Acceptance: element #4 of the hospice social worker mindset

One of the many recurring moments of irony in hospice is when colleagues show difficulty accepting a patient’s or family member’s denial. They may express a belief that it’s a problem that a family member is struggling emotionally about their loved one’s prognosis. They may describe the situation as “a lot of family dynamics.”

“This family is in denial. We need to get the social worker in here.”

A social worker can certainly help in this situation if s/he is capable of treating the struggle as normal, valid, healthy, or even good.

“Of course the family is in denial,” may be the social worker’s silent attitude as she nods thoughtfully in response to her colleague’s alarm.

Acceptance is validating

Acceptance is validating. How much more willing to connect with patients we are when our unspoken (or sometimes spoken) message is “I can accept that you are feeling depressed; these are difficult times,” instead of, “We’ve got to fix your depression: It’s making me uncomfortable.”

Clearly, we want to help fix what can and should be fixed, but hospice is about support and comfort more than it is about fixing anything. Just as hospice nurses don’t enter homes with the aim of curing the incurable illness, social workers want to facilitate support for the emotional challenges. Many emotional challenges in hospice are incurable. Many developed over decades and are dependent on a complex web of relationships and events. Many other emotions function as healthy elements of grieving. Attempts to cure grief do harm.

Hospice is about finding wellness without finding a cure. There’s pain, but there’s also relief. There’s isolation, but there’s connection, some of which we endeavor to provide. There are questions about the value of the life story that may be entering a final chapter, but we can affirm that value by treating it as important.

Turn the page to

Advice from hospice social workers on starting a new position

Go back to

3 characters that describe the social worker mindset (and a confession of sexism)