Hospice Social Work and the Taboo Topic

Spring 2014
Volume 1, Issue 7
Harbor Grace Hospice
Harbor Grace Offers:
 A 22-bed inpatient
facility providing
24-hour care; located
across the street from
Atlanta Medical Center
Hospice Social Work and the Taboo Topic
“I listened to a radio
interview this morning
about how people
mourn,” said Melissa
Sage, Licensed Social
Worker. “They discussed the subject of
death, how in the US by
and large the topic is
taboo. And they’re
right.” But Sage cannot
run from the topic; she
is a hospice social worker at Harbor Grace. “It's
strange, but I'm comfortable discussing dying, death, and mourning, and I suppose that
comes from a strong
belief system which I
feel is required for what
I do. My comfort level
seems to help my patients and their families
express themselves and
their wishes.”
Sage knows something
about how hospice patients and families feel.
“I lost my own mother
not long ago, and she
was a hospice patient.
So sometimes when I
visit hospice patients
and families my mom is
‘in the room,’ especially
when my patient is
someone's mother; the
connections are there,
what I went through
and what they are going
through. Families know
when you've gone
through something,
when you have real empathy based on personal
experience. I don't even
have to talk about my
mother for them to
sense that I understand.”
Harbor Grace Hospice Social Services Team (L to R): Ashley Mattox, Support Staff;
Melissa Sage, LMSW; Carmen Armstrong, MSW; Maria Anderson, MSW
The Harbor Grace Hospice Team is aware of
the emotional demands
of their jobs. “I feel that
hospice social workers,
chaplains, and nurses all
have touchstone experiences in their own lives
that inform and enhance what they do.
And we can't help but
become emotionally
involved to some degree, and yes that
makes our jobs emotionally harder than it
might otherwise be in
other settings. But giving the best care and
support to patients and
families necessitates
authentic emotional
connection. We can't
address people's pain
without bringing our
whole selves-- including
our own personal/
emotional experiences-into our hospice care.”
Sage still has strong
memories of patients
and families that she
served years ago. After
assisting a husband and
his family during the
death of his wife, the
husband himself shortly
thereafter entered hospice care. (Continued
Page 2)
 Home Care with a full
staff of professionals
including Nurses, Certified Nursing Assistants, Social Workers,
anf Chaplains
Editorial Staff and Contributors:
Bert Gary
Natalie Clark
Jeannie Mazzillo
Jodi Wrenn
Rachel Randall
INSIDE SPRING ISSUE
Continued: Taboo Topic
2
Online Mourning
3
Continued: Online Mourning
4
Page 2
Continued from Page 1: Hospice Social Workers
“Their gift to me
is that they allow
me into their
home to be a
part of their
team, and I'm
constantly aware
of what huge gift
that is to me
personally.”
Inpatient Unit across from Atlanta Medical
“I had already built a relationship with him and
the family. He really
opened up and bared his
soul, unafraid to talk
about his wife's death or
his own, really fully engaging the taboo topic of
death.”
What is it like to be a
hospice Social worker? “I
probably spend 50% of
my time doing my favorite part, providing emotional support through
direct patient/family
contact. I spend maybe
30% of my time doing
the required charting.
And then maybe 20% of
my time is spent managing or assisting concrete
services like Medicare
applications.”
Hospice social workers
are present at the time
of admission to help support and advise the patient and the family,
helping them make informed decisions, answering their questions,
and making the transition to hospice care easier. Hospice social workers help meet a family’s
basic needs by educating
and advocating for the
patient and family. The
hospice social work interventions may include
counseling and support
to deal with loss, grief,
and bereavement before
the death; helping patients and families deal
with stress and conflicts;
helping with funeral arrangements; and providing visits and collaboration with hospice team
members. Hospice social workers pay close
attention to practical
yet important matters,
such as identifying financial and other resources to meet basic
needs such as rent, utilities or medical co-pays
for medications; assisting patients and families navigate health systems and benefits; and
end-of-life planning including advance directives. An advance directive is a written
statement of a person's
wishes regarding medical treatment, often including a living will,
made to ensure those
wishes are carried out
should the person be
unable to communicate
them to a doctor.
Sage describes social
workers as joining families “in the trenches.” “A
terminal diagnosis is big
stuff and this becomes a
key moment in their
lives. Their gift to me is
that they allow me into
their home to be a part
of their team, and I'm
constantly aware of
what huge gift that is to
me personally.”
“When I was in training,” Sage continued, “I
wanted to be a therapeutic social worker.
But then I was introduced hospice. Boy,
was I ever introduced to
hospice! During my very
first visit as a hospice
social worker the patient died right there in
front of me. But instead
of that freaking me out, I
had this strong urge to
support, to love, and to
help. I learned that being
with a patient when he
or she dies can be so
powerful, and supporting
the family is an amazing
privilege giving me the
opportunity to make a
real difference.”
“A terminal diagnosis,
the dying process, and
death itself have significant impacts on families
of our adult and pediatric
patients,” said Sage.
“Sometimes there's
shock or denial, sometimes they find it difficult
to talk about death and
dying, and we can address all that. Sometimes
family dynamics involve
dysfunction or conflict,
and we can address that,
too.”
For Sage, it is a labor of
love. “I love being a hospice social worker. It
brings great meaning to
my life, I feel I am evolving as a person, and I’m
honored to be a part of
an intimate time and a
vulnerable time in patients’ and families’ lives.
We are inspired by their
courage, determination,
and endurance. If I can
do anything to make
their journey easier, I feel
I've done my job.”
Article by Rev. Bert Gary, Harbor
Grace Hospice Home Care Chaplain
Volume 1, Issue 7
Page 3
An Online Generation Redefines Mourning
In 2010, when Rebecca
Soffer’s father died of a
heart attack on a cruise
to the Bahamas, the
condolence notes came
pouring in, many in the
form of text messages.
“I got so many from
very good friends,” Ms.
Soffer, 37, said from the
couch of her Upper
West Side apartment
not long ago. “They said
they were ‘sorry’ or
‘how r u?’ ”
As befits the first generation of digital natives,
Generation Y-ers and
Millennials are starting
blogs, YouTube series,
and Instagram feeds
about grief and loss,
bringing the conversation about bereavement
and the deceased into a
very public forum.
Last November, to give
the topic a generationally specific space, Ms.
Soffer and Gabrielle
Birkner, 34, started Modern Loss, a website geared to people
around their age to address many permutations of loss, from miscarriages to a parent’s
death. For a generation
known for broadcasting
internal monologue
across the Internet,
some of its members
seem eager for spaces
to express not just the
good stuff that litters
everyone’s Facebook
newsfeed, but also the
painful.
In November, Melissa
Lafsky Wall, 35, the
founder of New Yorkbased Brick Wall Media,
turned to Modern Loss
after a miscarriage,
posting an essay called
“The Silent Sorrow.”
“The Internet should
speak to the parts of life
that we all experience,
but aren’t represented
in most media, a large
one being grief and
loss,” Ms. Wall said,
adding that the feedback she got was all
positive, which she
attributes to the site.
Modern Loss is a repository of essays, resources
and advice that the
founders try to edit so
that it doesn’t sound
glib, overly religious or
trite. For instance, you’ll
never hear, “At least
they are in a better
place.” (“Our least favorite line ever,” Ms.
Soffer said.) The website
also examines decidedly
21st century topics like
what to do when Gmail
keeps suggesting someone who has died as a
contact, a topic that
Esther D. Kustanowitz,
the founder of the blog
My Urban Kvetch, explored in a post called
“Deleting My Mother.”
Those who are accustomed to social media
as a way to tout how
fabulous your life is,
beware: “grief sites” can
be unflinchingly graphic
and wrenching. In November, K. H. (online
submitters use their initials) wrote, “My dad
passed away on May 31,
2003 in my arms as I
tried to give him CPR.”
“It’s such a push-pull
around the pros of allowing for a sense of
community that the Internet builds and the
distancing that it allows
from having to personally interact with others,
” said Heather ServatySeib, a professor at Purdue in the field of thanatology, the study of
death and dying
Then there’s the lingua
franca of social media
— the Like button —
that’s totally discordant
with death. “My God, is
there anything creepier
than a post announcing
someone lost a loved
one and seeing ‘136
people Like this’ underneath?” Ms. Soffer said.
Facebook floated the
idea of a “sympathize
button,” something that
came out of its annual
hackathon, but has no
plans to pursue it, according to the company.
(Facebook does offer an
option to memorialize
an account that prevents anyone from logging into it in the future,
but allows friends and
family, depending on
privacy setting, to leave
posts on the timeline.)
The fact that the Internet is perhaps not the
best channel for grief is
why David Fajgenbaum,
28, the founder of National Students of AMF,
(continued Page 4)
“The Internet
should speak to
the parts of life
that we all
experience, but
aren’t represented
in most media, a
large one being
grief and loss.”
A safe harbor in your time of need
Harbor Grace Hospice
Corporate Office
500 Lanier Ave. W., Suite 401
Fayetteville, GA 30214
Phone: (678) 962-5850
Harbor Grace Hospice
Inpatient Unit
320 Parkway Dr., 4th Floor
Atlanta, GA 30312
Phone: (404) 941-1700
Fax: (404) 941-1711
License 056-242-H
We’re on the web!
www.harborgracehospice.com
And please “like” us on Facebook :)
Continued from page 3: Online Mourning
a support network for
college students with
sick or deceased parents, said his organization of 40 chapters on
campuses has been cautious about integrating
an online component.
“Someone could say the
wrong thing online, and
could really hurt someone,” said Mr. Fajgenbaum, who started the
support group in his
mother’s memory while
an undergraduate at
Georgetown.
Miss Manners, a.k.a.
Judith Martin, writes
rather unequivocally on
the matter. “Letters of
condolence should be
written by hand,” she
said. “Burdensome as it
may be, it offers the
comfort of knowing that
one is representing the
deceased to those who
cared about him.”
But as Mr. Fajgenbaum
acknowledged, young
people are eager for
that virtual connection;
after all, technology and
the Internet are a ubiquitous part of their existence. That’s what Jason Feifer, 33, creator of
the instantly viral Tumblr “Selfies at Funerals,”
discovered when he
posted a few dozen
photos of teenagers
taking pictures of themselves at funerals. In
doing so, Mr. Feifer, an
CONSIDER
VOLUNTEERING
editor at Fast Company
magazine, said he was
documenting a newfangled mourning practice.
“It’s important for the
older generation to see
more than disrespect
and to see some kind of
genuine communication,” he said. Mr. Feifer
said, “I think there are a
lot of kids who will [stop
short of taking] a selfie
at a funeral, but it
doesn’t mean that the
kids who do take these
photos don’t know how
to grieve.”
This article by Hannah
Seligson appeared in the
March 21, 2014 New
York Times. It has been
abbreviated .
Volunteers are vital to
the work of hospice.
Perhaps you have a specific skill to offer, or perhaps you can be
someone's friend in a
difficult time.
Is there space in your
heart and your life for
this kind of work?
If more than a year has
passed since your loss,
and if hospice was helpful
to your family, consider
volunteering with Harbor
Grace Hospice.
You may call Rachel
Randall at 404-941-1742
at any time to investigate
whether this is a good
option for you.