End of life - Ideas for practice: Case study

The importance of social work support

Susan was a 56 year-old lady who initially came to the hospice in 2010 where she attended support and therapy and accessed social work support who liaised with health colleagues in order to maintain her independence in her own home. Susan was diagnosed with lung cancer and came to the hospice as an inpatient a number of times throughout her illness. Susan came to the social services department for support and guidance as she was concerned about the funeral costs and arrangements for her funeral. Susan was a Catholic and ideally would have liked a Catholic mass and burial at the local Catholic Church. She wished to be with her first husband and mother in their grave in the local area however this proved to be an impossible option. Susan and her family did not have any money to pay for her funeral. 

The social worker made several telephone calls to the local authority and confirmed that they wouldn’t fund a burial and therefore had no option but to agree to a cremation. They contacted funeral directors to identify whether any of Susan’s wishes could be met. The social worker felt that it was important for Susan to have the opportunity to speak to the funeral director who would be organising the funeral and for her to express her wishes with him and for him to make Susan aware of the options that were available to her and her family. The funeral director suggested that even though they were not able to meet her wishes for the burial, if she were to be cremated her ashes could be scattered at the grave. Her son agreed that he would help to remove the kerb stone at the grave and assist in scattering the ashes. It felt like although this was a compromise for Susan that at the end of the discussion she felt some peace due to the decisions that had been made and the opportunity she had had to express her wishes. Susan was able to take the lead in making decisions about her own funeral and meet some of this even though the finances were not fully available.

If it had not been for the social worker’s efforts in this, Susan may not have been able to die with the knowledge that her ashes would be with her mother and husband again.

This case highlights the need for social workers to promote independence and personal choice while recognising and being honest with individuals about the actual limitations and restrictions of availability of services and funding to meet their wishes.
All names and dates have been changed.