John G Cagle1, Philip Osteen2, Paul Sacco3, Jodi Jacobson Frey3. 1. University of Maryland, Baltimore, Maryland, USA. Electronic address: jcagle@ssw.umaryland.edu. 2. Florida State University, Tallahassee, Florida, USA. 3. University of Maryland, Baltimore, Maryland, USA.
Abstract
CONTEXT: Hospice social workers are charged with completing a psychosocial assessment for every new enrollee. This assessment is part of the patient's comprehensive assessment and serves to inform the plan of care and key quality indicators. OBJECTIVES: To review the content of hospice social work assessments because little is known about what assessment topics are included or overlooked. METHODS: Using a cluster random sample from all 50 states, we contacted hospice agencies and requested a blank copy of the social work assessment completed at intake. We then systematically reviewed the content of these assessments to determine which domains were included and which were omitted. A total of 105 hospice agencies participated (response rate 42%). Among the assessments provided, 76 (72%) were unique assessments. RESULTS: Participating hospices were largely freestanding (65%), nonprofit (60%), and either medium (39%) or small (37%) in terms of average daily census. Over 60% of the sample, assessments included content on the following: financial resources; family structure; coping resources; bereavement risk; past losses; caregiver depression; religiosity/spirituality; patient anxiety, patient depression; and advance directives. However, most assessments did not include items evaluating the following: patient physical/functional status; preferences for treatment/care; awareness of diagnosis, prognosis, or disease progression; communication and literacy issues; changes in relationship intimacy/sexuality; and cultural values, beliefs, and customs. CONCLUSION: Hospice social workers should consider modifying their assessment practices to include a comprehensive array of assessment topics pertinent to patients and families. An accurate, comprehensive assessment that contributes to a holistic, interdisciplinary approach will likely lead to better clinical outcomes.
CONTEXT: Hospice social workers are charged with completing a psychosocial assessment for every new enrollee. This assessment is part of the patient's comprehensive assessment and serves to inform the plan of care and key quality indicators. OBJECTIVES: To review the content of hospice social work assessments because little is known about what assessment topics are included or overlooked. METHODS: Using a cluster random sample from all 50 states, we contacted hospice agencies and requested a blank copy of the social work assessment completed at intake. We then systematically reviewed the content of these assessments to determine which domains were included and which were omitted. A total of 105 hospice agencies participated (response rate 42%). Among the assessments provided, 76 (72%) were unique assessments. RESULTS: Participating hospices were largely freestanding (65%), nonprofit (60%), and either medium (39%) or small (37%) in terms of average daily census. Over 60% of the sample, assessments included content on the following: financial resources; family structure; coping resources; bereavement risk; past losses; caregiver depression; religiosity/spirituality; patientanxiety, patientdepression; and advance directives. However, most assessments did not include items evaluating the following: patient physical/functional status; preferences for treatment/care; awareness of diagnosis, prognosis, or disease progression; communication and literacy issues; changes in relationship intimacy/sexuality; and cultural values, beliefs, and customs. CONCLUSION: Hospice social workers should consider modifying their assessment practices to include a comprehensive array of assessment topics pertinent to patients and families. An accurate, comprehensive assessment that contributes to a holistic, interdisciplinary approach will likely lead to better clinical outcomes.
Authors: Nai-Ching Chi; George Demiris; Kenneth C Pike; Karla Washington; Debra Parker Oliver Journal: J Soc Work End Life Palliat Care Date: 2018-06-01