Social Work in Advance Care Planning During Advanced Chronic Illness and End of Life: a Systematic Review

Abstract

Advance decision planning (ADP) is a process that helps people with decision-making capacity to understand and share their personal values, life goals and preferences regarding future health care. The intention of the PAD is to ensure that people receive health care consistent with their values, goals and preferences. The purpose of this review has been to provide a narrative synthesis of evidence on social work perspectives and experiences of advance decision planning during advanced chronic illness and end of life. Six databases were searched for peer-reviewed articles published in the last ten years, in English or Spanish that included social workers as a full sample or as a sub-sample. All relevant studies were reviewed and the results synthesized thematically. 21 studies met the eligibility criteria. Six thematic domains were identified: attitudes towards ADP, knowledge and training, role as a member of multidisciplinary teams, participation and goals, intervention effectiveness, and barriers and facilitators. The results indicate that social work contributes to the increased rate of care planning conversations and increased completion of the deliberative process in signing documents with comfort reports. To understand the complexity of social intervention and social work, further studies are warranted in different care settings, different socio-cultural contexts and with different chronic illnesses.