Interdisciplinary Perceptions of the Social Work Role in Hospice: Building Upon the Classic Kulys and Davis Study

Abstract

This national survey found that hospice directors (n = 43) considered social workers most qualified, and most involved, in 12 of 24 interventions considered by social workers to define their role. This is a change from Kulys and Davis' ( 1986 , 1987 ) findings of a more limited social work role in hospice. The results of the current study provide new information about director attitudes, social work involvement, and the impact of efforts to develop the hospice social work field. Social work education should incorporate more end-of-life care content to continue this progress, and hospice social workers should continue to document their effectiveness on the hospice team.

Hospice Psychosocial Service Availability and Utilization in the United States

“…The proposed study will initiate investigation into psychosocial hospice services by examining the constructs identified under the hospice social worker role as indicated by empirical literature (Christ & Blacker, 2009;Reese, 2011;Reese, 2013;Reese & Raymer, 2004;Reese et al, 2006;Reith & Payne, 2009;Saunders, 2001). These constructs (resource referral, mental health counseling, advanced directive counseling, respite care linkage as well as grief and bereavement counseling) have also been identified by hospice regulatory and organizational bodies CMS (2014a), NHPCO (2013a), andNASW (2004) as components of the hospice social work role.…”

“…There has been slight improvement in the perception reported by contemporary hospice directors compared to the results revealed in the 1986 Kulys and Davis study. However, according to Reese (2011), an expansion of the Kulys and Davis study showed that the social workers are not engaged in over half of the duties ascribed to them by the profession.…”

“…psychology, sociology, or other field related to social work) (Center for Medicare Advocacy, Inc., 2010).This is a reduction in qualification, creating more vague placement for an already devalued member of the hospice team as in the initial conditions in 1983 mandated that the individual enacting in the hospice social worker role needed to specifically have a degree in social work (Center for Medicare Advocacy, Inc., 2010). Despite social work organizations such as NASW and the National Hospice and Palliative Care Organization discouraging the changes, they were finally approved causing National Hospice and Palliative Care Organization, National Council of Hospice and Palliative Professionals, Social Worker Section, Guidelines for Social Work in Hospice were updated to reflect the change (Reese, 2011).…”

“…Due to the impending death of the patient, social workers may only see a patient for a short time, making implementation of standardized modalities such as mental health interventions difficult if not impossible to implement (Reese, 2013;Reese et al, 2011). In addition, the social workers that are providing care may have objections to the rigor and/or modality of available interventions (such as administering an extensive battery questionnaire) (Reese, 2013).…”

“…This can sometimes lend to the blurring of discipline roles with nurses addressing psychosocial issues and less frequently making referrals to the team social worker due to the convenience of visit frequency, familiarity with patient cases, and possible desire to address patient care needs rapidly (Reese, 2011;Reese, 2013;Reese & Raymer, 2004;Reith & Payne, 2009). …”