General Responsibilities
• Assesses emotional factors related to terminal illness.
• Assists the physician and other IDT/IDG members in recognizing and understanding the social/mental stress
and/or disorder that exacerbates the symptoms related to terminal illness.
• Assesses the patient/family psychosocial status, potential for risk of suicide and/or abuse or neglect.
• Assesses environmental resources and obstacles to maintaining safety.
• Participates in the development and revision of the plan of care. Provides social services including:
• Short-term individual counseling
• Crisis intervention
• Assistance in providing information and preparation of advance directives
• Funeral planning issues and transfer of responsibilities regarding fiscal, legal and health care decisions
• Prepares clinical and progress notes.
• Identifies family dynamics and communication patterns.
• Involves the patient/family in the plan of care.
• Identifies and utilizes appropriate community resources and assesses patient/family ability to access them.
• Participates in in-service programs.
• Evaluates patient/family response to psychosocial interventions.
• Assesses caregiver's ability to function adequately.
• Assesses need for counseling related to risk assessment for pathological grief.
• Assesses special needs related to cultural diversity including communication, space, role of family members and
special traditions.
• Identifying the developmental level of patient/family and obstacles to learning or ability to participate in care of
patient.
• Addresses patient/family questions and issues.
• Identifies obstacles to compliance and assists in understanding goals of interventions.
• Identifies support systems available to reduce stress and facilitate coping with end-of-life care.
• Evaluates for long-term care when appropriate and assesses ability to accept change in level of care.
• Communicates psychosocial information to in patient facility when level of care is changed.
• Assists patient/family in assessing financial resources when appropriate.
• Identifies patient/family needs when discharged or when level of care changes.
• Evaluates patient/family response to interventions when referred to community agency and satisfaction of the
service provided.
• Assesses bereavement needs.
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