Thursday, November 18, 2010

What Do Hospice Social Workers Do?

November is National Hospice and Palliative Care Month -- a perfect time to explain the role of the hospice social worker as a member of the hospice care team. President Obama’s recent Presidential Proclamation for National Hospice and Palliative Care Month encourages all of us, including social workers, to engage “in activities that promote awareness of the important role of hospice care.” Many people, even if they understand the hospice concept, aren’t aware that hospice care is provided through a team approach and that social workers are essential members of the team.

Hospice social workers are part of the core services covered under the Medicare Hospice Benefit. Social workers, working with other interdisciplinary team members, address the physical, psychological, social, emotional and spiritual effects of a person living with a terminal condition. Take note here, I said living, not dying, with a terminal illness. Hospice provides quality, dignified and compassionate care for a person and their loved ones during a person’s final days of living.

When a hospice social worker visits an individual and his or her loved ones in hospice care, she or he begins by completing a comprehensive assessment. The assessment helps the social worker understand the needs, strengths and goals of the patient and family, as they cope with the effects of progressive illness, dying and death. Social workers do this by building trust and a relationship with the patient and family, during a time of crisis and vulnerability. With this understanding and trust established, the social worker can best help the family manage this difficult experience.

Patients and families can be devastated in so many ways by the dying and death of a loved one. Hospice social workers help meet a family’s basic needs by educating and advocating for the patient and family. The hospice social work interventions may include counseling and support to deal with loss, grief and bereavement before the death; helping patients and families deal with stress and conflicts; providing palliative care techniques for distressing symptoms such as depression, pain and anxiety; addressing ethical dilemmas; and providing visits and collaboration with hospice team members. Hospice social workers pay close attention to practical yet important matters, such as identifying financial and other resources to meet basic needs such as rent, utilities or medical co-pays for medications; assisting patients and families navigate health systems and benefits; and end-of-life planning including advance directives.

Hospice social workers do not function in isolation, but rather, with other team members including the patient, family, physician, nurse, chaplain, home health aide and volunteers, to best meet the patient and family’s goals. Hospice social workers often have an advanced degree in social work or a bachelor’s degree from an accredited school of social work. But being a hospice social worker takes more than special training; hospice social workers bring compassion and sensitivity to people experiencing loss and grief and a willingness to be present when someone is dying.

Hospice social workers often step out of direct care to provide leadership and education, and shape research and policy in hospice and end-of-life care across the local, regional and national landscape. As hospice social workers, we celebrate National Hospice and Palliative Care Month and are proud to contribute to the ongoing mission of providing quality end-of-life care through hospice.

Karyn Walsh, LCSW

HFA Social Worker