VIGNETTE

Joan has end-stage heart failure. She hopes to be cared for at home as long as she can but is unsure how she will cope as she lives alone. Joan has a partner, Richard. They live separately; Richard lives in a flat adapted for his disabilities. Joan is also supported by an ex-partner, Margaret and Margaret's daughter Tracey. They lived together for 15 years from when Tracey was four years old. Tracey thinks of Joan as her second mother; she is now married with small children and they see Joan and Richard as another set of grandparents. However, Richard and Margaret have not always got on together. Both Richard and Margaret want to move in with Joan to support her. This would be difficult for Richard due to his disabilities; he has contacted his social worker to see what could be done to assist them to support Joan.

How might social workers support Joan and the people closest to her?

Introduction

Social workers support vulnerable people at critical times in their lives. This can include supporting people at the end of life, which could be said to be one of the most critical times in someone's life. There is just the one chance to get things right for both the individual who is dying and those close to them. In the United Kingdom (UK), the importance of end of life care (EoLC) for social work practice is now included in the Professional Capabilities Framework (Social Work Reform Board, 2012). EoLC should be an everyday part of social work and social care practice rather than being an exclusive domain allocated to palliative care social workers (NEoLCP, 2010, 2012a). Social workers, for example, have the expertise to support the people surrounding the individual at the end of life, that is, anyone the individual regards as being important to them, which is central to any EoLC support provision. At times when there are divergent or conflicting perspectives on the needs of the dying person, social workers can exercise their skills in mediation and negotiation.

There is scant research that addresses EoLC experiences of lesbian, gay, bisexual and trans (LGBT) individuals (Harding et al, 2012) to develop evidence-based social work interventions for this client group. Nevertheless, sexual orientation and gender identity are identified as issues of social difference in relation to EoLC (DH, 2007; Cox, 2011).