Discovering people’s strengths and resources at the end of life

On the 90th birthday of pioneering palliative care social worker, Elisabeth Earnshaw-Smith, we are delighted to republish this earlier post, which we hope will stimulate the thinking around the family and social model in palliative care. And you can download a free copy of the full-text article to which it relates from the archives of the European Journal of Palliative Care…

David Oliviere, Social Worker, Counsellor and Educationalist, describes the influence of Elisabeth Earnshaw-Smith on social work in palliative care – a backgrounder to David’s longer article in the January/February 2018 issue of the European Journal of Palliative Care.

David Oliviere

Who was it who held out their hand to show you the way into palliative care? Who held your hand maybe to teach you the skills to weather hard moments? Who had trodden the path before you?

Most of us know someone who acted as a mentor, as we learned the craft of palliative care, who inspired us, who went the extra mile in believing in us and gave us the confidence that we could do it!

For me, when I was appointed to set up the social work service at the North London Hospice in 1985, it was Elisabeth Earnshaw-Smith, first Director of Social Work at St Christopher’s Hospice, London.

“Palliative care is all about discovering people’s strengths and resources” Elisabeth told me when I entered the field. She was appointed by Cicely Saunders in 1979 and set about creating a family approach to psycho-social palliative care that has now spread worldwide. Her pioneering work is at the core of what it is to be a palliative care social worker and was further developed by the multi-professional team at St Christopher’s. The team that made ‘the family as the unit of care’ a reality through strategies from family therapy practice, such as family trees/genograms, family meetings and emphasising the part family dynamics play in the crisis of illness, death and bereavement.

Naming ‘the elephant in the room’

Elisabeth influenced not only the multi-professional team at St Christopher’s but also other palliative care workers through her teaching and publication. Several doctors and nurses have told me how she inspired and influenced them. Dr Tony O’Brien, Consultant Physician in Palliative Medicine, Cork, Ireland, talked about Elisabeth as the first social worker he had met and about her skill in clinical meetings in naming the unspoken, such as unacknowledged feelings in families and staff (O’Brien, 2013).

Elisabeth Earnshaw-Smith: her pioneering work is at the core of what it is to be a palliative care social worker.
Photo with kind permission of Elisabeth Earnshaw-Smith and the Association of Palliative Care Social Workers.

Elisabeth, the person, the professional

As the number of palliative care social workers grew in the UK through the 1980s, Elisabeth saw many colleagues into the work and ‘strengths and resources’ became a sort of mantra. She initiated the Association of Palliative Care Social Workers; she empowered many of us to speak and write about our emerging work. She consistently affirmed our input.

Elegant, her characteristic white hair in a bun, speaking the Queen’s English precisely and displaying impeccable social skills, those of us young social workers giggled that we were in the presence of royalty! After her retirement, I continued to meet her in the Charing Cross Hotel, London and, over cucumber sandwiches (where we and others had created the constitution for the professional Association), listened to her wisdom and advice about the world.

In the past few years, Jo Hockley, ex-colleague nurse and I have been visiting Elisabeth in her nursing home where, at 88, she receives excellent compassionate care and family support, the sort she advocated …

Palliative care social work

Social work is a crucial window on the world of palliative care. Social work’s view of the patient, in their social context, brings a vital, often refreshing and unheard perspective to the assessments and interventions offered by the multi-disciplinary team. The social worker is so often at the interface between the clinical team and the social world of the patient, their relationships, networks and resources (Earnshaw-Smith in Clark et al, 2005; Oliviere, 2001).


Clark D, Small N, Wright M, Winslow M, Hughes N (2005) A bit of heaven for the few. An oral history of the modern hospice movement in the United Kingdom. Lancaster: Observatory Publications, pp 163-166.

O’Brien T (2013) Social Work: looking inwards; looking outwards. Paper EAPC Congress Prague.

Oliviere D (2001) The Social Worker in Palliative Care – the ‘eccentric’ role. Progress in Palliative Care Vol 9 (6): 237-241.

Links and Resources

Read the full article in the European Journal of Palliative Care (free access to all)

This post relates to ‘Social Work in Palliative Care: the influence of Elisabeth Earnshaw-Smith. Discovering people’s strengths and resources at the end of life’ by David Oliviere published in the January/February 2018 edition of the European Journal of Palliative Care (EJPC) (vol. 25 (1). The entire archive of the EJPC – from 1994 to 2018 – is now available to access free of charge. Register here and then choose the year, issue and article. 

Read more posts relating to articles published in the European Journal of Palliative Care on the EAPC Blog.

This entry was posted in Bereavement, EAPC-LINKED JOURNALS, European Journal of Palliative Care, INTERVIEWS & TRIBUTES, PATIENT & FAMILY CARE, PSYCHO-SOCIAL ISSUES, Social work and tagged . Bookmark the permalink.

1 Response to Discovering people’s strengths and resources at the end of life

  1. Pingback: Elisabeth Earnshaw-Smith and Palliative Care | CanSupport

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