The Role of Social Workers in Home Care

Whether you’re thinking of beginning a career in social work or you’ve got years of experience under your belt—most would agree that people go into social work because they want to give back.

But it’s important to know that social work can be really varied. There are different types of social workers (like those specializing in substance abuse, forensics, child welfare, and more). And social workers can be found in a lot of distinct environments where they serve a variety of populations. 

In this blog, we’re going to focus on three types of health care social workers, in particular. But first, let’s review the basics.

What do social workers do?

Social workers work with clients to assess the full range of their needs and help them access services and resources to improve their quality of life. In short, social workers help people solve problems, set goals, and get things done.

In the field of home health care, there are multiple specialties that rely on social workers as a vital part of the multidisciplinary care team, including hospice, home health, and personal care and companionship services.

The role of a hospice social worker

Hospice is for people who have received a life-expectancy prognosis of six months or less. In lieu of curative treatment, hospice care focuses holistically on giving the patient and their immediate family members the best quality of life in their remaining time together. Much of that entails pain and symptom management, but the medical social worker plays a critical role in helping clients and families deal with the other emotions, relationship issues, and logistics that come near the end of life.

Duties of a social worker providing hospice care

• Advocacy: The hospice social worker acts as a strong advocate for patients and families, honoring self-determination, cultural differences, and end-of-life preferences.
• Active listening: The social worker uses active listening skills to support problem-solving and decision-making and to provide emotional support.
• Education: The MSW can guide the patient and family in areas such as finance, advance directives, available state and federal program funding, and funeral planning.
• Counseling: In this essential element of the hospice social worker’s role, they will counsel the patient and family in their grief and loss, help with end-of-life goal setting and wish fulfillment, and support the patient to gain insight into the existential meaning of their experience and to optimize their well-being at the end of life.

The role of a home health social worker

Home health is a suite of care services that help clients with short-term medical needs. Most of these clients recently transitioned from hospital to home. Maybe they are recovering from a surgery, injury, or acute illness. Or they may have a chronic disease such as diabetes, COPD, or heart failure, and a doctor has prescribed short-term home nursing care to help them better manage their condition.

Catherine Briggs, LSW, works as a medical social worker for BAYADA Home Health Care in Burlington, New Jersey. We asked her to tell us more about “a day in the life.”

What is a day in your life like?

Catherine: It’s hard to describe a typical day, because every day is different, which is part of what I love about my job. Medical social workers use our wealth of knowledge to bridge the gap between our clients and all the resources and services they need. In home health, the social worker often is the primary coordinator on a client’s care team, and we’re the one primarily thinking about emotional support and advocacy for the client and family.

Current insurance regulations only give us a few visits with each client, and the average home care episode lasts one to two months. So MSWs need to work quickly to identify problems and create immediate and longer-term interventions. We assess each client’s needs and create a plan to address each challenge. Then we’re their support system while the plan is implemented.

Medical social work is fast-paced and intense in nature, so you need to be an excellent problem solver who can juggle a variety of crisis situations at once. I love the challenge and variety this field provides me as a clinician. I am learning every day, and helping others learn as well.

What is it like to work with home health clients?

Catherine: When an MSW meets with a new client, our primary goal is for them to feel heard. Maybe they’re no longer able to drive and they’re worried about losing their independence. Or, they might need more care but are concerned they can’t afford it. One of my favorite parts of my job is the look of relief on a client’s or family caregiver’s face when I’ve given them hope!

We see clients during some of their most vulnerable moments. Many of them are scared and feeling hopeless. Maybe they were just given a new, life-changing diagnosis. They’re probably feeling overwhelmed as they adjust to their ‘new normal.’ Medical social work gives you the opportunity to work with nearly every population and address a wide range of complex needs. There is never a dull moment, and you can make a big impact in a short period of time.

What kinds of impact can you have as a medical social worker?

Catherine: In home health, social workers play a significant role in reducing readmissions and keeping people out of the hospital. By the time a case closes, I feel like I’ve helped the client address their short-term and long-term goals, and I’ve hooked them up with the long-term supports they need to stay healthy and happy in the comfort of their own home and community. Information is power. I empower people. Making someone feel empowered, when they’ve lived without that feeling for so long, is incredibly rewarding!

What is the role of a social worker in personal care services?

For those—most often seniors—who find it’s become more challenging to manage daily personal activities or housekeeping tasks on their own, personal care and companionship services can help them stay safe and independent at home. Depending on need, caregivers—usually home health aides—provide assistance with activities of daily living (ADLs) such as bathing, grooming, and dressing; meal planning and preparation; light housekeeping; running errands and shopping; escorts to appointments; and companionship.

Personal care and companionship services can differ from home health and hospice in that many clients receive care services for years versus months. Therefore, long-term relationship-building is an important aspect of being a social worker in this line of work. 

Jennifer House, a BAYADA MSW, works with senior clients and their families in Raleigh, North Carolina. We asked Jennifer to tell us about her role in helping those receiving personal care services and how it impacts those she serves:

Jennifer: When new clients call, they are often in desperate need of services and unsure of where to start the process, so I try my best to calm their nerves and validate their feelings throughout the phone call. It is important to make sure you take the time to listen and not rush the process, making sure you hear exactly what they need and feel comfortable in the services they will be receiving.

One of the most rewarding parts of the job is being able to connect with the family and checking on them if it is a phone call, couch visit, or sending them a thank you note. Now with COVID-19 and a lot of family members not being able to directly help their loved ones, the extra contact and communication is more important than ever to let them know we care.

As a director of the BAYADA office in Tempe, Arizona, Sarah Brambila, MSW, uses her experience in social work to help her staff bring the best care to her clients.

Sarah: For all of us working in personal care services, we know how family dynamics can impact our ability to care for our clients safely. Having the skill-set to mediate, create, and facilitate healthy dialogue about everyone’s best intentions can be such a helpful tool in coordinating care.

There is also the opportunity to connect our clients to needed resources and social workers have great access in this regard—not to mention the tight-knit community that social workers can share. Our community partners and referral sources know their clients will be in the best hands because a social worker is at the helm!