Career Story: Social Worker At A Hospice

Social Worker at a Community Mental Health Center

Job Title: Social Worker

Type of Company: hospice care

Education: BA, Philosophy, UCLA •• MSW, University of Chicago

Previous Experience: I was a social worker at a community mental health center in California for ten years.

Job Tasks: I work at a fifteen-bed hospice center. The center is a short-term facility providing acute care for patients who are on the verge of death. Some come directly from hospitals and have a limited understanding of what hospice care is about, others come from home with symptoms that are out of control. Both need lots of support.

I do an initial assessment of both patient and family, ascertaining how they've coped with the disease, how they are coping with the nearness of death, what their strengths are (and whether they're religious), and determining, where the families are concerned, what they need to get through this. After that, there are numerous things I can do; some of it sounds fancy -- counseling, crisis intervention and emotional support -- and can involve some therapeutic interaction, but a lot is simply listening and compassion.

I work with an interdisciplinary team that includes doctors, nurses, CNAs, physical therapists and a chaplain and a dietician. And I do a lot of counseling on disease progression, the dying process and normal grief. I am also responsible for discharge planning (where that's appropriate), coordinating services for patients who choose to go home or arranging for nursing home placement. More often, however, I do funeral planning, helping next-of-kin to choose a funeral home and make decisions about cremation or burial. When a hospice patient dies, I arrange a follow-up visit with the family and determine their level of "bereavement need"; this information is passed on to the bereavement counselor who will follow the family if they wish.

Best and Worst Parts of the Job: My job satisfaction comes when a patient arrives in severe pain or distress and the family is in crisis, but ends with a very comfortable and peaceful patient and an accepting and lovingly grieving family.

There are lots of difficulties that are hard to face. One is the big gap in the healthcare system for long-term care. If a family cannot care for a patient themselves and do not have money to hire aides at home or to pay for nursing home placement, there are really no good options. The second hardest thing is working with doctors who are not used to the large doses of medicines we use or who have very poor bedside manners.

Job Tips: Do lots of volunteer work in lots of different settings to see if you really like working with people. Take some time after college to get good experience in the field you think you will enjoy, even though you will make very little money, before going to graduate school. The MSW program is 2 years of very intensive work, and background knowledge will put you way ahead, and help you avoid making a mistake in choosing your area of interest.

Additional Thoughts: Know that you will never make a lot of money and your work will be highly stressful. You need to be the kind of person who wants to come home knowing your work has been valuable, changed lives and made the world a better place.

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