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Skip to 0 minutes and 10 seconds I think it’s been so hard for patients and their families. I think for the patients, they’ve not really had the opportunity to really articulate how they’re feeling about things, because I’ve not had the chance to go up and see them. I really love my role in that people see nurses and doctors every day and when they get a bit better, I’ll come and visit them and I’ll sit with them, and I’ll ask them how they are. But they usually think that I’m referring to how they’re feeling because of their medical conditions, not how they actually feel in themselves as a whole.

Skip to 0 minutes and 50 seconds So when I do, these people usually do confide so much more in me than what they would to other professionals, and they’ll be things that we weren’t even aware of that’ll just prop up. And I remember yesterday, I was speaking to this lady, and people had stated that sometimes she could be quite difficult to work with. But we ended up talking and she was– she went and she was holding my hand, and we’d found out that– she told me that two of her sons had died when they were really young and that her eldest son was still alive, but didn’t really have much of a relationship with her.

Skip to 1 minute and 31 seconds And she said that due to this, she didn’t feel that her life was worth living anymore, and no one would have known that’s why she might be behaving the way that she was with people. She just– I don’t know, she just had stopped engaging as much, I think, and didn’t really trust people because she felt, like, such an incredibly large sense of loss from her two sons dying before she did.

Skip to 2 minutes and 5 seconds These are the things that really matter to people, and if you know what’s really making them behave or think in a certain way, you can provide appropriate support that’s generally going to help them, that’s not going to act as a plaster– that’s actually going to have a meaningful impact on their life. So I think not having that time to go through with people what’s actually making them feel a certain way impacts on kind of the quality of care that they’re going to get.

Skip to 2 minutes and 40 seconds Also, what I’ve noticed is that people’s carers similarly feel very conflicted about whether they should be visiting relatives in order to provide care and support, or whether they should be staying away because they’re very scared that they’re going to infect them or they’re going to potentially pass on COVID-19 without realising that they even had it.

How are you feeling? It depends who's asking

In this video Sharna describes the unique position of the social worker. Not the same as a doctor or nurse, who patients may expect to be interested only in their medical prognosis. But not the same as a family members either, with whom they might not have the type of relationship in which they share intimate details about themselves.

From this unique position - a trusted professional, separate from the family, but not entirely in the world of the medical - Sharna’s curiosity elicits a powerful and useful response from her patient, providing insight into the familial loss and separation that can sit behind a seemingly “difficult” patient.

As we’ll hear next from Dr Scanlan, staff working in care homes can also find themselves in unique and important positions when it comes to holding expertise and intimate knowledge of a patient nearing the end of life.

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This video is from the free online course:

Grief, Loss, and Dying During COVID-19

The Tavistock and Portman NHS Foundation Trust

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