Impressionism -Capturing Feeling &

Experience

Betsy Sajish and Kim Hobbs

Presentation Contents3 case studies

● Oncology SWs see patients at various vulnerable points of their cancer trajectory

● Cancer leaves a deep imprint, one which can be felt for generations

● In SW interventions we don’t just talk about cancer we talk about all parts of patients’ lives

3

● Cancer shakes up people’s lives, sometimes for the better

● Purpose and meaning are important in anyone’s psychological functioning

● Each patient’s journey is unique and requires individual assessment and tailored intervention

4

OSWANZ

● Learning Platform

● Enabled upskilling & Learning from others

● Incorporate new skills into practice

5

Presentation Contents3 case studies

Case 1 - WC

Impact of cancer diagnosis and poor prognosis on meaning of life and

changing priorities

7

Mr. WC

8

Relationship breakdown- post diagnosis

SW

Mr. WC● 66 y/o, retiree● Divorced with 2 adult sons● Lives alone in own home● Diagnosed with pancreatic cancer 2

years ago● Worked in infrastructure construction

9

Mr. WC● 1 of 7 siblings● 1 step sister● Father died when Mr. WC was 17● Father had alcohol dependency

● Father ‘nasty’ to Mr. WC step-sister

10

• Grieving the loss of his “lady friend”

• Focused on re-establishing the relationship

• Reflected on his childhood experience and how it shaped his life.

• Dignity therapy- to pass on his learning to his sons._

11

Dignity therapy• As a young boy the things that shaped me the most…

• And when my boys mother left…

• Things that I want my family to known about me• The most important roles I have played in my

life(family/Vocational/ community service)…• My most important accomplishments and what I feel most proud

of…• I feel the need to say to my loved ones, or things I would want to

take the time to say once again…

• My hope and dreams for my loved ones…

• My most important learning about life I would want to pass onto others

• The word I would like to offer to my family in order to provide them with comfort or solace…

12

Case 2 - RD

From patient’s needs to family needs; shifting focus across the cancer journey

13

Mr. RD

14

Mood and suicide risk assessment

SW

Mr. RD● 47 y/o, single, never married● Was employed as a truck driver● Eldest of 3 children● Living with parents for past 12 years

15

Mr. RD● Dec 2002, 32 y/o● Sore joints, fatigue,

burning discomfort in arms and back, nausea, memory loss, general malaise

● Recommended bone marrow biopsy –lost to follow up

● Sep 2017, 47 y/o● Similar symptoms● Multiple specialist

consultations● Presumed

psychiatric diagnosis

● Final Diagnosis: Amyloidosis

16

Mr. RD● Mood & Suicide

risk assessment● Financial

concerns –Centrelink Benefit

● Demoralised and disengaged with staff

● Verbally abusive towards parents

● Coordinate liaison and consultation with treating team and psychiatry

● Support and information provision for parents

● Parents:● Drew his

well● Discussed

funeral● Discharge

planning

17

Case 3 - JM

Carer to bereaved and finding purpose after it’s over

18

Mrs. JM

19

Son diagnosed with cancer and moved back with JM

SW

Mrs. JM - Son● 51 y/o, single, never married● 15 y/o daughter, minimal contact● Diagnosed with Hepatocellular Carcinoma● Secondary to liver Cirrohosis● Secondary to ETOH and Hepatitis C● Moved from QLD to NSW at diagnosis● Died 13 months after diagnosis

20

Mrs. JM● 83 y/o, widowed● Lives alone in Dept. of Housing● Receives aged care services at home● Hearing impaired, no vision in left eye● Multiple chronic health conditions:

cardiac, lung, arthritis, vertigo

21

Mrs. JM● Only child● Mother – alcohol dependent● No maternal figure● 6 wk – 9mo resides in Tresillian due to

malnutrition● Struggled all life with abandonment● Father (non-believer) introduced her to faith,

Catholic Church- “Our Lady of Lourdes” becomes surrogate “mother figure”

22

Mrs. JM● Widowed past 20 years● 6 children● 1st daughter’s husband was alcohol dependent,

committed suicide● 3rd son died few days after birth● 5th son (patient) – alcohol dependent, cancer

diagnosed at 51● JM self-referred to Oncology SW

23

Mrs. JM● Concerned

about son returning to live with her

● Concerned with own safety

● Information seeking about alternate accommodation service for son

● Grief & Loss● Witnessing

son’s deterioration

● Identified Role: Be his mother and love him

● Bereavement & loss of purpose

● Revisiting/ reliving previous bereavement –husband + newborn son

● Introduction of bibliotherapy: ‘The Four things that matter the most’ ~ Ira Byock

24

25

“I love you”

“I forgive you”

“Please forgive me”

“Thank you”

Conclusion

27

Client

Value EthicPractice Standard

TheorySkills

Oncology

Palliative Care

Cancer Trajectory

Bereavement

End of Life

Carer Stress

Self Care

NDIS

Human Services

MAC

NGOsPeak

Bodies

OSWANZ

● Flexible in their thinking

● Able to individualise intervention

● Shift focus from patient to family, to other service providers (as needs present)

● Incumbent on Oncology SW to be a lifelong learner

28

Social Work is seldom routine and involves working with people, all of

whom are unique, in situations that are complex, frequently messy and obscure, rarely easy to understand

and almost never amenable to standardised or prescribed responses

~ Yelloly & Henkel 1995

29

Impressionism Capturing Feeling &

Experience

Footprints

Thank You