When asked to describe their role, many social workers will note the range of “hats” they wear to best serve patients and families. From identifying emotional and spiritual needs to supporting families as they navigate the Medicare system, the complexity of end-of-life care requires the skills of an expert educator, advocate, mediator and more.
During National Social Work Month, we honor the social workers championing these duties for the people they serve. We explored some of the roles of the hospice social worker, along with the support of Val Criswell, Emotional Support Team Leader in Kansas City and Leslie Brant, Emotional Support Team Leader in Atlanta.
Hospice social workers are essential in assessing and evaluating a patient’s circumstances from a problem-solving perspective. On an ongoing basis, they determine needs, goals, and support systems in the ever-changing landscape of a terminal illness.
“During the evaluation process, the goal is to find a roadmap to navigate an individual’s family dynamics,” says Leslie Brant, Emotional Support Leader in Atlanta. “A lot of this has to do with the medical decisions that have been made up until hospice, and how much information has been shared with and understood by the patient about the progression of their illness. We do constant reevaluation and reassessment. If the patient is living alone, we evaluate to see who might move in when extra support is required, if home care might be involved, assisted living, or nursing care. Once we see increased weakness, we help the family activate a plan.”
Social workers play a key role in identifying and teaching people the skills that could improve their circumstances, from budgeting to effective communication. Social workers must have a deep understanding of the resources available, where they are located and eligibility requirements.
“We are educators for the families, but we are also committed to educating ourselves about the resources in the community, and knowing where to turn, especially for Veteran’s benefits,” says Val Criswell, Emotional Support Team Leader in Kansas City. “If the patient is a Veteran, a lot of times they don’t know about the resources available. This can be an exhausting process for families, so we are there to provide support and guidance.”
In hospice care, social workers advocate for patients as they articulate their final needs, desires, and fears. They work hard to remember and remind others that patients are the best experts on themselves, despite medical professionals’ vast medical knowledge and experience. At times, social workers advocate for patients’ final wishes when they are unable to speak for themselves due to their illness or other circumstances.
Val Criswell explained the social worker’s role as an advocate for family members: “We provide education, and we identify the resources, but we want to empower the families, and play the role of an advocate to accomplish this. A lot of times when people enroll a loved one on hospice, they can feel like they’ve lost control. It can be very frustrating for families to navigate through the Medicare system. A lot of times our role involves connecting families with the resources they need to help their loved one themselves.”
Social workers are also tasked with taking on role of facilitator and mediator. They may address conflict between the patient and the family, or between the family members themselves. While the goal of hospice social workers is not to "fix" families with long histories of conflict, they must find a way to work with all members of the family to continue to promote the best goals of the patient within a safe environment.
“Family members may want to tip-toe around Mama, but Mama has to live in her body and knows what she needs much of the time,” explained Leslie Brant. “Sometimes it’s the facility that has an expectation for the patient that is not appropriate. This is a time when we have a care plan conference with all team members involved in a patient’s care, and talk about expectations around issues like food, physical activity, and medication. It’s a continuous process of education and chipping away at some of these issues while maintaining the best interests of the patient.”
Most importantly, social workers teach people to accept their emotions without guilt by normalizing their specific feelings about the situation and their loved one. Social workers provide support at the bedside, particularly during the dying process.
Val Criswell shared, “People have the right to choose their journey and the end-of-life. If they are of sound mind, we have to support their choices. We are joining them on this journey, and we are privileged and honored to be in this position. We are validating people’s emotions, feelings and decisions. We get to be part of a very beautiful, private end-of-life experience and form very meaningful relationships with the people we care for.”
Continue to celebrate National Social Work Month with Crossroads Hospice as we honor the 2014 recipients of the Caring More Award on our Facebook page! We’re excited to share the stories of these 11 evaluators, educators, mediators, advocates and validators who are doing more for patients and families each day.
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