EP 135: Dying My Way: Living with Dignity When Facing Serious Illness and Death

NASW Social Work Talks Podcast

In this powerful episode we chat with , palliative care social worker Dr. Arden O’Donnell, PhD, MPH, LICSW, APHSW-C about what it means to live—and die—according to our values. Dr. O'Donnell shares insights from over a decade of work supporting patients and families facing serious illness. The conversation examines the vital role of palliative care social workers in helping people navigate complex medical decisions, communicate their wishes, and maintain dignity at the end of life. Through real-world experience and reflection, Dr. O’Donnell discusses why early, honest conversations matter and how dying can be a conscious, meaningful part of living.

December 16, 2025

Read a transcript of episode 135

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More about HPCC
HPCC is the only organization that offers specialty certification in hospice and palliative care.  The APHSW-C® recognizes bachelor’s and master’s level social workers with experience, specialized skills, and competency in hospice and palliative social work. The certification assures the public that certified practitioners have the knowledge and skills to provide safe, high-quality care at an advanced level. 

Investing in the certification for social workers reinforces HPCC’s overall mission as the premier national credentialing organization that advances expert care in serious illness through state-of-the-art certification of continuing competence in hospice and palliative care and research.

There are currently over 800 certified with APHSW-C® credential.

Why I do this work
by Arden O’Donnell, PhD, MPH, LICSW, APHSW-C

As a palliative care social worker, my days are spent helping people find meaning while living with serious illness, supporting their families and caring for a team who measures success not in days added, but in the quality and dignity of each one.

This occupation is not conducive to light, surface-level conversations at parties or at the gym.  When I do tell people what I do, the most common question is “How do you do that work?”  And some days, I question that myself, but most days I know-- I don’t focus on the losses, I focus on the gains.  Even on the days my heart is battered and bruised, I leave work grateful to see my work as a calling rather than a job.

In the sea of endless helplessness, I find meaning in the various roles I can play.

A nameless usher, offering guidance and support for a small section of a very dark road, allowing space for the questions of “why me?” and “what if?”

A patient listener, knowing that acceptance of mortality comes slowly,
transforming through disbelief, anger, shock, denial, despair, hope, and finally acceptance. A witness, to the crushing blows delivered by white coats when they say, through averted eyes, “We have done all we can do.” I stay when the doctors leave—to console, to decipher, to hold the disbelief. A translator, decoding and reframing the sterile language of hospital culture. An advocate, smoothing the sharp edges of grief; asking the questions families don’t yet know to ask, trying to spare them a few “what ifs” that might haunt them in the early morning hours to come. An advocate, endeavoring to smooth the sharp edges of grief; I ask questions the family does not even know to ask- attempting to spare them a few “what if’s?” from the grief-stricken, early morning haunting’s their future will inevitably hold. 

After over a decade in this work, I feel at home.  The words flow freely, my compassion is genuine, and I am confident in the comfort I provide. And yet, the quiet consequences of this work; some mornings, my mind twists a sore throat into a clear sign of terminal cancer.

The ‘patients’ I learned the most from are those who lived their lives to the fullest until they could not.  Those who have found peace in the simple acceptance of a complex situation.  These individuals accept their fate in time to look back on their lives – they taken inventory, celebrate their accomplishments, tell people they love that they love them, ask forgiveness, and most importantly especially-- forgiven themselves by accepting that they are human.  They say, and believe, that they have lived a good life. They mourn what they will miss, write letters to future grandchildren, and allow themselves to be angry. They endure treatments that cause pain for a few more months, and they desperately wish they could stay longer -- but in the end, they accept that their dying is can be a conscious part of their living. There is little drama at the end because they have spoken to their loved ones, and everyone is clear on how they wish to spend their last days.

It is these people who answer the question of how I do this work. It is an honor to usher, to listen, to witness, to translate, and to guide. I honor them and learn from them. They inspire me to live fully—and model what it means to die with dignity.

I want to die with dignity

I want to die with dignity,

under a handmade quilt

sewn by someone who loves me.

I will not shrink into the white hospital sheets

with no trace of the life I lived.

I want to stand at the edge of life and death,

spirit shining through my eyes,

with a knowledge that I gave what I could,

feeling a clear unwavering pride

about the life I lived.

I want to be the patient who has the power

to wiggle through the boundaries of medical speak and latex gloves

to touch the humanity in those who care for me.

I want to take my last breath and let go,

without clinging to my ego’s version of my life story.

Fully knowing that my death,

is as important as my life.

Resources:

Educating Social Workers in Palliative and End-of-Life Care (ESPEC) – NASW
https://www.socialworkers.org/espec
Educating Social Workers in Palliative and End-of-Life Care (ESPEC) is an innovative training program designed for social workers, by social workers, to promote the integration of primary palliative care skills into clinical practice.

Mirrors and Windows: Reflections on the Journey in Serious Illness Practice
Edited by Terry Atilio, Anne Kelemen, Vickie Leff, Artika Moore Patneaude.
https://www.amazon.com/Mirrors-Windows-Reflections-Journey-Practice/dp/B0BW2CNP1F

CAPC Toolkit
https://www.capc.org/toolkits/social-work-palliative-care/
Social Work in Palliative Care – Tools and Resources for Social Workers – CAPC

Serious Illness Conversation Guide
https://www.ariadnelabs.org/wp-content/uploads/2023/05/Serious-Illness-Conversation-Guide.2023-05-18.pdf

High-quality patient-centered palliative care: interpersonal team members’ perceptions of social workers’ roles and contribution
https://www.tandfonline.com/loi/ijic20
Arden O’Donnell, Judith Gonyea, Taylor Wensley & Megan Nizza (2024); 38:1, Journal of Interpersonal Care; 38:1, 1-9,
DOI:10,1080/13561820.2023.2238783.