Social workers discuss importance of advance care plan

Apr 15, 2013

By Paul R. Pace, News staff

Deborah Waldrop understands the importance of discussing health care decisions before a crisis occurs, and she encourages social workers to take advantage of National Healthcare Decisions Day on April 16 by helping their clients with advance care planning.

“By providing information and promoting conversations, NHDD has the potential to facilitate powerful changes on how and where people die,” said Waldrop, professor and associate dean for faculty development at the University at Buffalo School of Social Work. “I spent many years working as a hospital social worker and experienced too many situations in which people had not told their families what they would want at the end of life. These situations all too often ended with families making decisions based only on what they ‘thought’ the person really would have wanted and leaving them with doubt about whether they were doing what their loved one wanted.”

Waldrop said such scenarios bring about uncertainty for family and friends, which can lead to feelings of guilt and self-doubt.

“Having conversations about end-of-life wishes well in advance of the death can ease the dying process for people and their families,” she said.

NASW is once again sponsoring NHDD, a campaign — now in its sixth year — that encourages adults with decision-making capacity to engage in advance care planning.

Visitors to can learn more about the education campaign and ways to get involved as well as download advance care directive documents and other resources.

Waldrop said she advocates for adults to have a health care proxy.

“Health care proxies are about choice and assuring that if you cannot speak for yourself, there is someone who knows what you would want and can advocate on your behalf,” she said. “Second, I would suggest that advance care planning is a specific process that fits more broadly within conversations about ‘goals of care.’

“Goals of care can be viewed as a more whole life perspective — that begins with asking the question, ‘What is important to you?’” Waldrop said. “The answer may not be immediately related to end-of-life care but, rather, related to being able to remain at home or to be present for a specific event.”

Waldrop suggests anchoring discussions of specific documents — such as advance directives, medical or physicians’ orders for life sustaining treatment and do not resuscitate orders — within the context of what the person knows.

Kathy Black

Kathy Black is another social work educator involved in aging issues. She is associate professor of Social Work at the University of South Florida Sarasota-Manatee and focuses her research on advance directive communication in gerontological practice.

She said research shows that social workers have important roles in advance care planning. For example, a social work education provides:

A strong value base that instills the primacy of client self-determination; substantial knowledge in human needs throughout the life course; and practice skills in which to assess and intervene in facilitating ACP needs with clients, their families and the broader network of care providers.

“Increasingly, social workers are developing advanced practice skills in these areas through such undertakings as the NASW Certificates in Aging and in Palliative and End-of-life Care,” Black said.

She added that social workers have been instrumental in helping older adults understand advance directives.

NASW is promoting the 6th annual NHDD through its SectionLink and MemberLink as well as through its blog, Facebook and Twitter accounts and through information sent to its 56 chapters.

NASW’s consumer website,, includes a section on advance care planning:

From the April 2013 NASW News.

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