Social work is tough. The job entails high levels of stress and lower levels of pay compared to other healthcare jobs. Hanging with it requires a dedication to providing essential care and critical social services to the most vulnerable members of our communities.
Some social work professions are arguably tougher than others. Hospice social workers provide guidance, comfort, and care for patients who are facing life-limiting illnesses and terminal conditions. This unique set of psychosocial health services supports what individuals and their families face during end of life care.
To those who choose the profession, it’s more of an honor than a burden. Training for hospice social work and palliative care means these practitioners are prepared to handle the very personal, individual needs of patients at the end stage of life.
Hospice social worker Louise Dahl begins by meeting a patient where they are with acceptance. “I don’t take away their safety net if they have nothing to replace it with,” she says. This includes allowing patients to accept their diagnosis on their own time while supporting family members and loved ones during the process. The patient sets the pace for care, leading discussions about what their own concerns are—financial worries, organizing home health services, conflict resolution—and how much they want other family members involved.
As the US population ages, demand for hospice social worker jobs and the unique skill set required for this type of care coordination should only grow. The US Bureau of Labor Statistics projects that medical social worker jobs will grow by 11 percent through 2031, about twice the rate predicted for all occupations. As Boomers continue to age out of the workforce and into managed care, professionals with this specialized training and skill set will be in greater demand.
How much do hospice social workers make? This article explores that question and also discusses:
Hospice social work is a sub-discipline of medical social work that focuses on the quality of life of those with terminal health conditions. Hospice social workers are MSW-holding licensed clinical social workers (LCSW) who provide a continuum of care services addressing the biopsychosocial components of death and dying. They work full-time or part-time in hospitals and medical centers and assisted living facilities, and in at-home care alongside a larger interdisciplinary group of caregivers.
Hospice social workers collaborate with family physicians, hospice physicians and nurses, home health aids, and volunteers to address the physical and emotional needs of the patient to improve or maintain their optimal quality of life. They may also act as community leaders in education, policy, and resource development and advocate for physical and mental health hospice initiatives.
Hospice social work is not only about age-related conditions,. Some hospice social worker jobs focus on pediatric care, oncology, and other specific practice areas. These areas of specialization allow practitioners to work with a group they are drawn to caring for and have acquired unique skills to help treat.
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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Each hospice social worker’s job description is dictated by the needs of their clients and guided by the standards of palliative and end-of-life care outlined by the NASW. The social worker does not lead with a personal agenda; they allow the patient to direct the focus of care to their own prioritized list of concerns.
The goal is to provide linguistically and culturally appropriate care for the patient and their family, recognizing that “individual and family perceptions of and responses to illness, disability, dying, death, grief, and bereavement vary greatly.” Hospice social workers are prepared to deal with the challenges of family conflict and also the realities of patients who don’t have a family to help them make decisions or act as caregivers.
Some patients will request help with medical and non-medical ways to relieve pain and anxiety or express fears about being alone. Social workers advocate for a patient’s needs, create space and time for patients and their families to openly discuss fears and concerns, identify resources like Meals-on-Wheels, Medicaid, or in-home care to provide additional support, keep caregivers up-to-date with a patient’s condition, and help identify and correct safety issues in the home.
Social workers also provide patients guidance on planning advanced directives and help the family plan for their loved one’s time of death. They may assist with financial planning, family therapy, support and resources for children, and grief counseling.
Some social work jobs require only a bachelor’s degree (BSW). These entry-level positions offer lower pay and require less experience. To work in a licensed position in hospice care, you’ll need a master’s degree in social work (MSW) and proper credentials. The National Association or Social Workers (NASW) reports that an MSW can increase earnings over a BSW by $13,000/year.
Certification at the master’s education level requires an MSW from a graduate program accredited by the Council on Social Work Education plus 20 or more continuing education units (CEU) related to palliative and hospice care. In addition, you’ll need at least two years of experience in supervised hospice social work and a current license to practice. Fulfilling these requirements will earn an Advanced Certified Hospice and Palliative Social Worker (ACHP-SW) credential from the NASW.
To start with the obvious: social work is not considered a high-paying career. The US Bureau of Labor Statistics reports the median annual wage for healthcare social workers was $60,840, with only the top ten percent with that job title earning more than $82,840. The top listing on Glassdoor is for VITAS Healthcare gives a salary range of $57,000 to $80,000 per year with listings from other companies in a similar salary range.
Ziprecruiter reports an average hospice social worker salary of $63,053 per year, with the 75th percentile at $66,500, and notes that the average annual salary can vary by as much as $15,500 depending on skill level, years of experience, and location. New York City is one of the top ten highest-paying cities in the US at $73,342, but like other major cities also has a cost of living higher than the national average. Salary estimates for positions in places like New York, San Francisco, or Los Angeles need to take cost of living expenses into account. A hospice social worker in Manhattan earns 20 percent more than one in Lincoln, Nebraska; however, the cost of living in Manhattan is more than twice that of Lincoln.
Low average salaries compared to other healthcare professions represent one clear con for hospice social workers. Case managers face several other obstacles. You’ll get to know and care for clients with the understanding that you will soon lose them. The reality of pain, death, and dying will be a constant in your work and career, and this can take an emotional toll. Social workers who specialize in hospice and palliative care need to take the time to focus on their own mental health in order to maintain a healthy professional and personal life.
Still, there is a lot to love about this career. Social worker Tammy Baehler said that she has been told by family members of patients, “I don’t know how you do this job, it’s so depressing.” While she understands that this job type might be viewed that way, she sees it differently. To her, it’s fulfilling to witness resolution and acceptance when people and families come together at the end of life, and she sees the good in people as a result.
Loise Dahl reflects that the work she does feels like walking on sacred ground: “What a privilege to enter people’s lives at this stage, to get a glimpse of lives led and receive life lessons, to help heal and bring family members together.”
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