The increase of treatment options at the end of life: impact on the social work role in an inpatient hospital setting.

Treatment choices for cancer patients are becoming increasingly complex as medicine advances and doctors are able to offer more treatment options at the end of life. Research data shows that 22% of all Medicare patients start a new chemotherapy regimen in the last month of life. In a study released in 2004, data showed treatment within two weeks of death has increased from 13.8% to 18.5% over a period of three years. Treatment options should be presented to ensure that the final treatment decision made is optimal and encompasses the patient's wishes, prognosis, financial barriers, and familial support. In this article we explore three case studies where patients and families were faced with the challenges of making treatment decisions at the end of life and the importance and impact of the social work role in the multidisciplinary team. An inpatient social worker can assume a leadership position to assist patients and families in navigating the health care system and with difficult treatment options.