{When Should a Social Worker be Contacted?}

Medical professionals, church or house of faith pastoral staff or anyone who finds themselves in the position of working with people discover there are times when the helping person wonders to whom they can turn for help for this family or this individual?  You as a helping person may encounter people for whom the person you are helping and/or their family just don’t know where to turn for help – and you are struggling with helping them. 

A medical social worker should be called in when people are at a loss for what to do next.  Ask yourself some questions as a helper: (1) Is the person you are helping failing to thrive?; (2) Do you or the family think the person is unsafe in their home environment?; (3) Does the person need some outside help to be able to live at home?; (4) Does the person or the family need to consider possible placement in an adult facility for the person’s safety, care or professional oversight of their condition?

A medical social worker can be a great resource to you or to families working through those stated issues and more.   A medical social worker begins by performing a thorough psychosocial assessment to determine the needs of the person in question and the family.  This assessment also ascertains what resources are already in place for the person and/or family.

Based on the psychosocial assessment, the medical social worker may educate or advise the person/family about:

• Home safety.  This is paramount, and it may include conversations about:
  • Security, such as a possible home security system
  • Personal alerts, such as getting a possible life alert device
  • A working telephone that the resident can operate
  • Modifications to the home, such as ramps, bannisters, assist bars, widened doorways, higher toilets or a toilet seat extension
  • Interior pathways without tripping hazards such as a buckled floor, a wrinkled carpet, or carpet edges that stick up or electrical wires across the lane of travel. Is the person able to make it to and from the bathroom safely?
  • Exterior walkways in which the person is able to get to and from a vehicle safely, smooth walks without tripping hazards
  • De-cluttering the home
  • Food preparation:  Can the person reach the stove controls?; Are there objects on top of the stove, perhaps from the last grocery trip that haven’t been put away?; Does the person have the mental capacity to cook?; Is the food in the house edible?; How well is the person adhering to their recommended diet per their medical provider’s orders?
  • Ability to drive: Is the person able to drive safely and without endangering others?; is the vehicle in safe running order?
• Finances.
  • Who is handling the finances? 
  • Are there unpaid bills?
  • Are there bills in collection?
• Legal solutions (including Powers of Attorney for Health and Legal Decisions, Advanced Directives (also known as a Living Will), Last Will and Testament, Legal Aid)
• Medical insurance (such as Medicare, Medigap, Tricare, private insurances and Medicaid)
• Qualifications for different non-government assistance, including from faith-based organizations such as the local Food Bank, Meals on Wheels, houses of faith
• The conversation may be steered toward different kinds of government assistance, such as their county and/or state’s Department of Social Services, Council on Aging or the Veteran’s Administration 
• And very importantly, the conversation may well be directed toward assessing caregiver burn-out, which is a very real problem in private homes.
  • This may include discussion regarding a home aide service
  • Support groups, such as those dealing with the person’s particular illness, Alzheimer’s, Multiple Sclerosis, Grief Share and so on
• Finally, the medical social worker will discuss with the person and/or family possible next steps in the person’s care.

After such a delineation of what a medical social worker does, the reader may think they don’t need a medical social worker as they can do the same thing on their own.  However, the medical social worker brings into the situation possibly many years of experience.  In addition, a Master of Social Work degree requires two to three years of graduate school past a four-year bachelor’s college degree as well as supervised field training during this study. Finally, not everything was listed in order to keep this fairly short.

Where does the reader find a medical social worker?  If the person is in a hospital, they have social workers on staff to help patients with their transition home or to a location that is safe as well as ensuring community services are available.  After discharge from the hospital or if a medical provider has concerns, the person may be referred to a home health agency that will include medical social workers on staff.  Finally, if the person lacks monetary resources, they may be helped by a social worker through the county or state Department of Social Services, although a staff person will likely not have a Master of Social Work degree.  This isn’t to discount the help available from a government agency as they are able to access programs that are not otherwise available to non-government employees.

I hope this was of some help to the reader.  Too often in our society as we encounter life’s problems that seem to pop up when we least expect it, we end up facing brick walls and we don’t know where we can turn.  When you see the wall approaching you – or when you get bruises from the wall you just smacked into – a medical social worker may be the avenue to a solution.

[This article was written based on notes presented during a staff in-service training at Medi Home Health of Raleigh, North Carolina on May 10, 2017 by Medical Social Workers on staff – Harriet Carter, MSW and me, John Myklebust, M.Div., MSW.]