Motivational Interviewing in End-of-Life Care

Motivational Interviewing in End-of-Life Care

by Ellen Young

A social work intern grapples with a situation that would challenge even an experienced clinician: helping a loving wife decide whether to stop feeding her dying husband of 64 years.
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Betty: A Case Study

When Betty answered the door and welcomed me into her living room, I couldn’t help thinking she looked almost like a different person from the Betty I’d seen just the day before: a neatly dressed, very composed 80-year-old woman. Today, her clothes were messy, her hair was disheveled, and she had bags under her eyes. Her husband, Frank, was resting in their room after his morning nursing visit. He had been diagnosed with prostate cancer a year earlier, and the treatment had been unsuccessful. The hospice team of which I was a member had been called in to assist with the final few days of his life, which is why we had met Betty and Frank the day before.
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Ellen YoungEllen Young, MSW, CCLS, is a new grad of San Diego State University's School of Social Work. Ellen worked as a Child Life Specialist at Mattel Children's Hospital UCLA before returning to graduate school for her master's degree. While in graduate school, Ellen discovered her passion for medical social work, specifically with hospice and palliative care. Ellen is currently living in New Orleans, Louisiana, and hopes to continue working in the healthcare field, helping patients and families cope with stress related to trauma, illness, and end-of-life care. Ellen can be reached at
It never would have occurred to me to use MI with end of life issues. Thank you so much for this excellent article. I shared this with colleagues during a training and it was a valuable learning tool. Thank you.
Valerie C., R.N.
As an LCSW and Medical Social Worker for many years I have become interested in using motivational interviewing with end of life patients and families. This narrative gave me the inspiration to use the technique because I saw how it made this wife's life so much more peaceful when confronted with such a heart wrenching situation. I applaud this worker and what she did!
Elise Nerenberg
Compelling story of a difficult situation and use of MI skills to help the client with her ambivalence regarding feeding her husband. With so little written on this topic, this article makes a useful contribution to the MI and older adult care literature.
Melinda Hohman
a wonderful narrative of using MI in a unique situation; not often associated with MI techniques. it is a grave situation that would make even experienced clinicians feeling awkward and perhaps anxious I like the way that the author structured her story within the MI model. very useful. thank you.
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CE credits: 1
Learning objectives:

  • Apply MI concepts and techniques to an actual counseling session in a hospice setting
  • See MI strategies in action over the course of a conversation
  • Distinguish the flow of assessment and response in an ambivalent client through an MI lens
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