Bridges link medical care and lifestyle preference
Bridges link medical care and lifestyle preference
Putting the puzzle pieces together
Social work is integral to the patient education process. While social workers don't provide information about treatment, medications, or diagnosis, they help educate patients about how these issues might affect their lives, says Margaret Meyer, LMSW-ACP, director of social work at University of Texas MD Anderson Cancer Center in Houston.
Social workers help integrate patients' medical care with their lifestyle and other things that are important to them. "We help integrate their family, community, work, and school with their medical care," she explains.
For example, if the patient's treatment plan requires that he or she be admitted to the hospital one week each month for a nine-month period, the social worker helps the patient deal with job problems or child care difficulties. "What is involved depends on what is important to that patient. Therefore, we might not do anything with some people, or we might spend a whole lot of time with someone else," says Meyer.
It's important to incorporate social work into the teaching process because social work evaluates a person holistically, adds Jennifer Woods Parker, MA, MSW, CCSW, clinical social worker at Charlotte (NC) Institute of Rehabilitation. The social worker looks at the whole person to see how all the pieces fit together. "Social workers are good at working through complex situations, and they are very good at working with systems," she explains.
Social workers can teach patients how to communicate with their physicians and other members of the health care team rather than being intimidated by them, says Nellie Garcia, LCSW, director of clinical social work at City of Hope National Medical Center in Duarte, CA. They can educate patients about community resources; teach coping techniques to help patients deal with anxiety, depression, and adjusting to the diagnosis; and explain advance directives. They also can teach people how to use resources within the institution and the community and how to advocate for themselves, she says.
What makes social work so suited to tackling lifestyle issues? According to Garcia, it's their training in the profession. "We are taught problem- solving skills, counseling skills, communication skills, and advocacy skills, so it seems to be a good fit," she says.
When cancer patients are accepted for treatment at City of Hope, a social worker automatically does an assessment to help them prepare for the treatment process. The social worker will make sure the patient has applied for appropriate entitlements if he or she can't work, review information on durable power of attorney, and cover issues such as transportation to and from the medical center for treatment.
"When we do the intake [assessment], we educate the patient and family on the kinds of feelings or emotions they might experience based on the things other patients have gone through, so we normalize the situation for them," says Garcia.
At Charlotte Institute of Rehabilitation, social work is involved in every case. "We get a baseline of where the patient and family were before the illness or accident, and assess for needs that may affect how the patient will do in his or her hospitalization. We look for possible barriers to discharge or healing. Then we research resources to meet those needs and overcome those barriers," explains Woods Parker.
The information collected by the social workers helps set the tone for the educational interventions of the entire disciplinary team, adds Robert Mittan, PhD, director of patient and family education at the institute. For example, if the patient and family have a limited educational background, the social worker alerts the rest of the interdisciplinary team so they can adjust their educational approaches accordingly.
Other institutions have criteria in place that signal the need for a social worker to become involved. At MD Anderson, each clinic has a screening process. At the breast center, for example, referrals to social work are made if the patients live alone or are elderly, indigent, out-of-state residents, uninsured, or underinsured, says Meyer. The social work department also has an informal screening process and reviews computer data on new patients throughout the system, trying to find similar red flags.
In addition to teaching patients, social workers also can be incorporated into staff education. For example, social workers at City of Hope are teaching health care workers how to identify and report child or elder abuse and domestic violence. (For information on patient education programs overseen by social work, see article, below.)
Social workers at Charlotte Institute of Rehabili tation often facilitate the team process. For example, when all the disciplines meet to discuss a case, social workers might assist the physician in facilitating the meetings. "We get disciplines to talk to each other," explains Woods Parker.
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