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Whether it is because of a recent national news story about a beautiful young woman with a terminal illness choosing to end her life or simply that the time has come for these discussions to be had, it seems that conversations are increasing about the circumstances surrounding the end of life. Polls show that more Americans want to “have the talk” about the end of life and have a voice in making decisions about how that end will occur.
These conversations often don’t happen without the assistance of a health care provider and our E-News Exclusive discusses the integral role of the palliative care social worker (PCSW) in facilitating these important conversations and the need for PCSWs to be able to bill for their time. According to our E-News Exclusive author, Sarah Josephson, MSW, LMSW, “The PCSW routinely initiates the conversation termed goals of care [GOC] by engaging the patient or family member together with the doctor. While the doctor contributes relevant clinical information, the PCSW is specifically trained to offer palliative options, taking into consideration a more holistic view of the patient. This helps a patient to synthesize the clinical, psychological, social, emotional and spiritual needs—all of which factor into a person’s decisions about end of life care. Reimbursing for the palliative care social worker would make GOC discussions more available and more effective. As a result, greater numbers of patients would be able to make informed decisions about their own end-of-life care.”
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— Marianne Mallon, editor |
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Does Our Health Care System Offer the Possibility of a ‘Good Death’?
By Sarah Josephson, MSW, LMSW
Though each of us will die, chances are you haven’t considered what a “good death” means to you. Yet, if you, like 70% of Americans, end up in a hospital or long term care facility at the end of your life, you might wish you had. You will be asked—if you retain mental capacity—about your wishes to mechanically prolong your life if/when your heart stops. You will be asked to weigh quality of life against mere survival. For most, these decisions follow a series of conversations not only with trusted family, but with physicians and social workers on staff at the facility. Insurance companies reimburse facilities for these conversations only when doctors and/or nurses are involved. But another person who is equally invested in this task—the palliative care social worker (PCSW)—cannot bill for his/her time. That must change. The PCSW routinely initiates the conversation, termed goals of care (GOC), by engaging the patient or family member together with the doctor. While the doctor contributes relevant clinical information, the PCSW is specifically trained to offer palliative options, taking into consideration a more holistic view of the patient. This helps a patient to synthesize the clinical, psychological, social, emotional, and spiritual needs—all of which factor into a person’s decisions about end-of-life (EOL) care. Reimbursing for the palliative care social worker would make GOC discussions more available and more effective. As a result, greater numbers of patients would be able to make informed decisions about their own EOL care.
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Care Manager
Seton Medical Center, Daly City, CA |
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