When pending tasks are urgent or significant, like when a family wants help with a financial need or an estranged relationship, it’s easy to feel purposeful. You greet, address the major issues, and feel accomplished, or as if you are working towards some accomplishment. But when everyone’s “fine,” or working really hard to pretend to be fine, it’s not as easy to justify why the hospice social worker routine visits. As we discussed in the previous section, you are there to continually build rapport. You are also there to continue your assessment, which needs to be ongoing, because many hospice patients’ physical and emotional conditions experience ongoing change.
In addition to whatever ongoing tasks you are helping the patient and family with, and in addition to listening compassionately to whatever they want to share, learn about how the patient is doing in the following areas:
Eating, sleeping and mobility
This will support your team’s efforts in assessing for decline so that the patient can be recertified, and will often elicit discussion from patient or family about their feelings about the prognosis.
Comfort
Comfort is a primary focus of hospice. Asking about a patient’s comfort and relaying pain reports to the nurse case manager helps your team accomplish this goal.
Interaction
How a patient is interacting with friends and reveals a great deal about how a she’s is doing. You’ll gain insight in her physical, cognitive, emotional and of course, social functioning. When I visit in a facility, I often ask how frequently the patient received visitors since I was last there.
Michael Giles is a hospice social worker and psychotherapist who works in Austin and Cedar Park, Texas. Also by Michael: Psychotherapy and living mindfully
How everyone is getting along
You may have learned a little about any family conflicts during your initial assessment. How have they progressed? How are family members adjusting to the patient’s prognosis?
Have they given any more thought to X, Y or Z?
Hospices bombard new patients and family members with information and ideas when they first come on service. Very likely they won’t be able to think much about even the most delightful of ideas from the social worker. Many topics require thought and family discussion, so it’s good to revisit them after a while.
I usually pay some attention to each of these areas every visit. Everyone available is an informant who deserves a supportive presence, including the patient, family members, facility staff or in-home attendants.
Asking these questions saves you from the “don’t know what to do” or “not sure why I’m here.” We’re there to support. If there’s no obvious need for support, we’re there to connect. A desire to learn about another person’s experience is great for connecting. A framework for purposefully learning about them can make the connecting more comfortable than “winging it.”
If you find this helpful…
…then please share… so that others can benefit. Also feel free to subscribe to receive new articles by email Sunday afternoons.
Thanks for tuning in!