A Day in the Life of a Hospice Social Worker

My days are planned ahead of time since my work is defined by policy and regulations. I have schedules, agendas and plans I develop to meet many individual needs and requirements. My training guides me as to how I approach each task and experience. I will start out each morning knowing where I’ll need to be – who I’ll see, where and why – however I always need to be prepared for the unexpected. I have clear guidelines for each engagement, assessment, presence, resource and information shared – with support and availability extended.

In a sense my role is simple and clear according to the professional social work parameters. However, the reality is that no patient, family member or situation is ordinary or average. I have to use my God-given discernment and judgment to best apply my knowledge to improve the quality of experience for each person I support.

People and their lives and relationships are complicated and circumstances for each patient can be complex. There is a detailed history of relationships, behavior patterns, hidden agendas, financial needs, emotional needs and personalities in endless variation. I often see dysfunctional families and dysfunctional personal pasts—as well as the usual grief, fears, loss, anxieties about caregiving and special personal requirements.

Always, personal issues come to the surface, as regrets are expressed and secret wishes shared.

In one case a couple who had been living together for 13 years expressed the desire for a wedding – to validate their relationship and love for each other. There was very little time left for the dying individual, and resources were scarce. However, the patent’s shared wish was to accept the hand in marriage of the man who had asked her many a time to marry him. Though she had denied this up until now, the decision seemed somehow fitting and respectful. So I considered how to manage this.

My social worker role was then augmented and suddenly I found myself to be a wedding planner – of a special kind. I became the coordinator of this enduring love’s final ceremony – the facilitator of one last loving wish. This was not part of the guidelines yet how often we are called upon to rise to a special occasion and make a life more meaningful.

The day came when we held a bedside marriage – with a chaplain, wedding cake, beautiful flowers, colorful balloons family surrounding both partners and a warm, wonderful hour – filled with love and emotion. It was a beautiful, defining moment where lasting memories were made and a spiritual presence was felt.

The next day, death came swiftly and silently – in a hallowed instant. Yet before death stepped in – a social worker together with a family stepped up to a last request. A deep commitment was realized, and vows unspoken for years were shared openly in the presence of loved ones – and a life was spiritually completed, breathed softly in relief.

Some days in the life of a social worker cannot be coordinated by the book. They are orchestrated from the heart – services rendered, though imprecisely defined by policy. The unexpected becomes the undeniable – and the exceptional becomes the exception. All of this … because we live in a world of people … who need people. And as a social worker I am deeply gratified that I am needed -- not just for my skill set but for my personal commitment.

Diana Zerkle
Community Mercy Hospice