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Monday, May 2, 2016

Hospice - improving the quality of life

Friday, October 9, 2009

Lori Bush is pictured at the Hospice Gardens located at the Cherokee Regional Medical Center. Bush is currently serving patients at CRMC to enrich their quality of life. Photo contributed
Hospice is palliative care for the dying patient. It is often thought of as the last resort when nothing else can be done.

That is unfortunate. Instead, Hospice should be thought of as an option of care that can help people continue to really live their lives until the end-of-life. It provides people comfort and symptom management, which allows them the opportunity to make the most of their time living with a life-limiting illness.

Hospice is made up of an interdisciplinary team of the doctor, nurses, aides, clergy, volunteers and social workers. Social workers are a core service on the Hospice team.

Lori Bush, BSW, is currently serving patients at Cherokee Regional Medical Center. Lori has worked for CRMC Hospice for over six years. The social worker helps individuals and their families and/or caregivers to promote optimal psychological, emotional, spiritual, social, and financial well-being.

Their professional values and skills are designed to treat the whole person to enhance quality of life. Social workers are strong advocates for self-determination and culturally appropriate care. They are trained in evaluating the strengths of individuals and families and understand that good care requires that the wishes and needs of the patients are respected. When cure is no longer possible, Hospice social workers are specifically trained to assist the individual and family to cope.

Social workers assist patients and families in many areas. They can help with physical symptom management, such as relaxation exercises to help with anxiety or nausea. They assist with teaching coping strategies when psychological or spiritual stressors are identified. Anxiety, guilt, or depression can be addressed and managed through counseling, education and providing emotional support. Social workers are trained in problem solving, advocacy and facilitating the proper resources to find solutions that are helpful for each family.

Financial concerns are often an issue at the end of life, and this is another area where social workers are trained. They help people navigate resources such as health insurance coverage, food assistance, heating assistance, and other community resources.

Social workers assist with advanced planning to ensure that final wishes are being met. Advance care planning entails making decisions about treatment in end-of-life care and funeral planning and communicating with loved ones in legal documentation.

Social workers are able to use reminiscences to help patients recognize the importance and meaning of their lives. Hospice social workers have often assisted patients and their families in doing a life review and then recording the life history on DVD for the family to keep. This has often brought families closer together during the process and becomes a treasured keepsake for years to come.

Social workers in Hospice begin by doing an evaluation of the needs and desires of each patient and family taking into consideration the unique circumstances of each. Coping skills and strengths are identified and the social worker assists the patient and family to utilize these. If there are special difficulties, such as multiple losses or financial stresses, social workers help make plans to provide extra interventions, support, and/or resources.

As part of the interdisciplinary team, Hospice social workers will represent the patient's and family's wishes at every team meeting and advocate so that the patient and family receives care that is specific to them.

Social workers are also trained in helping others to cope with loss and the grief process. Dealing with the intense emotions associated with grief can be overwhelming without proper support and information. Social workers have information and skills that help facilitate grief and help people avoid obstacles that can lead to more complicated reactions like depression.

After death, social workers provide bereavement care for 13 months. Grief information, education and support are provided to help survivors cope. Monthly mailings are sent out and quarterly visits are made to the bereaved. The Living With Loss grief support group is offered several times throughout the year to Hospice families and others in the community who have suffered a loss. A Trees of Light memorial service takes place each year to honor those who have died.

Hospice services are paid for with doctor referral by Medicare, Medicaid and third party insurance carriers. You may reach Lori Bush at 225-6459 with any comments or questions regarding Hospice care.

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