Purpose of Hospice Care
Hospice care is a humanistic and holistic that focuses on the psychosocial, physical needs of the patient and the family. The primary goal of a hospice is to assure that a patient facing the end of life situation is free of physical, mental, social, and spiritual pain to live as fully as possible. Hospice care is a model of compassionate care for people facing life-threatening and limiting illnesses. They provide expert medical services for pain management and psychological wellbeing. It also targets the spiritual needs of the patient as well as those of the patient’s loved ones. In most cases, provision of care takes place at a person’s home, freestanding hospice centers, nursing homes, hospitals, and other long-term care facilities. Hospice services are available to any person with any terminal illness of any age, race, or religion. The majority of managed care organizations such as Medicaid, most private insurance plans, Medicare, and other managed care organizations cover hospice care in their contracts.
Effective management of pain and other distressing symptoms must start at the diagnosis of the problem and continue throughout care. If the therapies involve children, it is essential to have a holistic approach for assisting children and families in covering their physical, psychological, educational, social, and spiritual goals. At the same time, it is essential to remain sensitive to developmental, personal, cultural, and religious values, beliefs, and practices.
The behavior of some communities in the country makes it necessary to provide culturally-sensitive end-of-life care. The increase of ethnic diversity among seniors makes it essential to highlight the need to gain a greater understanding of elderly patients and caregivers at the end-of-life to serve them better. According to Kirkendall et al. (2015), some ethnic communities such as the Hispanics underutilize hospice facilities because they face various barriers such as language, lack of insurance, preference of informal structures over professional services. Others include mistrust of the medical system in the country, concerns over revealing their immigration status, and low referral rates. Some communities refuse to acknowledge terminal diagnoses believing that such acknowledgment is accepting that the loved one would die. While denial is an adaptive method, it may interfere with planning for end-of-life and the patient’s plans for medical treatment. Therefore, it is essential to have culturally-sensitive approaches when discussing the terminal diagnosis of patients with their families. The ultimate goal is to support the medical wishes of the patients and increase their satisfaction with hospice services.
The provision of emotional support from hospices results in higher levels of patient and caregiver satisfaction. People who do not know the availability of hospice services may not take advantage of moving services. At the same time, the support that hospice staff may not be adequate to communities such as the Hispanics that rely on religious beliefs and prayers for emotional support during the end-of-life period. Some ethnic communities also rely on the comfort of their family support system instead of relying on medical professionals who they consider as strangers in hospice facilities. Therefore, it is essential to understand the cultural preferences of minority ethnic communities in the United States to develop culturally sensitive approaches for providing emotional support to these groups in hospices.
Honest communication is critical when dealing with seriously ill patients at end-of-life. The discussions that take place during prognosis are essential catalysts for the conversations that take place during treatment and care. It is crucial to have honest reviews between patients, their families, and healthcare providers to quality care. Honest communication is also essential for care planning because it is based on the values and needs of patients and their families and developed with professionals who guide and support decision-making processes (Boyd et al., 2011).
The role of the medical social worker
Over the years, the psychosocial component of hospice care has become prominent in an interdisciplinary approach. Consequently, social workers occupy a distinct position in the hospice care multidisciplinary team. The training of social workers prepares them to help families deal with the financial and social consequences of a terminal illness. As a result, the multidisciplinary team becomes competent and capable if they consider the input of social workers. Social workers provide several services in hospices, hospitals, and palliative care institutions such as emotional support and bereavement counseling, generic problem solving, and psychosocial assessment. They also play other roles such as referral, brokerage, case management, client advocacy, staff training, and support. They also participate in hospice legislation, research, and community education.
Social workers are experts at handling diverse issues. For example, their training teaches them how to deal with people from different ethnic, cultural, economic, and family backgrounds. They are also useful in developing support networks and in managing multidimensional symptom management. They also provide excellent services when families are bereaving in a multidisciplinary manner. Social workers’ training allows them to navigate health care systems and help their patients and families overcome most of the challenges that they face in society. It is only the medical social worker who can know whether the family of a patient is under stress, how they perceive death, and whether they have particular concerns about death.
Social work is a profession that dual purposes. It assists individuals and groups whose needs are not adequately met and help change institutions to enable them to respond to the needs of individuals and groups. The definition of health workers coincides with that of hospice care institutions because they focus on terminally ill patients. As a result, social workers play critical roles in reforming hospice centers to provide appropriate care to the people who do not require traditional medicine. The people who do these duties are known as medical social workers or hospital social workers. The training of nurses, doctors, and other healthcare professionals enables them to deal with the patient’s physical needs and not any other issue. Medical social workers train to fill such gaps to give the patient a holistic recovery process.
Medical social workers have specific roles to play in a healthcare institution. First, they assess patients for psychosocial problems. They determine the financial and social issues that a patient may have because of their medical conditions. In most cases, hospital health workers do not see all the patients that come to a healthcare facility. Doctors and nurses refer to the specific instances that require social work services, after which they make the necessary interventions. All the responses that they can make depend on the particular needs of the patient. For example, a patient may require drug treatment support or homeless shelters, while others may require help navigating their treatment regime. Hospital social workers help educate patients on the treatment option available in an institution. They also help coordinate the services of a healthcare institution after the discharge of some patients. Additionally, they also provide counseling sessions for patients.
The training of doctors and nurses provide them with different skills from those of a medical social worker. Nurses assist patients in alleviating physical pain but lack the expertise to address nonmedical issues. On the other hand, the training of medical social workers gives them patient engagement skills such as motivational interviewing. It has a sophisticated understanding of social and environmental barriers and resources to health. They have the skills to assist with case management services and can help patients navigate social service systems. They link individuals to resources that enable them to access food, rehabilitation services, social networks, and active living resources. Medical social workers can collaborate with community-based social services such as domestic violence shelters, food banks, child protective services, treatment programs, and housing programs to improve the health of a person. Medical social workers like nurse coordinators can connect patients to specialty providers and ensure that there is an alternative flow of information. Therefore, the presence of medical social workers facilitates the smooth transition of patients from inpatient facilities to assisted living and rehabilitation services. They can also help resolve difficulties with pharmacies, insurance, and home-based care.
Medical social workers also provide patients with some services outside healthcare institutions. They provide individual, family, and couple’s counseling services that take place away from clinics. These services are critical for recovering patients as they can assist patients in building healthier skills, relationships, and lifestyles. Some hospice care institutions and hospitals recognize the role that social workers play and employ them to meet their patients in addressing issues such as depression, anxiety, and health-promoting behaviors such as tobacco cessation.
Improvement in health outcomes in disadvantaged communities takes more significant effort more than care coordination. The traditional methods of providing healthcare have family and patient visit their doctors during working hours. Such a model disadvantages working for families because it favors individuals who can plan and get permission from work to attend to healthcare issues. Those without leverage in their work, such as immigrants workers, find it difficult to operate under the traditional system of getting healthcare. As primary healthcare practitioners work to increase accessibility, they need social workers to connect to communities that have difficulties in following conventional access methods.
Hospices are very critical institutions in the provision of healthcare in a country. They provide a range of support and treatment services to people managing complex and long-term illnesses. People miss on getting vital support because of misconceptions about the role that they play. Hospices provide care to people after the recognition of their conditions as a terminal to the time they lose their lives. They work towards ensuring that the end of life of a terminally ill person is with a lot of dignity and respect. Hospices provide that they meet the wishes of the suffering person, meet their needs and those of their loved ones. These institutions collaborate with health professionals to give care to these patients at any place, including in their homes and inpatient units. Some of the professionals that help these cadres of patients are medical social workers. These experts are critical in hospice care because they help evaluate the emotional status of a patient and their families. Their training enables them to help manage emotional distress among patients and, in the process, support the wishes of the patient. Some of them train in stress management and help patients and family members cope with emotions during the end of life moments.