Session: End-of-Life Care: The Challenges and Implications for Social Workers (Society for Social Work and Research 15th Annual Conference: Emerging Horizons for Social Work Research)

Quality end-of-life care across settings is a complex and challenging issue as the care and services provided for individuals are influenced by multiple factors including hospice utilization and presence of advance directives, as well as individual and organizational factors. This symposium speaks to the diversity of end-of-life concerns and addresses the importance of social workers in meeting end-of-life needs. Dr. Frahm begins with a discussion of hospice care, social service utilization, and trends across time within the Veterans Administration (VA). The VA system provides services for a growing number of frail older veterans at the end of life and is a major provider of hospice care. The implications for social workers within the VA are identified as the number of veterans nearing the end of life continues to increase. Dr. Park follows, discussing the role of race/ethnicity in length of hospice use among older adults. This is an important area of research as the diversity of hospice patients continues to grow, length of stay in hospice has been linked to quality of care, and social workers play a key role in identifying unique end-of-life preferences across cultures. Dr. Osman then presents her research on the use of advance directives in the nursing home setting and adherence to resident wishes at the end of life. This has significant implications for both patient and family satisfaction with end-of-life care as well as the quality of care provided. Finally, Dr. Becker discusses her findings on unnecessary hospitalizations of nursing home residents near the end of life, a significant quality of life issue. The importance for nursing home social work is presented as social workers are often the key link between providers that may have important implications for reducing unnecessary hospitalizations at the end of life as well as for improving overall care quality. The symposium concludes with a discussion among presenters about the challenges and implications for social work professionals in ensuring quality end-of-life care across settings and the future directions of end-of-life care.