In previous entries, we’ve discussed what hospice social work is and what success in social work in hospice can feel like. We’ve gone into how to get a hospice job and organize patient information at a new job so that can start getting to know patients who were on service before you joined. Now let’s approach some social work interaction, starting with the hospice psychosocial assessment.
Wednesday afternoon you receive a report that a new patient is being admitted that day. You know nothing about the patient, his condition or his demeanor. Or about the family. You wonder how approachable they are and how present they are in your new patient’s life.
This is what you know:
You know that by Monday evening you will hand in to your office a complete assessment that predicts how how much difficulty they are likely to face on the road ahead.
You know that you will have done your very best to connect with these individuals through attentive listening and expressing a humble intention to support.
And you know that you will start to get a sense of who these individuals are: their values, temperaments and preferences for styles of interaction.
You know that you will be revealing to your team:
- end-of-life wishes to the extent that you have been able to ascertain
- DNR status
- where the family is in choosing a funeral home
And you know you will have put your best foot forward in establishing relationships that will most likely last until a patient has passed away.
Scheduling the initial assessment
You know the plan in the grand scheme of things. Some more specific planning includes arranging a time to meet the patient and family.
You have five calendar days, including today. If there is a weekend in the window, you may have fewer than five days to accomplish your assessment.
It is important to make an actual physical visit to the patient, so you can see for yourself how communicative they are. Ever so often, there are patients who sleep through the admission process and get labeled as nonverbal. And there are sometimes patients who don’t talk much but communicate a lot with their eyes. Or who really want to hold your hand. It’s important to see the patient for yourself to assess how much they may benefit from future visits.
It is also important to speak with family members. If the patient resides at a facility, you’ll want to at least speak with a family member or two on the phone, or even better arrange a time to meet. Sometimes patients don’t speak for themselves and the only way that you can learn about the patient’s preferences and history is to speak with family members. Regardless of how much a patient may be able to tell his own story, it is important to speak with family members because it is our job to provide them with support as well.
Back to Wednesday. You’ve learned that a new patient is coming on service. You know the overall goal of your psychosocial assessment and that you have five days to complete it. Go forth and do good! Swing on back next time and we’ll look closely at the actual assessment that you’ll be doing.
Michael Giles is a hospice social worker and psychotherapist who works in Austin and Cedar Park, Texas.
Also by Michael: Transcend either-or thinking about politics, racism and psychotherapy