American Hospice Foundation, Washington DC, USA

Emotional Assurance: A Hospice Social Worker's Perspective

By Ileen Koller, MSW, ACSW
Medical Social Worker, Hospice of Arizona

Some time ago I received a call, not from one of my patients, but from someone in the community. As a hospice social worker, I often get calls from people in the community wanting general information about hospice services.

The phone conversation went something like this: "Ileen, my name is …. I am in my fifties, happily married with a beautiful family and a wonderful job. But, recently I was diagnosed with prostate cancer. Now I plan to fight this with every possible treatment. However, I know that life does not always go the way we want it to. Should this disease get the best of me, I want to know about the options of care and support that will be available for my family and me. I need to know that something and someone will be there for us for whatever lies ahead."

I could hear in this man's voice the feelings of hope, but also despair. I could hear the desire to maintain control of life and yet the possibility of becoming dependent. I could hear living, as well as dying.

Our conversation ranged from discussing aggressive treatment to palliative/hospice care. We talked of grief and loss before anything difficult had yet happened. We talked of end of life planning while still looking forward to seeing children graduate. We talked about life and death.

Our society has a difficult time facing death. We certainly don't want to talk about dying when we are so busy living. But dying will come to all of us, either suddenly and traumatically or more slowly and sadly with a terminal illness. Either way, we need to plan ahead and anticipate for those events that won't possibly happen, but will happen.

We invest a great deal of time, effort and money in obtaining the security of health insurance, life insurance, auto insurance, mortgage insurance, etc. to plan for the unexpected. But what about grief insurance, comfort insurance and emotional insurance for the inevitable losses we all will face in life when physical, emotional and personal problems befall us?

As a professional social worker in health care, I have come to realize that counseling services need to cover the full spectrum in the continuum of care, namely, health and healing to death and dying. We need knowledge, skill and ability to transition individuals and their families through the course of life and beyond. We focus on presenting problems, but we also need to focus on issues and anticipated needs that an individual and their family may not have thought about or even wanted to consider.

Professional social workers can and should be proactive in helping patients, families, other professionals and the general public know of the resources and choices available to make sound, intelligent decisions about living and dying.

We may not be able to give guarantees of "no pain" or "no stress," but we must be able to give the emotional assurance that there will be caring and compassionate, knowledgeable and innovative professionals to help guide people through this unpredictable journey called "life."


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