Archive for Social Worker

Let Me (Not) Give You Some Advice

Advice

Giving advice starts early!

I resist giving advice.

I relish giving advice.

Both statements are true.

Obviously, I spend considerable time with advice-giving by posting regular essays about hospice. I want those considering hospice (for themselves or others) to have resources during this crucial time. I want to offer suggestions—through questions, concerns, insights—for families currently served by hospice. Whether wondering about odd medical terms or nudging people to be honest about dying and death, I hope my views (advice!) help a few readers.

But advice is inherently tricky. What works for me may not work for you. At times I’ve asked friends if they’d like my advice about a situation they are facing. If they nod assent, I respond with, “Don’t trust anyone else’s advice but yours.” We laugh. We roll our eyes. It’s a joke! However, it also rings true. Follow your heart. Take the time to listen to your inner voice. If you are a person of faith, pray . . . and then be open to the ways the Holy provides guidance. Carefully seek input from trusted family members, friends, and professionals. Cautiously use the Internet with its smorgasbord of bad/good, weird/wonderful, fickle/fact-filled viewpoints. (Which includes my website on advice about hospice!) Read More →

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Hospice’s Two for One

two for oneBack when working as a hospice chaplain, one of the newer social worker suggested that we visit together. We shared various patients as part of their hospice “team.” I recall that two of those patients lived a long and winding drive from our office. Carpooling was a good use of resources. Additionally, the families wouldn’t be interrupted by multiple phone calls from multiple staff trying to schedule multiple visits.

Everyone loves more phones calls and visits, right?

On the way there, I said, “You know, this does defeat part of our impact.”

“What do you mean?” the social worker asked.

“We won’t get much of a chance for one-on-one encounters. A lot of what we do is based on being with the patient or family member. Having another person around changes that.”

“Oh,” was mostly what she replied. She was young. She was new. On we drove, excellent stewards of hospice resources. Read More →

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A Hospice Chaplain is Quantifiably Wrong

(*Photo by John Rothwell.)

“The nurses do things that can be quantified,” one of our hospice chaplains announced, “which is not like what us chaplains or the social workers do.”

With hospice, a patient is supported by a “team” of doctors, nurses, social workers, chaplains, home health aides, and volunteers.

Was the chaplain, a person and a professional I respect, correct?

What is quantified? It’s a word describing precision, numbers, and comparisons.

A nurse may ask a patient what her or his pain is like on a scale of 1-to-10 or (especially if a patient can no longer talk) to choose from a range of emoji faces depicting happy smiles to grim anguish. Nurses increase or decrease the precise dosages of medications based on experience, information, and established guidelines.

The medical staff in hospice—and this is one of the tough parts of patient care—needs to regularly report how a patient is declining. If a hospice patient demonstrates consistent improvement in their physical health, they certainly still have an illness (and can’t stop the aging process), but they may no longer be eligible for the hospice benefit.

  • Is the patient losing weight?
  • Does he require stronger doses of pain medication?
  • Is she eating less, or only liquids, compared to last week or month?

Yes, nurses quantify, with specifics, to discern a patient’s changes. Read More →

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