Exploring palliative care debates: Equitable access and the role of social workers

Abstract

INTRODUCTION: Equity of access to palliative care for older adults and the role of social work are interwoven as older adults are the largest population group requiring end-of-life care and hospice social workers predominantly work alongside older adults. This article explores the intersections of palliative care policy and practice, older adults’ inequitable outcomes, Te Tiriti o Waitangi (1840), and challenges faced by social workers seeking to be effective advocates for older adults. APPROACH: Undertaking post-graduate study in palliative care allowed for an exploration of the literature and older adults’ experiences of inequity observed in practice through a social work lens. Literature reviews completed during post-graduate study foreground the literature search informing this article. The literature search was completed using University of Canterbury Library and CINAHL Health sciences databases focused on palliative and end-of-life care, older adults and caregivers. Keywords used included literature reviews, palliative or end-of-life, older adults or elderly, caregivers or family, psychosocial, New Zealand, caregiver distress, and ageism. Abstracts of articles were reviewed; literature was chosen based on relevance to the topic. Additional literature was sourced through Google Scholar, Google searches of current proposals/reports, and international databases. CONCLUSIONS: The current Aotearoa New Zealand Ministry of Health (MoH) (2001) Palliative Care Strategy does not effectively respond to older adults’ end-of-life care needs or acknowledge the roles and contributions of social workers within palliative care. Improving older adults’ equity of access to palliative care requires interlinking and prioritising older adults’ end-of-life care and empowering the contributions of social workers.