Reflections from a silent guardian: The vital role of a social worker in palliative care

The vital role discharged by a Social worker in hospice care often goes unnoticed. Social workers help provide essential emotional support, facilitate communication, and help arrange practical assistance for palliative care patients and their families to ensure that patients receive comprehensive care. A social worker’s exceptional skill to actively listen and understand the needs of a patient or their caregivers helps them to form strong bonds with the patients and the caregivers, all while frequently remaining in the background. These hidden pillars of support also assist patients and families navigate complex healthcare systems, advocate for patients’ rights, and discuss end-of-life wishes. During each interaction, they identify subtle needs and offer support along with providing a comforting presence.

Two years ago, while enroute to a patient’s home for a home care visit, I noticed a man with a severe facial wound walking aimlessly on the road. I asked our driver to stop the van and approached him. Though he was initially reluctant to talk to me, he eventually explained that he had cancer and was self-treating his wound with a handkerchief. He reeked of alcohol and shared that he was heading home from a liquor store.

I told him about palliative care and how we could help him. I introduced him to the palliative care services offered at Sparsh Hospice. After some reluctance he eventually agreed to take our support. We then scheduled a visit to his home. During our visit, I saw the household in disarray. I met his daughter who told us about the various challenges that the family was facing due to her father’s illness. I understood that his wife avoided him as she was not only repulsed by the wound but was also overwhelmed by their financial struggles. The daughter went on to share that she was also unable to help much as she was married not long ago and had only recently given birth.

Upon further probing I realized that the patient’s wife loved him but blamed his smoking and drinking for the illness. She also highlighted the social pressure and the verbal assaults that they had to endure from the community due to her husband’s open wound.

Over the next several visits, we cleaned his wound, provided medication, and inserted a feeding tube. His condition however kept fluctuating due to poor wound management. When his pain increased, we admitted him to Sparsh Hospice. His addiction for alcohol and cigarettes motivated him to leave the hospice on several occasions. Understanding this, we arranged to settle for the lesser of the two evils in the current situation and allowed him to have an occasional drink or a smoke, within a controlled environment, hoping that this would allow for us to continue caring for him.

Gradually, with support from the team at the hospice, his wound improved and he began enjoying time with his grandchild. He was in comfort and without pain.

Two months later, he passed away with dignity.

His family thanked us for the care and love he received while he was with us. They shared how it was such a blessing to have had access to quality health care and how our support helped improve the family’s social standing within the community.

For me, as a social worker, this case exemplified the profound impact that palliative care can have on truly alleviating the suffering of a patient and their caregivers. This one episode has continued to inspire me and also increased my dedication towards improving the lives of those with incurable conditions and their families.

I take pride in my work as someone who holds hands, listens and extends kindness to individuals facing their life’s most challenging moments. With this narration, I would like to acknowledge and appreciate the contributions of every social worker who works in palliative care or health care in general. I urge you to recognize and celebrate these hard working and large hearted heroes in your team as you strive towards improving end-of-life care experiences of your patients.