Healthcare and HospiceUnit 8

Dawn Burgess, Ed.D

A few reminders:

Next week is our last seminar

There is work to do in Unit 10 so don’t overlook it

The deadline for ALL work is ____

Did you know that Human Service workers can work in the Health Care Industry?

Examples?

Human Services in Hospitals Psychosocial assessments Post discharge follow up Providing information and referrals Consultation Pre-admission Planning Outpatient care Discharge Planning Patient and family

conferences Psychosocial Counseling Case

management Financial Counseling Referrals to

support groups Health Education Trauma response

Crisis and Trauma Counseling

A big part of a medical social worker’s job is to provide crisis and trauma counseling to patients and their families.

Maslow’s Hierarchy of Needs is a good model for how to approach a family in crisis

Why?

When people are facing crisis they feel the need to have their most basic needs met

In this case, they NEED information about their loved one

Each family handles crises differently

You must figure out coping styles and read between the lines

Adjustment, advocacy and resources

Working with Patients with HIV/AIDSOriginally was crisis intervention and dealing

with death

Now it is seen as a chronic, rather than terminal disease

More focused on the psycho-social issues of dealing with chronic and sometimes terminal disease.

Also fear of discrimination, not receiving proper medical care, jobs and housing.

The Hospice MovementProvided to the terminally ill

Focuses on physical, emotional, social and spiritual needs.

Addresses the psych-social and spiritual needs of the dying patient.

The History of Hospice: The Neglect of the Dying

Dame Cicely Saunders is the founder of the modern hospice movement.

The medical community’s failure to address the comprehensive needs of terminally ill patients.

Wanted to develop a system of care committed to the dying process that was without pain and one that maintains the patient’s sense of dignity.

The Hospice PhilosophyDying is not failure, but a natural part of life.

Every human being has the right to die with dignity.

Palliative (soothing, painkilling) care rather than curative care.

Highly supports patients remaining in their homes whenever possible.

The Hospice TeamThe Hospice PhysicianRegistered NurseChaplainHome health aidTrained volunteersBereavement Counselors

The Role of the Hospice Human Service Worker: The Psychosocial Assessment

Basic Demographic InformationAssessment of the current crisisAssessment of physical surroundingsAssessment and development of a safety planAssessment of patient’s current mental stateAssessment of family relationshipsAssessment of patient’s social support system

Intervention Strategies

Placement in residential facilityContracting a home health agencyEstablishing Day respite careGovernment assistance and Medicare

Case Management and Counseling

Dealing with the terminal illnessThe loss of control because of increased

debilitationImpending deathHelping and assisting family membersIncreasing the comfort levels

Resisting the Reality of DeathEmbracing death does not have to let go of

life.Not losing hopeConfronting denialResponding affectionately and

compassionately

Planning for the DeathThe practical plans and detailsAdvanced directivesDNRFuneral arrangementsWho will take care of what?

The Spiritual Component of DyingPraying with the familyAre you comfortable in this role?The spiritual tone of counseling

The Journey Through GriefAcknowledging the reality of the deathEmbracing the pain of the lossRemembering the person who diedDeveloping a new self-identitySearching for meaning in the lossReceiving ongoing support from othersReconciling the grief

Multicultural Issues

Hospice workers must remain flexible enough to meet the needs of all cultural groups

Policies that discriminate against ethnic minority groups, such as admittance requirements, be challenged and changed if needed.

Ethical Dilemmas

Family denial of illnessDenial of services to those unable to payCounseling patients regarding euthanasiaPoor Pain ManagementDischarge of terminal patients