Social Worker, Home Care - Eastern Territory - Alive Hospice

Performs initial and ongoing assessment of the patient and family's psychosocial status and assists in accessing resources for social, financial, and community needs for adequately managing care and dealing with death.

Upon initial contact with the patient, reviews the services hospice is responsible for providing. Assists in obtaining informed consents.

Develops a plan of care that optimizes patient and family ability to cope with the psychosocial impact of illness and impending death.

Offers support, guidance and counseling in order to diminish stress and enhance emotional wellbeing.

Provides information about and/or refers to other community resources that are available to supplement psychosocial needs.

Describes additional Alive Hospice support services that may be used if appropriate, to ease care-giving demands (i.e., Patient Care Volunteer, Home Health Aide, Respite).

Educates patient and family about Advance Directives as a means of promoting self-determined life closure.

Assists patients and families to complete Advance Directives as needed.

Initiates opportunities for patient and family to discuss funeral planning and burial arrangements.

Participates in interdisciplinary care planning conference.

Collaborates with other team members about ongoing psychosocial issues and family dynamics in order to heighten the delivery of empathetic and emotionally supportive care.

Assesses family's bereavement needs throughout the duration of the patient's life and develops a bereavement plan of care for the family following the patient's death. This includes referral to Grief Support Services as necessary.

Facilitates bereavement support groups.

Conducts presentations to professional and community organizations about patient services, issues related to death and dying and bereavement support groups.

Attends department meetings.

Serves on department and agency committees.

Attends mandatory agency in-services as part of continuing education.

Completes all clinical documentation in a timely manner, per Alive Hospice policy.

Notifies team members of significant changes in patient status, using established agency procedures.

Completes required EMR documentation to reflect time worked and mileage accrued.

Follows all agency protocols, policies and procedures appropriately.

Participates in the after-hours on call program and is available to respond in situations when the need for psychosocial care arises.

Other duties may also be assigned.