor how the patient is coping with changes in his/her life as a result of treatment. This is the phase in which many families find that the instrumental and financial burdens are the highest. With frequent visits to the hospital requiring transportation and days missed from work, the costs can be significant. Social workers can help by finding volunteer or community resources that can take some of the burden off caregivers. As well, social workers can help with the coordination of community provided care. Social workers are often the source of referrals to home care agencies and can be instrumental in mobilizing homecare resources so that you can remain at home and avoid unnecessary hospitalizations. If the patient is hospitalized, social worker will work with multidisciplinary team to help plan discharge home so that transition can be seamless. For those of patients who will require daily radiotherapy in addition to his/her chemotherapy, speak to social worker to explore what option there are for assistance with parking, transportation or accommodations if he/she is coming from remote areas.
Receiving a diagnosis of cancer is a significant life challenge. However, the patient is not alone. Social worker is one of the effective members of cancer team can make this time in patient’s life a little easier and more comfortable.
Social work is an integral part of the multi-disciplinary team within palliative care, offering a holistic service to patients and families. Unlike many fields of social work, specialist palliative care social work is potentially a universal service and they used to work with a diverse range of people in terms of age, diagnosis, class, ethnicity, sexual orientation, religion and culture. Palliative care social work involves working with two groups of people – direct service users with life threatening or terminal conditions and those who are bereaved. Social workers are skilled at balancing the different and sometimes competing needs of the two groups.
Specialist palliative care social work is provided in a range of settings, including independent hospice, day hospices, NHS specialist palliative care units, oncology wards and in home care teams. It includes working with people with cancer, HIV/AIDS, chronic circulatory diseases and other life threatening illnesses. Specialist palliative care social workers are used to working across the fields of health and social care and often provide a link between the two. They are used to work with both children and adults and in working with people in their own homes.
Specialist palliative care social workers offer a wide range of support to patients and families from practical help and advice around income maintenance, debt counseling, help with housing and accessing other services, through to advocacy, individual counseling and group support. This will include bereavement work with adults and children both as individuals and in group settings. Key to specialist palliative care social work is the desire and ability to see people as whole people and not as set of problems, to understand the connections of their lives and to seek to act, rather than ignore the constraints and discrimination they experience in society. The combination of skills offered by specialist palliative care social workers makes a unique contribution to the psychological and social aspects of the multi-disciplinary professional team caring for patients, their families and cares.
Sajjad Majidi Parast
PhD Student of Social Work at Allameh Tabatab’i University