Difficult Conversations

Touro teaches students to usher families through grief and bereavement with grace.

November 09, 2017
Allison Bobick

"Whether working in private practice, a mental health clinic, or a pastoral setting, social workers will at some point find themselves sitting across from a client with a terminal illness or at the end of their life. For many, it is a difficult conversation to initiate and brings up an array of emotions for patient, families, physicians and social worker," explains Touro Professor Allison Bobick, a professional in the areas of health care, trauma and bereavement.

Seventy million aging Baby Boomers are intensifying the need for social workers skilled in helping patients and their families facing issues of life-limiting illness, dying, death, grief and bereavement. Touro Graduate School of Social Work (GSSW) has responded to this need with a special course focusing on the social worker in ethical decision-making in end-of-life care. 

Social Worker’s Important Role

Touro’s Graduate School of Social Work students and alumni pursuing advanced training are learning useful strategies, theory and the ethical principles that surround end-of-life care and the integral role the social worker plays in helping patients and their families through this process. “How and when to initiate end-of-life conversations with patients and families as well as key social work tasks and interventions in preparing clients for end-of-life are some of the topics that we cover,” explains Professor Bobick. 

"One of the most important roles for a social worker is to remain in tune when working with a client at the end-of-life,” explains Professor Bobick. “Although the client is living, death is looming before them. A social worker can be enormously helpful in assisting a patient through this process. It is a significant time in a person’s life where one has the opportunity, through self-reflection and life review, to gain insight into and understanding of the meaning and purpose of one’s life. And, ultimately, acceptance of one’s eventual passing."

The school also teaches the doctor’s perspective and the importance of doctor/social worker collaboration in end-of-life situations. “A physician can determine a patient’s prognosis and understand the risks and benefits of various kinds of interventions,” says Dr. Harvey Gross, Chief Physician in the Department of Family Practice at Englewood Hospital in New Jersey, an active member of the GSSW Professional Advisory Committee and a recent presenter at an end-of-life class held at the school. “With the terminally ill, interventions can have consequences that don’t reflect a patient’s wishes. For instance, a respirator may keep a patient from dying but if we are unable to wean a patient off it, is this treatment in keeping with a patient’s desires? A social worker can be enormously helpful helping patients and families with these decisions.”

GSSW also teaches students to collaborate with medical professionals when working out the best approach to care. According to Dr. Gross, although doctors can determine a patient’s health and acuity, it is the social worker who is relied upon to answers questions related to cultural background, living situation and finances. “When a patient is looked at as an entire person, from medical prognosis, to acuity, to cultural background, to living situation and finances,” explains Dr. Gross, “the patient and families always benefit.”


This article originally appeared in the fall 2017 edition of Touro Links.