Palliative Care Interview

By Saara Mohammed

I interviewed a physician about the thoughts I’ve been putting out on the blog about palliative care, end of life care, and the role of health professionals in that area of health care. The interview cleared up a lot of my confusion, but also clarified a lot of claims I feel I made (maybe prematurely) in past posts. The part one of the interview follows:

Disclaimer: The responses are a single internal medicine physician’s experience and views. This interview has been condensed and edited.

- So if you were to sum up a social worker’s role in end of life care, what would it be? (I started the interview talking about social workers)

- To be honest, they’re usually not really involved in end of life care. That’s mainly doctors and nurses or visiting doctors and nurses that work in hospice. The social worker mainly sets up hospice if the patient is dying and has been in a nursing home or the family doesn’t want to take the patient back home. They arrange for nursing homes to take the patient on for hospice care.

- Can you think of any times where there has been conflict between those involved and the decisions being made?

- Sometimes conflicts arise when family members have to make decisions about keeping the patient comfortable. If the patient doesn’t have a will or power of attorney, they have legally documented statements on what to do if something happens to them. Sometimes the children or family have other ideas, and then there’s a conflict over how to treat the patient, and continue to make the patient comfortable. There is also the option of appointing a person to make decisions in case the patient can’t make decisions. If the patient is very sick and the family doesn’t know what to do, or if there are too many family members involved who don’t know what to do, a social worker is called in.

This is just part one, and I already felt that a lot of my perceptions of the actual problem I thought was at the root of lacking end of life care, had changed. Part two discusses the interaction between social workers and physicians, and how the decision is made to transition a patient to a hospice care.