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Agency Placement Observation Report

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Report of Agency Observation This report was based on an actual 8-day observation placement in a hospice. For confidentiality purposes, the hospice will be referred as XY Hospice and it is located in England's northeast region. The main purpose for this observation was to explore the organization and delivery of social welfare services, and to understand and assess the function of a social welfare agency. This report attempts to provide a reflective and critical analysis of the organizational context of the service rendered, and the influences this has on agency practice. This paper begins with a brief description of the hospice itself, it then explores the territory that specialist social work occupies in palliative care and outlines its contemporary position. This is followed by critical reflection from a social work student's perspective on some key concepts of the related policy, and the legislative framework supporting the whole issue. It then discusses the experience of a service user that receives the provided service for more than five years and, finally, contemplates the role of the agency in providing palliative care within the local community. Hospice movement is often associated with special concern for the needs of dying people and those close to them. According to a leading charity supporting hospice care throughout the UK, Help the Hospices (2009), "hospice care aims to improve the lives of people whose illness may not be curable. It helps people to live as actively as possible after diagnosis to the end of their lives, however long that may be." More than anything else, however, hospice is a philosophy about caring for others. It is an "attitude towards providing a particular type of care to those who are terminally ill and their families" (Hayslip and Leon, 1992:2). Although the concept of hospice dated back to medieval times in Europe, existing literature frequently locates the origin of modern hospice movement in the work of St. ...read more.


With cancer and Motor Neuron Disease (MND) cases received the highest referrals; XY Hospice strives to provide three major services - hospice at home, day care and in-patient care. Hospice at home is provided for people needing a sitting service, practical nursing help and counselling. Day care is provided for the local community within the hospice local area. It offers a range of treatments, therapies and activities. Services such as massage therapy, acupuncture, aromatherapy, reflexology, special bath, library, hairdressing and manicure are used to complement the treatment provided for patients. The hospice's in-patient unit has 6 community palliative care beds. The unit provides respite care, pain and symptom management for patients on its own. This means that some patients will have local access to beds, while at the same time retain contact with their regular District Nursing team and their own General Practitioner (GP). This encourages continuity of care with easy access to the Specialist Palliative Care Team (Consultant in Palliative Medicine and Macmillan Nurses), at the hospice. During the reflection on the writer's observation placement in XY Hospice, he remembers having the interests in knowing the best practice theory or methods in dealing with death and dying. Albeit sporadically documented, there is little doubt that "Kubler-Ross is the most familiar name associated with death and dying" (Walter, 1994). Kubler-Ross's (1970) five stage theory of dying has placed great importance on understanding how dying persons cope with their terminal illness and eventual death. This stage of dying consists of (i) denial (ii) anger (iii) bargaining with others (God) in order to prolong life (iv) depression and (v) acceptance. With this five-stage model, Kubler-Ross (1970) never purports a linear process of dying, yet the strong normative strand that exists in her work goes beyond description to give a prescriptive course of feelings, and hence has been opened to misuse in practice (Walter, 1994; Corr, 1993). ...read more.


Sharing the experience, he expresses his frustrations when his wife abandons him after the bleak diagnosis. Blessed with two children, he is currently living with his son who is also a carer. The optimism in viewing his life starts to afloat, when he was first referred to XY Hospice by his GP. He received several counselling sessions and the much needed support from everyone in the hospice. Although from the nurses' reports his condition is deteriorating every week, Jonathan never regrets or expresses his sadness anymore compared to before. He come to the hospice twice a week for a daycare session and enjoys the acupuncture therapy provided by a professional registered acupuncturist. In Jonathan's own word, "the services and facilities in this hospice made me quickly feel that I was appreciated and very much alive." With a natural setting of beautiful landscape surrounding an old English bungalow, the XY Hospice has successfully created an ambience in which the patients can find comfort and solace as if in their own home. It is apparent that, the hospice is at a distinctive juncture both in providing treatment and making the patients comfortable. Clearly, it attempts to ease patients in trying to adjust with the practical, psychological and emotional changes in an unfortunate event of a terminal illness. For more than 23 years, XY Hospice has provided a great service to the local community. Gradually, the premises and facilities have grown alongside with the quality of service that they have offered. Likewise, the short observation placement has provided the writer an opportunity to experience and be part of a dynamic team that is championing the cause for end of life care. The observation also provided an avenue to learn about death and bereavement issues within a different setting and culture, distinct from the writer's. Indeed, the writer will treasure the words uttered by a bereaved man who expressed his gratitude to the hospice, "When I came here, I found empathy, not sympathy", and that was enough to prompt the writer to reflect and ponder about the new dimension in appreciating the quality of life. ...read more.

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