The Subject We Would Rather Not Discuss- End of Life.

It is not a topic at my dinner table, with my friends and relatives, nor is it one that comes up at staff meetings.  In fact, it is not one that is  met with enthusiasm if  it happens to come in conversation with a friend who may be dealing with death in one's family.  However, this was the subject of NASW's Annual Practice Conference held in Boston this month. Betsy Clark, the Executive Director of NASW presented a fascinating perspective on death in her opening remarks entitled “Social Challenges for Social Workers in End of Life Practice.”

Her first point was to emphasize that it is not the subject of death that causes burnout for social workers who specialize in End of Life Practice, but rather the paper work and the boundary issues. Interesting. She went on to explore our varied and odd relationship with death and the mention of it.  For instance, our use of phrases like,  passed away, passed on, passed, expired, kicked the bucket, pushing up daisies are odd ways to avoid the 'dead' word.  Then again, we use the 'dead' word in weirder contexts: 'Scared to death', 'dead-a-head', 'drop dead gorgeous', 'a dead head', 'death by chocolate', 'deadline', you are 'dead right' and so on.

She actually had the audience guffawing at times with the multiple ways we deny and avoid the topic that affects all of us in the most natural ways.  Having put the issue in a context that we could relate to, she went on to point out that social work is the ideal profession to address all the issues related to death and we had better get over the cultural aversion to the subject to take our place in this important and growing work.  We need to not only seek out the jobs in nursing homes, cancer centers, hospices and palliative care settings but also start doing more research in this area.  We hear the stories, we sit with the families, we counsel the clients.  We have the material to bring to our larger profession. We can start producing empirical data on how to address this universal life phenomenon. Our particular approach to viewing clients within their environments-social, cultural, economic and geographic, provides us with the research material that will advance our work in End of Life Practice.  After hearing Betsy and many other speakers of the day, I came away with a newer and much more comfortable response to the subject I would rather not discuss.


Carol Trust