Hospice Patients Alliance: Consumer Advocacy


MEDICAL SOCIAL WORK SERVICES
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Hospice social workers are an important part of the hospice services available to you and work as part of the hospice team. 1 Hospice social workers evaluate the needs of the patient and the family upon admission to the hospice program and may visit with you regularly as needed. Dealing with a terminal illness involves more than symptom management and patient comfort: it involves changing roles within the family unit, difficulties with coping, added responsibilities to family members, major decisions concerning care of the patient, increased concerns about financial matters and legal issues regarding advanced directives about care of the patient, wills, plans for the future, possible needs to relocate and so on.

Social workers are trained professionals who specialize in helping patients and families work through the many changes that occur as our loved ones health declines and eventually pass on. Hospice social workers are focussed on respecting your wishes and the wishes of the patient as a whole. They can help you access needed resources in the community for financial or legal assistance or help you get the information you need to make informed decisions about the present and the future. Social workers must advocate for your needs and rights and help you meet the goals which are part of your plan of care.

Remember, the hospice plan of care includes the family unit as well as the patient, and psychological, emotional and spiritual needs are also important parts of the plan of care. The social worker can help the patient make his or her own decisions about where they wish to spend their last days, whether at home or in a facility, or make decisions about whether or not to use artificial feeding methods such as feeding tubes. Each patient's circumstances vary from another's, but everyone will have some major decisions to make. The social worker's role is to not impose any particular agenda, but to support your wishes and facilitate the process.

For those experiencing tremendous emotional grief, the social worker may act as grief counselor and hospice therapist...helping you to work through the waves of feeling that may overwhelm some. In some hospices, counseling may be provided by other therapists as well as the social worker. The goal is to make the most of the time left together with the patient and to build a strong foundation for the future, with all the changes to come. Feelings of loneliness, anxiety or fear may be common, and the social worker is experienced in helping you recognize your feelings, express them and deal with them constructively.

Hospice social workers or other specially trained bereavement counselors may provide bereavement counseling for up to 13 months following the death of the hospice patient.


1 For Federal Guidelines regarding hospice social worker services, see: 42 CFR ch. iv. Part 418.68, 418.84, 418.88, 418.202(d).






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