Hospice Patients Alliance: Consumer Advocacy


There are many counseling services available in hospice, including social worker services, chaplain or spiritual care services, bereavement counseling, dietitian services and other services which may be needed by the patient and/or family/caregivers. Hospices must also provide occupational therapists, physical therapists, and/or speech-language therapists if your loved one would benefit from these types of therapy. See our therapy page on these types of therapy. You have the right to request these services and to receive these services.

The RN casemanager may recommend one of these services depending on her assessment of the needs. Your physician will approve (order) the provision of these services if you need them. Many patients and families may feel unsure about using these services, because they're unfamiliar with them. However these fears are usually quite unfounded, and counselors can help to make the total difference in your quality of life as the days unfold.

Social workers are licensed and extensively trained to counsel patients. The social workers used in hospice are specialists in "medical social work." They are familiar with the issues that confront families dealing with a terminal illness, and are prepared to help you take care of whatever issues confront you. In some cases, families may be confronted with confusing documents and forms which need to be filled out. Others may have needs for financial assistance or difficulties understanding correspondence or bills that have been left unpaid. There is often some "unfinished business" which needs to be taken care of.

In other situations, there is emotional/psychological "unfinished business" which needs attending to. The social workers are trained in helping you get through these demanding times and healing some of the emotional difficulties you may be going through. Depending on your beliefs about religion and your preferences, a priest, minister, or rabbi may be made available if you do not have a spiritual counselor of your own,even if you have not been to church or temple services for years.

For those patients who have nutritional difficulties, dietitians are available. When a patient has difficulties with nausea or vomiting, the physician may order medications to control those symptoms. In addition, a dietitian can recommend foods or drinks that will be easier to tolerate or different methods of food preparation which may also be helpful to the patient. Minimizing nausea and vomiting will help the patient to feel better and increase his or her strength. A dietitian may also be called in to evaluate the patient's nutritional status and provide information which can assist the physician in making decisions about the patient's nutrition.

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