National Social Worker Awareness Month

Medicare established the hospice benefit to ensure that people living their final chapter of life have their physical, spiritual and psychosocial needs met. Physical and spiritual needs are more easily defined; nurses assess and treat symptoms (with physician orders), certified nurses aides provide personal care and spiritual leaders, spiritual care. It?s not uncommon for people to question why a social worker is part of a hospice team. Let?s see if I can put it into words, as March is National Social Work Month.

First and foremost, as the social worker, I want to know who our patients are. If you are 1 day old or 105 years old, a person is a lot of ?things? before they are a hospice patient. To list a few: a spouse, parent, child, friend, niece/nephew, aunt/uncle, cousin, neighbor, community member. A person has a lifetime of experiences, career history, hobbies, spiritual practices (or not) and accomplishments that contribute to the person they?ve become. It is important to know what those ?things? are, to help the team care for them in this stage of life. Knowing a favorite sports team or love of motorcycles is important with a team of new people entering your life.

Being referred to hospice care can be a shock. Terminal illness affects more than the person living with the disease; who are the support people? What kind of care is needed for the patient and the caregiver, as we embark on this journey? What is most important to the person, now that they?ve been told that time is of the essence? Is there unfinished business, are legal and financial documents completed or do they need to be? How?s the family coping with this person?s limited prognosis? Lots of emotions are anticipated in this stage of life. The role of the social worker is to help the patient and the family prepare and cope through this process.

Change becomes the new normal in this chapter of life. The social worker is available to help meet the needs of those changes, to brainstorm ways to accommodate changes in physical abilities and patient and caregiver needs. Social workers are fluent in resource and referral within the community: Family Medical Leave Act (FMLA), coordinating family caregivers, private, complementary therapies, and completing a Living Will /IPOST, to name a few.

As the social worker, I provide support and education to our patients and their families regarding: levels of care (defined by Medicare), how pain and symptoms can be managed through the end of life, assessing caregiver needs. I am a third person to process thoughts, fears, concerns, achievements and successes with.

Outside of the patient home I collaborate with the team, to ensure the patient and family goals are kept at the center of a person?s care. I advocate for patient and family needs to be met. I communicate with facility caregivers, if a patient is in a facility, to ensure we are all working toward the same goal for the patient.

As the Social Worker for Hospice of Washington County, I am involved with Hospice and Palliative Care Association of Iowa, a state organization, to remain informed of legislative issues facing hospice care and advocate the Medicare Hospice Benefit be improved, if it must be changed. I participate in continuing education, to ensure Hospice of Washington County is informed of best practices and caring for patients to the best of our ability.

People often comment to the challenge of working in hospice care. My verbal response is that hospice care is a wonderful service to provide and a horrible way to meet people. Writing this article, I will elaborate. It?s truly a privilege to be welcomed into a person?s life, at this vulnerable stage. As a team, we are given the opportunity to walk this journey with each patient and family, as they face uncharted territory. We are the professionals that do this every day, but our patients and their families are the coaches. I learn something from every patient and family I meet. Does it get hard? Yes. Is it worth it? Absolutely.