Hospice is specialized care for people with life-limiting illnesses or conditions. A patient receiving hospice care is usually supported by an interdisciplinary team that includes doctors, hospice nurses, aides that provide practical medical care, clergy, counselors, therapists, and social workers.
Hospice social workers have a big, multifaceted job. They serve not only terminally ill patients but also their families. They help hospice patients access the resources that will keep them comfortable while also offering emotional support. They sometimes also serve as care coordinators and financial advisors, and they assist with tasks like filling out advance directives.
Becoming a hospice social worker is not a decision you should make lightly. Choosing this career path means knowing that the people you serve will die soon. You will be committing to working with people—patients as well as their loved ones—who are facing unimaginable loss. If you can cope with the emotional challenges, however, you'll forge deep connections with the people you serve and know that you have helped make the end of their stories as peaceful and as meaningful as possible.
In this article, we'll cover:
Social workers are problem solvers. In the hospice world, these professionals look for ways to empower people to live comfortably, as they approach the end of a life-limiting illness or condition. Every patient is different, and every family will have different needs; there are no fixed algorithms or processes for hospice social workers to follow. Many people associate hospice care with the elderly, but hospice social workers may choose to specialize in pediatric or adult care.
On an average day, a hospice social worker will talk at length with patients and families to understand their values, their end-of-life wishes, and their goals for their remaining time. With this information, the social worker can create a personalized care plan in collaboration with a patient's care providers. That care plan may address practical, emotional, and even spiritual challenges facing the patient and his family.
After creating a patient care plan, the hospice social worker will support a family through the plan's implementation. They may:
Hospice social workers spend much time listening. Listening may be the most important thing a medical social worker serving clients in hospice will do. They listen to people who are trying to process the fact that they won't be there for their family and friends in the future. They listen to people who need an outlet for feelings like resentment, rage, and other tough emotions that go hand-in-hand with a terminal illness diagnosis.
Moreover, hospice social workers listen to the people who are left behind; hospice care doesn't end when a client passes away. Some hospice social workers will care for families for a year or more after they lose a family member.
Hospice is not a place. Hospice care happens not only at hospice facilities, but also in hospitals, nursing homes, long-term care centers, and at home. Many social workers will work in more than one hospice program, visiting clients in hospice centers and homes. Hospice social workers may also spend time in hospital intensive care units (when a terminally ill client needs more medical help than a nursing home or in-home health staff can provide).
Hospice and palliative care are often lumped together, and so articles about becoming a hospice social worker usually cover the ins and outs of becoming a palliative care social worker, too. While these careers are quite similar, however, there are some key differences.
Palliative care is specialized medical care designed to treat the symptoms of a disease (versus curing it) so patients can enjoy as much quality of life as possible. Hospice care can include palliative care, but many patients who are receiving palliative care are dealing with painful or debilitating conditions, not fatal ones. A palliative care social worker may or may not work with clients nearing the end of life. Hospice social workers only work with clients and families who are facing that eventuality.
If you're not sure that you're strong enough to make a career out of supporting people through end-of-life care, a career in palliative care social work is another option you should explore.
Is graduate study required to become a hospice social worker? While it may be possible to find an entry-level social work position in a hospice setting with a Bachelor of Social Work and work experience, most employers in hospice care require social workers to be licensed MSWs. That's because hospice social workers provide much more than access to resources.
Their work with clients includes:
To do everything they need to do effectively, hospice social workers need expertise in gerontology, death and dying, medicine, and ethics. These subjects are covered at the graduate level.
The process of becoming a social worker in any specialty area begins with a bachelor's degree from a school accredited by the Council on Social Work Education.
Most BSW programs can be completed in four years of full-time, on-campus or online study. We've listed eight excellent affordable BSW programs below:
You can also earn your BSW online. Some of these programs require multiple on-campus sessions, so do your research before enrolling. Some, like the The University of Tennessee - Knoxville, are only open to in-state students.
The following schools offer an online BSW:
BSW programs are quite broad in terms of the topics they cover because they need to prepare students for different types of social work careers.
Nearly all BSW programs will include coursework in:
Students in most BSW programs will also complete fieldwork under the supervision of a licensed social worker.
Once you have completed your bachelor's, you can take the Association of Social Work Board's (ASWB) Bachelor's Exam and become a Licensed Bachelor of Social Work (usually abbreviated as LBSW or LSW).
Next, you will likely want to complete an accredited Master of Social Work (MSW) program. There are numerous on-campus, hybrid, and online MSW programs—Boston University's online MSW is one of the best—and many accelerated MSW programs can even be completed in 16 months.
Unfortunately, very few programs offer a specific hospice concentration. A 2018 research study found that of the 105 accredited MSW programs that participated in the study, only 10 even had courses specifically dedicated to end-of-life and palliative care and nine of those were part of a certificate program. The University of Iowa School of Social Work is one of the few master's degree programs that lets students choose a concentration in end-of-life care.
If attending that program isn't an option, look for master's degree programs with courses in:
You can essentially cobble together your unofficial hospice concentration by choosing adulthood and aging as your MSW concentration and then taking on as much hospice-specific elective coursework and fieldwork as you can.
Once you've earned your master's degree, you can take the ASWB Master's Exam. and become a Licensed Master of Social Work (LMSW). From there, you can begin looking for work.
As noted above, you might be able to find work in hospice care with just a BSW. You should have little trouble working in end-of-life care if you're a licensed MSW. However, if you want to grow in your career, you'll need to get certified. There are two primary levels of certification for hospice social workers—both of which are offered by the National Association of Social Workers (NASW) in conjunction with the National Hospice and Palliative Care Organization (NHPCO).
The bachelor's level Certified Hospice and Palliative Social Work (CHP-SW) is available to any social worker who has a BSW, 20 continuing education units directly related to hospice and palliative medicine and care, and three years of supervised work experience in hospice and palliative care. In states that don't allow BSWs to practice as clinical social workers, applicants must show proof of 40 continuing education units and four years of relevant work experience.
The master's level certification for hospice social workers is the Advanced Certified Hospice and Palliative Social Worker (ACHP-SW). Applicants must have an MSW degree from an accredited school and two years of documented supervised social work experience in palliative or end-of-life care.
Many states require social workers across specialties to participate in specific continuing education courses to maintain their social work licensure. There are also post-MSW educational opportunities for social workers who want to build careers in hospice care.
For instance, New York University offers a Post-Master's Certificate Program in Palliative and End-of-Life Care for social workers with two years of experience working in hospice. Smith College School for Social Work has a Certificate in Palliative and End-of-Life Care for students who possess a master's degree in social work or psychology, have at least two years of post- master's experience, and are currently practicing in end-of-life care. Icahn School of Medicine at Mount Sinai has a one-year Social Work Fellowship in Palliative and End-of-Life Care for practicing hospice social work clinicians.
Is a career in hospice social work right for you? You need to carefully weigh the pros and cons of becoming a hospice social worker.
Ultimately, you may discover—as many hospice social workers do—that this career is not defined by the weight of loss but by the moments of happiness that social work makes possible.
In an interview on the VITAS Healthcare website, Judy Weisenfeld discussed a surprising fact about her job: "I have found joy in my job as a hospice social worker," she said. "My first week on the job, I coordinated a wedding in the unit. I arranged for decorations and a chaplain to officiate at the bedside of an elderly couple who had been together for a long time. The groom was on hospice. The couple was so happy to be getting married. It helped me from the beginning to realize that there can be a joy."
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