Provides comprehensive psychosocial services and supportive counseling for hospice and home health patients, families, and caregivers. Core member of the Hospice Interdisciplinary Team (lDT).
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Including, but not limited to the following:
Assesses the psychosocial status of patients, families, and caregivers in relation to the patient's medical condition and environment.
Identifies psychosocial goals and expectations and in coordination with care team, develops a Plan of Care which helps patient/family to maximize quality of life and which supports the patient's goals.
Provides explanation of hospice philosophy of care; coverage and services, and payer source benefits, either as a pre-hospice referral or at the time of admission.
In collaboration with lDT, works in partnership with the patient and family to identify issues that may complicate life closure.
Provides supportive counseling to patient, family, and/or caregivers regarding the psychological aspects of illness, palliative and end-of-life care, as well as issues identified by the patient as important/relevant. Conducts family meetings as indicated.
Assesses patient's financial resources; completes Patient Financial Disclosure documents for patients with limited or no insurance.
Assures that medically related and social needs of patients are met and maintained on an individual basis.
Assists patient/families to identify with and find mechanisms for dealing with stress which accompany illness. Assists them in formulating plans for enhancing patient's health and well-being.
Coordinates community resources, including caregiver assistance, placement
options, meals, transportation, financial resources, nursing home placement, etc.
Serves as liaison between patients, families, caregivers and community agencies to advocate for and maximize resources for the patient.
Completes clinical documentation reflective of the patient services performed per agency standards.
Collaborates with other members of the IDT including bereavement, spiritual care and volunteers.
Collaborates with other home health disciplines to ensure coordination of care.
Coordinates and/or participates in various support groups as determined by agency programs and identified community needs.
Participates in community education, including volunteer training and marketing.
Participates in patient care conferences, discharge planning and in-service programs.
Other tasks or projects as directed by the Clinical Director.
Education, Certification, and Licenses -
Education - Bachelor’s Degree or Master's Degree from a school of social work accredited by the Council on Social Work
License by the state to use the title of social worker. (LMSW, LCSW, CSWA)
Current Driver's License.
A minimum of one year of experience in Social Work in a health care setting with home care, hospice, or palliative care experience preferred.
Internal Number: 212
About Coastal Home Health & Hospice
Coastal Home Health & Hospice is here to work closely with you, your physician and family to make sure that you have a care plan that is appropriate for you. If you and your family need Home Health to get you on the road to recovery or you and your family needs the warmth provided through the comfort care of Hospice…we are here for you.
At Coastal Home Health & Hospice, we know what it means to care for a sick or elderly family member and we understand the effort and special care required to live life to the fullest when under the weather or dying. Because of this, as a community-based, not-for-profit organization, we are dedicated to serving patients and families in our area at all stages of life.
We offer a number of comprehensive programs that include Hospice, Home Health, Social Services, Lifeline, and more. As needs change, we are available to provide caring support and education to our patients and their families.
We would love to speak with you personally! Contact us today for a free informational visit. We have dedicated professionals on staff who look forward to being part of your home care team.