Assesses the psychosocial status, spiritual and emotional needs/factors of patients, families, and caregivers related to the patient's terminal illness and environment and communicates findings to the registered nurse and other members of the interdisciplinary group. Provides an assessment in the patient's identified residence and assistance when this is not safe and another plan is required. Assists the physician and other members of the ho spice team in understanding significant social, spiritual, and emotional factors related to the patient's health problems to establish a plan of care that fosters the personal worth, spiritual well-being, and human dignity of each patient, Carries out social evaluations and plans intervention based on evaluation findings. Counsel's patient, family, and caregivers as needed in relationship to stress and other identified coping difficulties. Helps the patient and family understand, accept and follow the medical recommendations and provide services planned to assist the patient and family in achieving the optimum social, spiritual, and health adjustment within their capacity. Prepare the patient to deal with the changes and the family to support the patient. Assesses bereavement needs of patient's family members after patient's death and provide bereavement counseling as identified in the bereavement plan of care Patients, families, and caregivers will be visited a minimum of two times per month. On the off week a phone call will be made to every patient, family, and/or caregiver. This will be patient driven. If there is a circumstance where a patient, family, or caregiver does not want to have visits twice per month, you will be required to speak with the Director of Hospice Services. Social Worker will review the End of Day email the next morning to review patient activity from the previous evening and determine schedule changes based on patient and family need. Meet with the Director of Hospice Services on a weekly basis or as directed to by Director of Hospice Services. Maintains clinical records on all patients referred to social work. Communicate on a daily basis with other team members about patient care. This includes checking in and out of buildings with key staff members providing an update on visit and checking the status of patients prior to beginning the social work visit Participates in the on call schedule Provides information and referral services for organization patients, families, and caregivers. Provides information to patients, families, caregivers, and community agencies. Serves as liaison between patients, families, caregivers, and community agencies. Maintains collaborative relationships with organization personnel to support patient care. Maintains and develops contracts with public and private agencies as resources for patient and personnel. Participates in the development of the individualized plan of care and attends regularly scheduled interdisciplinary group meetings. To be in attendance for the entire meeting. Assists physician and other team members in understanding significant social and emotional factors related to health problems and death and dying issues. Actively participates in quality assessment performance improvement teams and activities. Other duties as delegated by the Director of Hospice Services or Clinical Services Manager.
The above statements are only meant to be a representative summary of the major duties and responsibilities performed by the employee of this job. The employee may be requested to perform job related tasks other than those stated in this description.
The employer for this position is stated in the job posting. The Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US. Each of these businesses is operated by a separate, independent operating subsidiary that has its own management, employees and assets. More information about The Pennant Group, Inc. is available at http://www.pennantgroup.com.