“People do their own work. We’re just there to help set the direction.”
Mary Hackman, MSW is an exemplary professional in geriatric care and hospice care. Her credentials are impressive, and her years of experience as a social worker grant her a level of expertise that’s difficult to match. However, these things really aren’t what make Mary stand out in her field. It’s her heart that makes a difference.
Mary is a social worker with Salus Hospice and has been with the company for about a year and a half. Prior to joining our team, she spent four years at another hospice organization, eleven years in the acute hospital setting and ten years as a psychiatric home health social worker.
The Goal of a Social Worker – Patients First
Her goal has always been to put the patient first. In fact, she left the hospital setting, in part, because she no longer felt empowered to do that.
In Mary’s words, “Like many facilities, the hospital that I worked at made some changes and began using social workers more as discharge planners. Rather than being able to spend time with patients and helping to ensure that they had the services and support they needed, we were charged with working under the nurse case manager and spending more of our time freeing up beds. Discharging patients wasn’t the reason I entered the social work field, and so, these changes had me considering a new career path. That’s when I moved to hospice care. Working here allows me to spend more time with patients and families, more time helping people.”
A Day in the Life of a Hospice Social Worker
Speaking with Mary on a warm Tuesday afternoon offered a unique glimpse into her world and the real-life situations that she sees every day.
What’s most evident is that Mary is a hospice social worker who cares deeply about her patients. She leaves her cellphone number with each family she visits, and she encourages them to call her anytime. There’s never a minute of hesitation when she’s asked to make an extra visit, speak with a family member, talk through concerns, or discuss steps in the hospice and bereavement process. She constantly assesses situations and looks for ways to help families to find the right community resources and support. If you ask her why she goes that extra mile, she’s ever-so-humble, indicating that it’s not a big deal and just what she does.
The Role of a Hospice Social Worker
Writing Mary’s job description would be a difficult task because she wears so many hats. However, joint visits with a nurse when a patient enters hospice care are a regular occurance. She appreciates that Salus Hospice gives her the flexibility to handle visits in this way. It’s a unique approach and one that she believes benefits families.
“Joint visits give the hospice nurse time to fully assess the patient on a micro level, as an individual. Meanwhile, I spend much of my time with the family caregivers and assess the home environment. I’ve found that sitting with a spouse, son or daughter, one-on-one, gives me an opportunity to understand their history and the family dynamics, the environment, and the living conditions. Essentially, I look at the situation from a macro view. The things I learn often impact the family caregiver’s relationship with their loved one, their end of life care needs and the family’s view of hospice care. I then share this information with the hospice nurse, and they share what they’ve learned with me. It’s a holistic approach to care that allows us to develop the best plan of care and help the patient to most effectively reach their end of life goals.”
Supporting Hospice Patients
Mary’s job isn’t limited to assessments. She also spends hours upon hours getting to know patients. Her days are spent talking to them, supporting them, and doing the things that she views as “not a big deal,” – even though these things mean so much to someone else.
“One of the families I helped, they were just the cutest couple. They spent all their time together, in their matching recliners, watching a long list of favorite television shows. There they sat, with coffee in hand and just enjoying each other’s company. When her husband passed, I knew instinctively that watching a body bag leave the home would be a negative experience for her. It was certain to be one with long lasting repercussions.”
Mary continued, “The solution, it turned out, was simple. She was a smoker, so I suggested she go outside and smoke her cigarette. I made her a snack and some coffee and sat with her, talked to her, listened to her. Inside the home, the medical team was finishing up. These final steps were necessary, but she didn’t need to experience them. As I saw it, my job was to ensure that she didn’t have to. I still call her regularly, just to check in and see how she’s doing. She doesn’t have much family, so I’m there for her.”
Variety is the Spice of Life
Mary enjoys the variety in her days and is an effective problem solver. With each new hospice patient, she’s driven by NOT knowing what’s on the other side of that door.
Family mediation and education are a regular part of her job. She values helping families to understand their end of life care options and why taking certain steps is important. In one home, through education and pulling from her own professional experience, she proactively helped young children to avoid complicated grief. Family members were resistant to let their young children visit with a sick grandfather. She recognized this as potentially problematic for the children. As a result, she provided the adults with information about the importance of final goodbyes. Ultimately, the family allowed the visit, just in time. The day the grandchildren were with their grandfather was the last day he was able to speak. He passed soon afterwards. The family now recognizes this as an important day and one that they all view in a positive light.
Mary also sees it as her job to educate nurses about the importance of being realistic. You can provide comfort and manage pain in end of life care. However, you can’t change 50 years of family history and dynamics. A care plan that’s developed without those things in mind won’t provide the most benefit to patients. That doesn’t benefit the patient or their family members.
Her training in psychiatric diagnoses also empowers her to educate family members. She helps them to understand the reasons behind their loved one’s words and actions. Understanding leads to forgiveness, letting go at the end of life, thinking in realistic ways, and developing important coping skills.
Mary is a person who I could sit and speak with for hours, enjoying every minute of the conversation. Even then, I could not fully grasping all that she contributes to the world. During Social Work Month, we want to express our gratitude for all that Mary does for our hospice patients and their family members. She, like all of our hospice social workers, is an irreplaceable member of our team and a valued member of the Salus family.