Activities of Counsellors in a Hospice/Palliative Care Environment

Abstract

This study examined activities related to the provision of psychosocial care by counsellors in the hospice/palliative care setting. A qualitative design using written reports was used in an urban Canadian hospice/palliative care program. A convenient sample of 13 counsellors indicated the activities they typically performed in their work with patients and families. Thematic analysis of the activities directly related to patient and family care was performed and then validated by presenting these activities back to the counsellors in a group setting. Seven themes resulted: 1) companioning; 2) psychosocial assessment, planning, and evaluation; 3) counselling interventions; 4) facilitation and advocacy; 5) patient and family education; 6) consultation and reporting; and 7) team support. These thematic findings confirmed those of previous studies and also highlighted two additional findings. Team support was seen as an activity that directly affected client care, and there was a strong emphasis on the activity of companioning the dying and their families. Also discussed are implications of these results, as well as suggestions for further research. Resume I Cette etude se penche sur les taches de travail des conseillers dispensant des services dans Ie cadre d'un programme de soins palliatifs dans un nopltal urbain au Canada. Ainsi, on a fait une etude de nature qualitative en utilisant les rapports ecrits comme mode de cueillette de donnees. Treize conseillers ont ete choisis et on leur a demande de repondre par ecrit adeux questions ouvertes, I'une portant sur les taches specifiquernent liees aux soins aux malades et, a leur famille et I'autre se rapportant plutot au travail. A partir des reponses, l'equlpe de recherche a fait I'analyse thematique des taches reliees aux soins des malades et leur famille et a de nouveau reuni Ie groupe de conseillers afin de leur presenter les resultats et les faire valider. Les conseillers ont regroupe ces taches selon sept themes principaux soient : 1) la presence physique; 2) l'evaluation psychosociale et la planification des interventions; 3) Ie conseil et les interventions; 4) la mediation et la representation; 5) l'education des patients et leur famille; 6) la consultation et les rapports; 7) Ie soutien dans l'equipe de soins. Ces conclusions, quant aux themes retenus, confirment les resultats d'etudes anterieures mais tout en attirant I'attention sur deux nouvelles thernatiques. Le soutien dans l'equipe a ete retenu comme I'un des themes ayant un impact sur les soins aux malades et on accordait beaucoup d'importance a un autre theme soit la presence physique aupres des mourants et leur famille. L'article se termine par une discussion sur les consequences de ces resultats et offre des suggestions pour de futures recherches.

Guidelines for a Palliative Approach in Residential Aged Care: Enhanced Version--May 2006

“…The aged care team will likely experience loss following the death of residents with whom they have established meaningful relationships [314,409] (Level QE; Level QE). Therefore the team should be provided with opportunities to formally acknowledge the loss, and have access to adequate bereavement support [429,437] (Level QE; Level QE). One study reported that members of an aged care team who had experienced many deaths of residents reported being significantly more comfortable when thinking and talking about death to residents who were dying [438] (Level IV).…”

Creating social work competencies for practice in hospice palliative care

“…8 For social workers, the focus of practice within this collaborative approach is centered primarily on psychosocial needs at end of life and during bereavement. 9,10 They bring to the team an expertise regarding health and social systems, individual and family dynamics, cultural diversity, grief and loss, communication, advocacy, ethics, and interdisciplinary practice. 1,8,[11][12][13] As Brandsen 11 points out, 'social workers are integral participants in developing and delivering end-of-life care, and have been for quite some time' (p. 58).…”

“…14 The lack of a clearly defined identity has contributed to other professionals' confusion about what social workers actually do in HPC, and, consequently, other professions often have inadequate knowledge about the complexity and value of social work practice in this area. 5,10,15 The resulting ambiguity has contributed to boundary and role issues between social workers and other health care professionals, particularly nurses and physicians. 12,16 Furthermore, without a clearly articulated role, social workers have questioned their adequacy and competence to provide professional care to individuals and families during the dying process and after death.…”