This was a difficult post to write.
Within a span of two weeks, two of my social work students had each lost a parent to cancer. A medical social worker I was mentoring had shared her lingering grief of losing a patient even though it had happened several months before. A social worker friend had texted me about her emotional state while preparing for the inevitable loss of a loved one.
Talking About Death
Death is not an easy topic to discuss. Even though it is natural for every living being to face their own mortality, the subject is often taboo and uncomfortable to raise. For some, talking about death is akin to an open invitation to its visit. And, when life seems full of promises and possibilities, introducing death in a conversation dampens the mood.
Yet, this is a topic that social workers will have to steel themselves to broach with their clients when the time comes - Does an ageing couple need to talk about their post-death care plans for their intellectually-disabled adult child? Would a patient prefer not to be resuscitated if he goes into a medical emergency during his operation? Has a dying hospice resident considered leaving a will or an advance medical directive? Is a teenager fully aware of the decision to terminate her unwanted pregnancy? These are tough issues, requiring deep conversations that social workers may need to initiate.
Social Workers and Death
Many social workers, especially those working in hospitals, nursing homes, care facilities and hospices faced death often in their work - be it having to deal with the death of patients they have been helping or meeting their grieving family members. Social workers in the community, at times, have to deal with their client's passing and even be the one to make funeral arrangements for those who lived alone and isolated.
While death may come after a client's long-drawn battle with illness, it may also be sudden and unexpected. Social workers sometimes have to be the ones to comfort mothers who had miscarriages, talk to survivors of suicides or attend to those who had lost a loved one in a tragic accident.
Social workers also have to deal with their own trauma of dealing with death. It must have been heart-wrenching to manage cases of child-death from severe physical abuse or dealing with a client's unexpected suicide after a 'good session' the week before. It must have been sad when a long-time client passes away when you have already established an emotional bond from the helping relationship over the years.
Supporting the Social Worker
Supervisors play an important role in supporting their social workers in dealing with death. However, they must first be comfortable to talk about death and its impact on the self before extending support to the social worker. Have our experience in the field prepared us well enough to help our social workers process their struggles when facing issues of death and dying?
Here are four suggestions I have collated from various literature:
1. Recognize the impact of the event on the social worker.
When a social worker encounters death and dying issues with a client, this may well be the worker's first experience of death. Supervisors may need to check on how this is impacting the worker at the personal, interpersonal and professional level. While some workers may have their own philosophical beliefs about death and are able to bring these out as a source of strength, others may struggle to reconcile the feelings of loss and grief. Supervisors should check-in with their social workers and process the impact of this event on them.
2. Offer agency support.
Supportive relationships with colleagues help. Supervisors can connect the affected worker to colleagues for emotional support. This is useful when there are colleagues who have had similar experiences. If needed, allow the worker to talk about the event in a safe holding space amongst supportive colleagues and manage confidentiality. Some agencies have developed policies to provide individual counselling support for workers impacted by clients' death.
3. Consider a grieving ritual.
While death in personal relationships is accompanied by grieving rituals like attending funerals and memorial services, professional boundaries and client confidentiality might get in the way of the social worker's expressing grief. In some cases, the client might not even have family members to mourn his or her passing, leaving the social worker as the only link to this world. Supervisors might have to assist the workers to come up with alternative ways to say their goodbyes and find closure.
4. Promote self-care and self-compassion
Self-care, in general, can already be a struggle for many social workers. But, this is an important aspect of how we manage work stress. When coping with clients' death, self-care
is essential to bring the workers out of the abyss of self-blame and regrets over what they could have done better for the client.
Supervisors can be more cognizant to ensure that social workers are managing their daily self-care - are they eating and sleeping well, getting enough exercise or are getting back into their social routines? Supervisors may also need to remind social workers to practice self-compassion; to recognise and acknowledge that they have done their professional best for their clients.
Death is a naturally difficult topic to talk about. However, supervisors have a role to bring this to the surface to allow social workers to develop their competency and be comfortable when dealing with issues of death and dying.
You can read more about coping with the emotional aspects of a client's death. HERE
Read this article if you are a social work student.