Many of you have heard me talk about one of my favorite articles, which I consider a seminal paper, “The Ambiguous Dying Syndrome” written by Mercedes Bern-Klug. In this paper she explores the challenges experienced by those who are certainly dying, but their time of death is unknown, and as such, they miss out on the ‘death benefits’, those things that we “get” when we are dying, i.e. the opportunities for closure, financial benefits, home support help etc etc etc! She links in with Joanne Lynn’s materials on dying with chronic illness, and how many people will not know a week before they die that they are in fact going to be dead in a matter of days. (Health and Social Work: Feb 2004; 29, 1, page 55)
In a new book Mercedes brought together experts on nursing, law, medicine, sociology, and social
work to provide a thorough understanding of palliative care in the long term care setting. Their broad definition of palliative care suggests that comfort care is appropriate across the illness experience, not just in the last days. A majority of residents in long term care are older adults facing multiple, advanced chronic conditions. This book is grounded in the provision of palliative care in nursing homes, but can be applied to other long-term care settings, such as assisted living. The contributors combine scholarship with practical wisdom in each chapter, mixing reviews of scholarly literature with insights gleaned from clinical practice.
I highly recommend you ordering this book if you work in the long term care setting, and if you believe that palliative care should not be limited to those dying of cancer in a shorter more predictable timeline.
Mercedes Bern-Klug is an assistant professor in the School of Social Work at the University of Iowa
Title: Transforming Palliative Care in Nursing Homes The Social Work Role
ISBN • 978-0-231-13225-1