Defining the Indefinable: Hospice Social Workers

What do you think of when you think of a social worker?

Some people think that social workers remove children from their home. Some may think that they only get involved with families of lower socioeconomic status. Still others might think that they are going to force your loved one into a nursing facility.

I work as a hospice social worker for Crossroads Hospice in Kansas City, MO, and I’m here to tell you the truth: social workers are available to help patients and families get the best, most appropriate care possible.

Sometimes it can be difficult proving a social worker’s worth to new patients and families if they don’t need to be connected to resources and don’t have any family “issues.” A patient’s husband once asked me very directly what I could do for him; what exactly my role was. Even after working in medical social work for over six years, it can be hard for me to verbalize concisely what a social worker does. I can say for certain, however, that every family on service with hospice could benefit from a social worker’s services as they navigate a new world of learning what is hospice care.

One of the easiest ways to build rapport with a family and prove our worth quickly is to connect people to community resources, which is something I strive to do with our patients’ families.

I once had a patient with cancer who was a Veteran connected with the localVeterans Affairs (VA) hospital. The patient was rapidly declining and could benefit from some extra caregiving in the home, but could not afford private caregivers.

Social workers would be able to offer this patient many resources, and the one that helped him was theHomemaker/Home Health Program through the local VA. This patient received about 12 hours per week of care with a personal care assistant through a local private-duty caregiving agency, paid for by this VA program. This family had no idea that such a program existed, until they worked with a hospice social worker.

Social workers are meant to be advocates. Our job is to fight for the patient’s rights and goals. If patients are of sound mind and wish to remain in their home versus going to a long-term care facility, a social worker will advocate for safe ways for that patient to maintain their goal of staying at home. With our Veteran patient, the family, patient and social worker were able to find ways to help the patient remain safely in his home, and maintain his quality of life.

But what if a patient and family have no concrete needs like this? How can a social worker assist them? Like I said before, our services aren’t specific, but they’re versatile and flexible, so they’re applicable to many situations.

For example, I have a patient whose goal in life is to make someone smile every day. He has a limited social support network and some days has no one with which to communicate. I visit this patient regularly and he tells me jokes and funny stories and we laugh.

The simple act of listening, engaging and laughing helps this patient have a purpose in life and gets him needed socialization. As I have served the patient in a fun-loving fashion for many months, he now trusts me to be with him on the days that he doesn’t feel like smiling. Although he usually avoids the “serious stuff” as long as he can, occasionally some deep things come to the surface. . .between jokes.

We can also help patients with serious, life-changing diseases. One of my most challenging patient subsets are patients with dementia or who have had a stroke. Some people wonder how a social worker for hospice patients can make a difference with this population and, quite frankly, I wonder this at times, too. But then I have a break through with a patient with dementia.

I live for the days that I feel like I actually made a connection with someone living with dementia.

Making a connection with a patient with dementia can feel like chasing a shadow, which is what makes those connections so important. Music is an amazing tool for hospice social workers that seems to bridge the gap and foster a connection. While the patient probably doesn’t want to hear me sing, I can play some music from my cell phone. I find that the most popular genres include gospel, country, bluegrass and good old “Blue Eyes” Frank Sinatra. It’s amazing how you can see the spark of a connection in an advanced dementia patient’s eyes; when the wheels are turning and they recognize the music.

I have a patient that can no longer speak due to effects from a stroke, but if a song is played that she knows she will hum along with perfect pitch! She comes out of her shell, if only for a few fleeting moments. Those moments make it all worth it, and allows me to say “now, that’s how a social worker can help.”

Social workers are not available just to our hospice patients, but also their families. I find that the most common way we support families and caregivers is through encouragement. I’m amazed everyday by the caregivers I come in contact with that live on interrupted sleep and missed meals. If I can fan the fire to help keep them going, through some simple words of encouragement and validation, then I have done my job.

Caregivers need constant reminders that they must take care of themselves as well as the patient. Social workers teach self-care techniques and educate on caregiver burnout. Social workers also coordinate with hospice volunteer managers to arrange respite visits from a volunteer so a caregiver can take a nap or run an errand.

However, sometimes a caregiver simply needs an extended break. Hospice offers a short respite stay at an area nursing facility so caregivers can recharge their batteries. The hospice social worker helps to coordinate and arrange this service.

While we can’t necessarily find the words to describe exactly how we can help, we work tirelessly for our patients and walk beside patients and families during their end of life journey. I am proud to be among the ranks of hospice social workers, especially those at Crossroads Hospice.

Jenny Sego
LMSW Social Worker
Crossroads Hospice