A study published in a social work journal, Practice, this week might well not be seen by palliative healthcare professionals, and is a good example of the small practitioner-type research studies that are coming out about social work. It describes a small study of middle-aged people bereaved within the past two years in a northern Ireland health and social care trust (in NI health and social care are always provided by joint trusts). Service users were socially isolated, they were not aware of whether full bereavement assessments had been done, and sometimes they hadn’t been, and this led them to fear that their ‘poor mental health status’ was undetected. Bereavement support was offered, but often not accepted, being offered at the wrong time, offering no choice of provider and participants not recognising their needs. Most people were helped by informal social networks or, occasionally, GPs. Where used, social workers were unanimously felt to provide good bereavement help, but were not always available.

What this, along with many other studies, tells us is that having a social worker is good for your service, provided that others know about it and what social workers can offer. Also, a bereavement service needs to be offered regularly, perhaps especially in the second year of bereavement when other help has dried up or people have only just realkised their needs. Enthusiasts for bereavement risk or need assessments will gain some encouragement from this study, since it shows that leaving it to people to refer themselves is at best haphazard. However, there is not a lot of evidence that bereavement assessments enable services to be targeted, and they are often done without involving the potentially bereaved person; regularly offering a consistently available service so that people can pick it up when they realise they need it might bring better rewards than trying to focus (or does that mean ration?) services.

Agnew, A., Manktelow, R. and Donaghey, K. (2008) User perspective on palliative care services: ewxperience of middle-aged partners bereaved through cancer known to social work services in Northern Ireland. Practice 20(3): 163-80.

Pics of the rebuilding works at St Christopher’s Hospice, in solidarity with colleagues who are working in difficult conditions, so that things can be better in the future. Fish shelter: the reflecting pool containing koi carp has been partially boarded over to protect the carp from falling masonry or something.