March is National Social Worker’s Month, so we are taking a closer look at the role social workers play in end of life care. The goal of hospice and palliative care is to improve the physical, psychosocial, and spiritual quality of life for people living with a serious illness and their families. The close relationship between hospice and palliative care means that social workers who work in hospice care by necessity also work in palliative care. It is important to note that not all palliative care social workers will work in hospice settings.
In hospice care, a social worker’s core responsibilities involve conducting psychosocial assessments, coordinating care, providing counseling and psychotherapy, intervening in client crisis situations, and educating patients and families about their treatment plan and the resources and support systems that are available to them.
Patients who require palliative and/or hospice care can experience difficult emotional and mental health challenges, including depression, anger, and anxiety; intense physical pain or discomfort; financial strain; social isolation; and family conflict. This phase of life often carries the added emotional weight of grief and bereavement and frequently involves pain management.
For these reasons, the participation of palliative & hospice social workers is critically important. They provide guidance and support for patients and their families. Social workers help them navigate the difficult process of end-of-life planning; managing the mental, emotional, familial, and monetary stressors of debilitating physical illness; understanding patients’ treatment plans and connect to other support services as well.
These specially trained professionals are advocates for patients and their families. For instance, they might conduct home visits to help patients and their families with establishing effective palliative care, while also providing services to visitors of hospice centers and following up with terminally ill patients who must visit the hospital for intensive medical care.
Hospice and palliative care social work can be a challenging field, as it involves helping individuals through some of the most difficult and stressful times of their lives. However, the rewards of the field can include making deep connections with individuals, learning and celebrating their life stories, and having a dramatically positive impact on patients and their families.
While hospice care includes palliative care, sometimes palliative care will also be provided to patients who are not suffering from terminal illnesses and who require non-curative remedies for painful or debilitating symptoms.
The simultaneous distinction and overlap between hospice and palliative care means that social workers who work in hospice care by necessity work in palliative care, while palliative care social workers may not work in hospice settings.
During the past decade, consumer advocacy groups, health professional organizations, and government agencies have paid increased attention to the quality and accessibility of care along the continuum of illness and at the end of life. As a result, health care professionals are often trained by those already practicing in their respective discipline. Social work is no exception. Social Work Leadership Summits on End of Life and Palliative Care address the need for a formalized collaborative efforts in the social work profession that focus on palliative and end of life care. During these meetings, participants design plans for improved care and to elevate the social worker’s role.
The National Association of Social Workers (NASW) has developed Standards for Social Work Practice in Palliative and End of Life Care, a useful practice tool for social workers. The standards reflect core elements of social work functions in palliative and end of life care and professional social work practice and are targeted toward social workers practicing in various settings dealing with these issues. For many practicing social workers in palliative and end of life care, these standards reinforce current practices. For others, they provide an objective to achieve and guidelines to assist in practice.
Numerous opportunities in professional development are also available through NASW and other professional organizations, institutions, coalitions, and service agencies at local, state, and national levels. Social workers participate in and contribute to professional conferences and training activities on a regular and consistent basis to provide the highest possible level of care. Social workers also assist in identifying palliative and end of life professional development needs by participating in research and collectively encouraging organizations and institutions to collaborate, advocate, and provide appropriate education for the field.
Social workers can serve as a viable conduit between physicians, patients, and their families to ensure that frank and honest discussions are held about sensitive but necessary topics, from do-not-resuscitate orders, feeding tubes and medications to decisions about burial vs. cremation, or having a religious funeral vs. non-religious memorial service.
National Social Work Month is an ideal time to recognize the contributions of social workers in end of life care planning. They manage multiple responsibilities and services for hospice patients and their families, and bring important support for the healthcare profession, across the board.