Gerontological social workers and end-of-life care in South Korea
Kwon, Sung Ae
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This dissertation has examined the attitudes and tendencies of geriatric/gerontological social workers regarding end-of-life care issues and their willingness or intention to provide end-of-life care in a large metropolitan area of South Korea. The findings of this study indicate that geriatric/gerontological social workers have little or no education or training on end-of-life care issues, especially about advance directives. The social workers tend to agree on the need for end-of-life care in geriatric/gerontological institutions and show a moderate willingness to address end-of-life care issues for older adults. However, they feel they are not ready or prepared to provide psychological, psychosocial, or emotional support within the area of death and dying. Participants in this study tend to have a positive attitude toward hospice care and advance directive planning and prefer not to use sustaining treatment during the last stage of life. Moreover, the study found that people emphasize self-determination in end-of-life care decision-making and value the principle that one’s wish is regarded as the most important factor when there are conflicts between oneself and a family member. By contrast, half the respondents in this study still prefer a family decision-making process, and some even want to exclude the patient from the process to protect him or her from feelings of fear or abandonment. In addition, because of the cultural influence related to death and dying, social workers generally feel uncomfortable talking about death with elders and worry that such a discussion might cause distress to older adults. This study refocuses and readdresses the issue of end-of-life care decision-making (individualism versus collectivism) and disclosure of diagnosis of a terminal illness. It also raises a concern about the discrepancy between the social workers’ professional values, the ethical principle of self-determination and the traditions of Korean culture. The findings of this study suggests the need for an educational and informational program for social workers to achieve competency in end-of-life care, as well as education for the general public, in order to bring the topic of death and dying into the public arena and promote familiarity with the concept and practice of end-of-life care.