What Exactly Does a Hospice Social Worker Do Anyway?

Besides basketball and St. Patrick’s Day, March is also Social Work Month! It’s a time to share information about the career of a social worker and what social workers bring to the world.

I’ve worked with a lot of different populations through my career as a social worker, but I found my true passion when I became a hospice social worker over twelve years ago.  What do I do as a hospice social worker? Let’s start with a short introduction into hospice.

Hospice is specialized end of life care, provided by an interdisciplinary team. The focus is on providing comfort and managing symptoms, while also providing emotional and spiritual support to the patient and family. 

Hospice is covered by Medicaid and most individual insurance plans. It is a benefit available to people with Medicare (Part A) whose physician can certify a terminal diagnosis with a life expectancy of six months or less. People on hospice sometimes live longer than six months, and are entitled to remain on hospice as long as they continue to meet the criteria for eligibility.

Hospice can take place wherever the patient lives. In some areas, there are hospice facilities that people go to at the end of their life, however most hospice care in the United States takes place in people’s homes, assisted living facilities, and nursing homes.

Hospice care is based on the needs and preferences of the patient and family system. Direct care is provided by a hospice team that is comprised of nurses, chaplains, social workers, home health aides, volunteers, and physicians. In a more limited capacity, additional therapies are sometimes available including physical therapists, occupational therapists, massage therapists and Reiki practitioners.

So what is my role within this team? As a hospice social worker, I provide emotional support and resource management to the patient and family system. What does that look like in more depth?

A hospice social worker:

• Provides education on the dying process to the patient and family
• Models comfort with the dying process
• Helps develop a current and future plan for caregiving
• Provides Information on choices for final disposition (mortuaries, cremation, natural burial, whole body donation, organ donation).
• Educates on, and assists family members with completing, Family Leave paperwork
• Helps patients who have elected MAID to navigate and prepare for the process (and often supporting the patient and family during the ingestion process)
• Coordinates respite care for patients so that caregivers receive a break in caregiving
• Provides joint visits with nurses to provide emotional support to the family as a nurse provides medical care, helping family members process information
• Anticipatory grief support (we tend to begin grieving before they die) to patients and family members
• Helps patients adjust to their physical limitations
• Encourages and facilitates patients in completing legacy gifts (letters to children, handprints, Legacy videos)
• Teaches strategies for system management (visualization/breathing exercises)
• Uses tools like art, music, pictures, and videos to connect to patients with dementia
• Supports caregivers, helping caregivers adjust to their new role
• Educates on grief,  including children’s grief responses
• Leads grief support groups as part of the bereavement services provided by hospice
• Facilitates conversations about patient’s goals for end of life
• Assists patients in completing their Advance Directive
• Advocates for patient within state funded programs such as In-Home Supportive Services
• Helps make the final dreams of a patient come true (coordinating one last trip to the beach)
• Facilitates family meetings, typically with other members of the hospice team present
• Provides emotional support to other members of the hospice team

This is not a complete list and not all social workers in all hospices do the exact same thing. Palliative care social workers have similar roles as hospice social workers. My hope is that by educating others on the comprehensive services that hospice can provide, it will pave the way to a better end of life experience. 

For more information about hospice and palliative care:

https://www.medicare.gov/coverage/hospice-care

https://www.nhpco.org/