Palliative Care: Evolution and Scope of Practice

Author:

Altilio Terry,McKinnon Anna,Rivas Nansi

Abstract

Palliative care is an interdisciplinary specialty that privileges patient-centered, family-focused care and is ideally accessible across ages, settings, and diagnoses. While hospice care is also provided to patients and families of varying ages across setting and diagnosis by an interdisciplinary team, in the United States it is generally available to patients and families with anticipated prognosis of six month or less. Alternatively, palliative care is accessible at any point along the continuum of illness, regardless of prognosis, and is often provided concurrently with disease-modifying or curative therapies. Palliative clinicians often work in collaborative relationships with primary providers toward the shared work of identifying and responding to the goals and needs of patients and their families as illness evolves. Palliative social work brings values and ethics specific to the profession, along with varied skills that begin with a psychosocial-spiritual assessment, that reflect a whole person in environment perspective that naturally coheres with the goals and focus of the specialty of palliative care. As palliative care has evolved to a specialty over the past decades, domains of care, preferred practices, training programs, discipline-specific certifications and competencies, and program certifications have developed, providing definition to the skill sets and program elements that may be expected. The mandate for access to palliative care has been informed by an increasing evidence base that documents the benefit to patients and families, enhanced quality of care, and cost effectiveness. As demand for palliative care increases across countries, diagnoses, and settings, there is a concurrent need to define specialist and primary skills and to create opportunities for practicing health-care clinicians to validate existing skills relevant to palliative practice, and, when necessary, to learn or further integrate palliative principles and practices. This is uniquely relevant to the thousands of social workers who practice across health settings and have a rich opportunity and responsibility to engage their skills in communication, advocacy, family systems, group dynamics, and psychosocial and cultural aspects of experience to enhance patient-centered, family-focused care across ages, settings, and illnesses. It is additionally relevant because the national and international call for palliative care mandates a continuing dialogue within the social work profession related to the imposition of Western values and the need for critical and creative thinking in servicing resource-poor nations.

Publisher

Oxford University Press

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Mental Health Risk in Palliative Care;The Oxford Textbook of Palliative Social Work;2022-04

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