Satisfying needs and expectations of terminal cancer patients: Organizational challenges to social workers

Abstract

Despite medical and scientific advances, numerous clinical essays, and research to fight cancer, endless concerns associated with this pathology continue to persist in the twenty-first century, with a strong impact on individuals’ lives particularly at the economic, social, emotional, relational, behavioural, and spiritual levels. However, metamorphosing this into reality still seems to be a distant event because this pathology is still considered one of the leading causes of death in different countries worldwide, and Portugal is no exception. This study aims to study the motivations expressed by terminally ill cancer patients and their caregivers, whose main diferences are characterized. The results show that the clinical, social, spiritual, economic, and emotional issues associated with the end -of- life context are numerous, therefore patients and their caregivers may have a number of circumstances to face. The presentation of the patients’ and their caregivers’ needs, expression of motivations, requests for social work, and emotions experienced at the end of life are some of the core features of the study. We show disparities between patients and their caregivers, including different motivations, needs, requests, and different manifestations related to the place of death that constitute a major challenge for social work in the context of palliative care and care at the end of life. The paper identifies a number of organizational issues relevant to healthcare management contexts. Such issues recognize the importance of integrating innovative social work procedures and protocols into internal medicine departments, planning hospital discharges, making psychosocial and complicated grief risk screening at patients’ admission, promoting social work palliative care education and training for hospital social workers, and the creation and development of more hospital palliative care teams in acute care hospitals. Also the relation between cost and quality of healthcare seems to place social workers in a very relevant healthcare management position.