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In publishing her psychological studies in a pioneering book about the need for dignity in death, she redefined end-of-life medical care as we knew it then. Rather than dying in a hospital, Kubler-Ross said, a person who is facing terminal illness can be better served in a nurturing home environment surrounded by family.
It took some time for private and public institutions to warm up to this dramatic shift in treatment for those facing death and to develop protocols for end-of-life care. Eventually, the medical community embraced the model of hospice — that dying patients should be cared for at home with proper medical and support services. By the 1980’s, Medicare had started funding hospice, and it was considered the standard of care for the terminally ill.
Like many areas of social work practice, hospice and palliative care has become a specialization in which Masters of Social Work (MSW) professionals play a vital role. In fact, MSW graduates are the preferred practitioners in the field.
Hospice and palliative care work goes beyond meeting the physical and medical needs of terminally ill patients. Social workers play an important role in addressing the emotional, psychosocial, administrative, and financial needs that often accompany end-of-life treatment and decision making.
Social workers help patients and families navigate resources and administrative tasks such as completing end-of-life directives, power of attorney, and other more bureaucratic issues relating to illness. They may also refer families to agencies that help manage financial hardships unique to terminal and devastating illness. And these social workers are particularly trained to help patients and families manage their depression, anger, and anxiety, providing psychological, social, and emotional support.
Some of the specific services of hospice social workers include:
Psychosocial assessments and services
Facilitating and coordinating care
Acting as a liaison to the medical team and working closely with physicians in decision-making and treatment plans
Counseling and psychotherapy
Referring to other resources and support services
The work these social workers do may be performed in hospice centers or hospitals, or in private homes.
Entry-level requirements for hospice social workers vary from state-to-state and employer-to-employer. Aspiring hospice social workers may want to check with future employers to determine which degrees and certifications best meet their career goals.
At a minimum, a social worker who is interested in hospice work must obtain a bachelor’s degree in a social work-related field, such as psychology or sociology, or a BSW (bachelor’s of social work). Although some hospitals and agencies employ those with only a bachelor’s, bachelor’s degree holders might be limited in the duties they can perform, and must be supervised by an MSW or a psychologist.
For those looking to operate at a higher level of practice, a common pathway to becoming a hospice care social worker is to obtain an MSW from a school accredited by the Council on Social Work Education. Social workers who pursue this path may specialize in hospice and palliative care through their fieldwork assignments and coursework.
A benefit to earning an MSW is that you will also have the opportunity to become licensed. In fact, the majority of settings and employers require hospice workers be licensed MSWs. Likewise, the degree of choice for most states in offering licensure is the MSW. Additional coursework and professional supervision in a hospice or palliative care setting post-MSW may be required for certification or licensure.
A helpful guide to professional hospice worker requirements can be found in this Medicare Hospice Requirements document for social workers.
There are a couple of significant practical considerations:
- A Bachelor’s or Master’s degree in social work
- A license to practice or required social work certification
Credentials vary among careers, states, and territories. Licenses include:
- Certified Social Worker (CSW)
- Clinical Social Work Associate (CSWA)
- Licensed Advanced Practice Social Worker (LAPSW)
- Licensed Advanced Social Worker (LASW)
- Licensed Baccalaureate Social Worker (LBSW)
- Licensed Clinical Social Worker (LCSW)
- Licensed Graduate Social Worker (LGSW)
- Licensed Independent Clinical Social Worker (LICSW)
- Licensed Mental Health Professional (LMHP)
- Licensed Master Social Worker (LMSW)
Most of these licenses require a Master’s or Doctorate, along with additional coursework or clinical internships. ( )
A survey of 2017 social work graduates by the National Social Work Workforce Study found that social workers with Master’s degrees and Doctorates made substantially more than those with no advanced degree. ( )
- People with MSW degrees made $13,000-plus more than those with only BSW degrees
- MSWs make more in large cities or urban clusters
- People with doctorates earned $20,000 to $25,000 more than people with only MSW degrees
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Additional certification for hospice and palliative care social workers is available through the National Association of Social Workers (NASW) Advanced Certified Hospice & Palliative Social Worker (ACHP-SW) program.
According to the NASW, the ACHP-SW is the most elite credential that social workers can earn in the field of end-of-life care, or for practicing in pain and symptom management.
Eligibility requirements as stated by the NASW are as follows:
A Master’s degree in social work (MSW) from a graduate program accredited by the Council on Social Work Education
Twenty or more CEUs (continuing education units) related to hospice and palliative care.
At least two years of supervised and documented social work experience in hospice and palliative care.
A current license to practice as a professional social worker.
Adherence to NASW Code of Ethics and NASW Standards for End of Life Care