When Karen Miller meets an individual beginning hospice care, she keeps one priority at the forefront of her mind: making sure the person has a strong advocate on their side. With Miller’s every action, the Intrepid USA Hospice at Home social worker is careful to prioritize the individual’s wants and needs above everything else.
“We have a very unique role in the interdisciplinary team,” Miller said, emphasizing the person-centered, team-focused aspect of the care a person receives.
With a holistic approach, she and her colleague Josh Shorter work alongside the entire care team to ensure the person entrusting them with their care gets the support and services they need to achieve their personal end-of-life goals.
When Miller or Shorter walks into a room, the first thing they do is assess the person’s needs. This assessment will be the foundation for the care plan that comes after.
“We bring the psychosocial aspect to the hospice team. We work with a lot of techniques to reduce their anxiety and feelings of being overwhelmed so they hear and retain the information we’re providing,” Miller said. “A lot of times we’re really working from the hierarchy of needs – making sure their basic needs are being met and then we can go up the pyramid.”
Their duties can include helping to meet an individual’s spiritual, emotional, environmental, and other needs in a holistic way.
“We empower people and help them find their strengths,” Shorter said. “We really promote their autonomy and their self-determination.”
Miller added that social workers place the person’s personal priorities at the center of all they do.
“We are part of the interdisciplinary team and part of the care plan, but sometimes we have to say now I’m going to put on my patient advocate hat,” she said. “When a patient cannot advocate for themselves, it is professionally and ethically our role to do that even when they want to make unhealthy choices.”
In helping a person through their journey, they often help them navigate the advance care planning process, relieving their loved ones of the burden of decision-making should they no longer be able to do so themselves.
“A big part of what we do is dignity work and helping them finding the meaning of their life and their legacy,” Miller said.
Another big service they provide is caregiver support, such as for those caring for a loved one living with dementia.
“It’s a very demanding role for caregivers and their loved ones often need 24/7 supervision and care, so they’re not getting a break,” Miller said. “We teach a lot of techniques and a lot of planning about being ready for the next stage so when the next decline comes, they are prepared, and all the equipment is in the home before it happens.”
The emotionally taxing role of a hospice social worker means Miller and Shorter work to support one another while also practicing good self-care.
“We fill each other’s wells and we laugh a lot – nobody else knows what we do and what we see,” Shorter said. “We’re part of this really great team with a really great sense of humor in the kindest, most compassionate way.”
Recharged after prioritizing their own rest and mental health, they go back to work and thoughtfully provide the best support possible.
“We come in at their weakest moment, and that can include providing additional hospice education and listening to their thoughts regarding comfort care instead of trying to cure their illness,” Shorter said. “We help them focus on thinking about their quality of life versus quantity.”
It’s a job he and Miller wouldn’t trade for the world.
“In this field and in caring for the dying, I’m learning something every day, and for the self-growth of social work and hospice, I can’t see myself doing anything else,” Shorter said.
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