1. Healthcare and Hospice Unit 8 Dawn Burgess, Ed.D

2. 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 ____

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

4. 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

5. 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?

6. 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

7. Working with Patients with HIV/AIDS Originally 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.

8. The Hospice Movement Provided to the terminally ill Focuses on physical, emotional, social and spiritual needs. Addresses the psych-social and spiritual needs of the dying patient.

9. 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.

10. The Hospice Philosophy Dying 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.

11. The Hospice Team The Hospice Physician Registered Nurse Chaplain Home health aid Trained volunteers Bereavement Counselors

12. The Role of the Hospice Human Service Worker: The Psychosocial Assessment Basic Demographic Information Assessment of the current crisis Assessment of physical surroundings Assessment and development of a safety plan Assessment of patient’s current mental state Assessment of family relationships Assessment of patient’s social support system

13. Intervention Strategies Placement in residential facility Contracting a home health agency Establishing Day respite care Government assistance and Medicare

14. Case Management and Counseling Dealing with the terminal illness The loss of control because of increased debilitation Impending death Helping and assisting family members Increasing the comfort levels

15. Resisting the Reality of Death Embracing death does not have to let go of life. Not losing hope Confronting denial Responding affectionately and compassionately

16. Planning for the Death The practical plans and details Advanced directives DNR Funeral arrangements Who will take care of what?

17. The Spiritual Component of Dying Praying with the family Are you comfortable in this role? The spiritual tone of counseling

18. The Journey Through Grief Acknowledging the reality of the death Embracing the pain of the loss Remembering the person who died Developing a new self-identity Searching for meaning in the loss Receiving ongoing support from others Reconciling the grief

19. 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.

20. Ethical Dilemmas Family denial of illness Denial of services to those unable to pay Counseling patients regarding euthanasia Poor Pain Management Discharge of terminal patients