Job Description
Awarded Best Quality of Care — Once Again! Behind every award is a story, and ours is written every day by more than 900 dedicated employees and hundreds of compassionate volunteers who walk alongside patients and families when they need us most. At Community Hospice & Palliative Care, we’re honored to be recognized with the Hospice Honors Elite award, a testament not just to our clinical excellence, but to the compassion we bring to every bedside, every home, every conversation. Every day, we serve approximately 1,500 patients living with advanced illness, wherever they call home, be it a private residence, a long-term care or assisted living facility, a hospital, or in one of our nine inpatient care centers. We’re here to improve quality of life, to ease pain and lift burdens, and to be the Compassionate Guide that families need when time matters most. And most importantly, as the only non-profit hospice provider in the region, we never turn anyone away due to an inability to pay. Position Summary Under the direction and supervision of the Social Work Manager, this position, as a member of the Interdisciplinary Group (IDG), provides medical social services and support to patients and their families. The social worker will provide all psychosocial interventions and referrals, assessments, supportive counseling, networking, and resource procurement. Job duties are performed with awareness and respect of the patient’s developmental stage, patient rights, and patient and family personal, cultural, and spiritual beliefs, according to specific program guidelines. Contributes to the smooth functioning of services, attends IDG meetings and advocates for patient/family needs with the team and community at large. Essential Functions In unpredictable and/or unknown environments assesses patient/family needs regarding psychosocial history including assessing emotional factors related to terminal illness, psychosocial needs, including risk factors such as mental health, suicidal and homicidal ideation, substance abuse, bereavement risk, and offers recommendations accordingly. Will also assess environmental resources and obstacles to maintaining safety. Visits patients in various settings, to include but not be limited to: hospice inpatient units, private homes, long term care or assisted living facilities, group homes, shelters, or other locations where services to patients/families may need to occur. Manages a caseload of patients including, but not limited to, assessing for and assisting with advance directives, funeral and memorial planning, assessment of care situation, and the provision of more complicated case management. Assesses for financial needs or barriers, and facilitates referrals as needed to internal and external resources. Provides patient/family education as appropriate and within the scope of practice. Identify and utilize appropriate community resources and assess patient/family/caregiver ability to access them. Evaluate patient/family/caregiver response to intervention(s) when referred to community agency and the satisfaction of the services(s) provided. Provide clinical therapeutic services to patients and families such as, but not limited to: Short-term individual counseling (loss, anticipatory grief and bereavement, coping, transition) to patient and/or family Goals of Care discussions Crisis intervention Assistance in addressing/supporting decision-making, ensuring the best interest and rights of the patient. Coordination and collaboration with ancillary therapeutic services, including but not limited to Child Life services and Music Therapy Evaluate, intervene, and support the patient/family/caregivers throughout life transitions, regardless of disease trajectory and location on the continuum of the condition. Participate in IDG meetings as a contributing member of the team in ongoing communication, coordination, and continuity of the patient and family care/service needs from the psychosocial perspective, including the development and revision of the patients POC. Act as advocate for patient/families right to self-determination. Assist the physician and other team members in recognizing and understanding the social/mental stress and/or disorder that exacerbates the symptoms related to terminal illness. Identify family dynamics and communication patterns; assess for special needs related to cultural diversity including communication, space, role of family members and special traditions. Identify the developmental level of patient/family and obstacles to learning or ability to participate in care of patient; assesses caregiver’s ability to function. Identify support systems available to reduce stress and facilitate coping wit