The social worker's role in patient care and advocacy

Social workers play a big role in hospital frontline services for patients and family members. According to a 2006 survey of licensed social workers, hospitals are the most common primary employment setting for them (Whitaker, Weismiller, Clark & Wilson, 2006.)

The roles and functions of Social Workers in health care

Their primary role helps patients and families understand an illness, come to terms with the emotions of a diagnosis, and provide counseling on the decisions. They are essential participants in the hospital medical teams; collaborating with doctors, nurses, and related health professionals. Social workers help the medical team members to recognize the emotional aspects of a patient’s illness.

Patient advocate

In an interview with Nancy Kriseman, a licensed Geriatric Social Worker and author of The Mindful Caregiver Finding Ease in the Caregiving Journey, she helps and supports patients navigate through the confusing issues in elder care.

After helping her father through numerous hospital discharge events and seeing how stressful the process was for him, Ms. Kriseman found a new passion. Advocating patients, especially those living with dementia, became her focus.“A useful tip for every family: Become a partner with the facility that cares for your loved one. No matter if it’s an acute-care hospital, an assisted living facility, a home care agency or a rehab center, collaborate with them,” advises Ms. Kriseman.

Unfortunately, medical teams don’t advocate enough for older people because they feel they’re going to die anyhow.But as loved ones move through the health care system, family members take on a lot of pressure and need to learn fast. Since hospitals base their care on the Medicare guidelines and requirements, sometimes a patient may feel their discharge from the hospital is too early. The patient and family can request an appeal. Find out more here.

There’s a significant need for patient advocates in the hospital settings. Sometimes the hospital will offer trained volunteers to help patients navigate the system. But Ms. Kriseman thinks social workers are more qualified due to their counseling education and training.Social workers have a keen eye for emotional upset and distress plays a big part in health care. The patients and families deal with many aspects of illness. They have to learn about the disease; the diagnosis, how to care for their health, the steps to heal, and how to recovery safely.

Family advocate tips

“When you have a child, parents will research for schools and even interview the administrative staff. A young mom and dad will visit several schools, even kindergartens, before choosing one. Be that diligent for older loved ones too. Research the types of care that’s available before one’s needed,” suggests Kriseman.Once a surgery is scheduled, but prior to hospital admission, the family should start looking for post-care.

‍Here’s what to do:

1. Make a list of questions to ask and use the same list for every facility you visit. Make an appointment with the Admissions Director.
2. If you’re checking out a rehab facility, find out about the type of medical care they give. Don’t assume they provide medical care just because physical, occupational and speech therapies are provided.
3. What is the medical care staff ratio to the number of patients?
4. What illness or chronic condition do they care for most frequently? How much experience do they have to treat your particular disease or illness?
5. Will the facility take the patient’s insurance?
6. Will your insurance pay for their services once Medicare stops paying (usually on the twenty-first day at the institution.)
7. How does the rehab medical director work with the patient’s physician and current medical team?
8. Some rehabs are very aggressive in their treatment. Will your loved one be strong enough to recuperate there?
9. Be sure to select several post-care facilities, one or two may not have openings (beds) when you need one.

Once a patient is admitted to hospital:

1. Most discharges occur 3 to 5 days after treatment unless the person is unstable.
2. Find out if the hospital has an Ombudsman onsite.
3. Find out immediately who (discharge planner or care manager) will handle your case. Meet with care manager and tell them that you’ve assessed several rehab, assisted living and nursing home facilities and the ones you selected. Tell them that’s where you want patient information faxed.
4. Insist that the planner talks with you first before faxing the patient records because you want your loved one to have the best possible opportunity to get accepted.
5. If the patient has a significant medical condition, a family member can talk with the doctor first who will know exactly how to interpret the patient’s prognosis and get them into a particular rehab facility.
6. Plan for discharge during the week. And if the patient suffers from sundowners, make it early during the day.

Be a partner, not an adversary. Patients have the rights, especially to have a safe discharge.......Carol Marak is a contributor for the senior living and healthcare market.