The Need to Revise Assumptions about the End of Life: Implications for Social Work Practice

During the 20th century the experience of dying changed dramatically. At the beginning of the 1900s, dying and death were integral parts of the life experience of most people at any age. Many deaths occurred at home following a short course of illness largely unaffected by the limited medical care available. At the beginning of the 21st century, in many cases, the process of dying has become invisible. Today, most deaths occur in old age. Social workers have a key role as "context interpreters" in helping people at the end of life and their families understand the natural course of the illness, the process of dying, and the advantages and drawbacks of medical interventions. An expanded role for social workers in helping people comprehend the medical and social contexts within which they face end-of-life decisions is discussed.