
Asia Pacific Academy of Science Pte. Ltd. (APACSCI) specializes in international journal publishing. APACSCI adopts the open access publishing model and provides an important communication bridge for academic groups whose interest fields include engineering, technology, medicine, computer, mathematics, agriculture and forestry, and environment.

Medical social work in hospice settings: Bridging clinical care and emotional support
Vol 3, Issue 1, 2025
Download PDF
Abstract
Medical social workers play an indispensable role in hospice settings by addressing the multifaceted needs of patients and their families during end-of-life care. This paper focuses on how their expertise in psychosocial assessment, care planning, advocacy, counseling, and resource coordination ensures holistic, patient-centered care that integrates clinical and emotional support. Medical social workers foster culturally sensitive practices through interdisciplinary collaboration, enhance communication among care teams, and provide tailored interventions that address emotional, social, and spiritual concerns. This integration improves the quality of life for patients and alleviates emotional and systemic burdens on healthcare infrastructures. In addition to their immediate contributions, medical social workers support sustainable healthcare systems by promoting health equity and addressing disparities in hospice care. Their work aligns with global Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being) and SDG 10 (Reduced Inequalities), by ensuring equitable access to compassionate care for marginalized populations. Furthermore, their efforts to empower communities, advocate for cost-effective care strategies, and integrate social and medical perspectives contribute to the long-term resilience of healthcare systems. As the healthcare landscape evolves, the role of medical social workers in hospice care becomes increasingly critical. Their ability to address root causes of distress, navigate complex family dynamics, and facilitate interdisciplinary collaboration exemplifies the necessity of their role in advancing equitable and effective end-of-life care.
Keywords
References
1. Kelley AS, Deb P, Du Q, et al. Hospice Enrollment Saves Money For Medicare And Improves Care Quality Across A Number Of Different Lengths-Of-Stay. Health Affairs. 2013; 32(3): 552-561. doi: 10.1377/hlthaff.2012.0851
2. Jack TJ, Izah SC. Public Health Outcomes through Medical Social Work: A Focus on Common Bacterial Infections. Journal of Advanced Research in Psychology & Psychotherapy. 2024; 7(1&2):6-20.
3. Cagle JG, Osteen P, Sacco P, et al. Psychosocial Assessment by Hospice Social Workers: A Content Review of Instruments from a National Sample. Journal of Pain and Symptom Management. 2017; 53(1): 40-48. doi: 10.1016/j.jpainsymman.2016.08.016
4. Cagle JG, Kovacs PJ. Informal Caregivers of Cancer Patients: Perceptions About Preparedness and Support During Hospice Care. Journal of Gerontological Social Work. 2011; 54(1): 92-115. doi: 10.1080/01634372.2010.534547
5. Weng SS, Valenzuela J. Working with Older Adults in Integrated Health Care: Social Workers’ Perspective. Journal of Applied Gerontology. 2022; 41(10): 2235-2243. doi: 10.1177/07334648221105266
6. Shoemaker LK, Aktas A, Walsh D, et al. A Pilot Study of Palliative Medicine Fellows’ Hospice Home Visits. American Journal of Hospice and Palliative Medicine. 2012; 29(8): 591-598. doi: 10.1177/1049909111433810
7. Quigley DD, Parast L, Haas A, et al. Differences in Caregiver Reports of the Quality of Hospice Care Across Settings. Journal of the American Geriatrics Society. 2020; 68(6): 1218-1225. doi: 10.1111/jgs.16361
8. Koh MYH, Chong PH, Neo PSH, et al. Burnout, psychological morbidity and use of coping mechanisms among palliative care practitioners: A multi-centre cross-sectional study. Palliative Medicine. 2015; 29(7): 633-642. doi: 10.1177/0269216315575850
9. Gray NA, Boucher NA, Kuchibhatla M, et al. Hospice Access for Undocumented Immigrants. JAMA Internal Medicine. 2017; 177(4): 579. doi: 10.1001/jamainternmed.2016.8870
10. Hughes NM, Noyes J, Eckley L, et al. What do patients and family-caregivers value from hospice care? A systematic mixed studies review. BMC Palliative Care. 2019; 18(1). doi: 10.1186/s12904-019-0401-1
11. Reese DJ, Csikai EL. Social Work Assessment and Outcomes Measurement in Hospice and Palliative Care. American Journal of Hospice and Palliative Medicine. 2018; 35(12): 1553-1564. doi: 10.1177/1049909118788342
12. Lau DT, Joyce B, Clayman ML, et al. Hospice Providers’ Key Approaches to Support Informal Caregivers in Managing Medications for Patients in Private Residences. Journal of Pain and Symptom Management. 2012; 43(6): 1060-1071. doi: 10.1016/j.jpainsymman.2011.06.025
13. Wittenberg-Lyles E, Oliver DP, Kruse RL, et al. Family Caregiver Participation in Hospice Interdisciplinary Team Meetings: How Does It Affect the Nature and Content of Communication?. Health Communication. 2013; 28(2): 110-118. doi: 10.1080/10410236.2011.652935
14. James M. Where is the voice of social work in the multi disciplinary palliative care team?. Aotearoa New Zealand Social Work. 2016; 24(2): 49-60. doi: 10.11157/anzswj-vol24iss2id134
15. Nedjat-Haiem FR, Carrion IV, Cribbs K, et al. Advocacy at the End of Life: Meeting the Needs of Vulnerable Latino Patients. Social Work in Health Care. 2013; 52(6): 558-577. doi: 10.1080/00981389.2013.779359
16. Lee S, Kim B. A Photovoice Study on the Position and Role of Hospice Volunteers in Korea. Risk Management and Healthcare Policy. 2023; 16: 931-943. doi: 10.2147/rmhp.s403746
17. Washington KT, Alaniz Staner LM, Collie BE, et al. Toward a Practice-Informed Agenda for Hospice Intervention Research: What Are Staff Members’ Biggest Challenges?. American Journal of Hospice and Palliative Medicine. 2020; 38(5): 467-471. doi: 10.1177/1049909120948222
18. Lehto RH, Heeter C, Forman J, et al. Hospice Employees’ Perceptions of Their Work Environment: A Focus Group Perspective. International Journal of Environmental Research and Public Health. 2020; 17(17): 6147. doi: 10.3390/ijerph17176147
19. Graven V, Petersen A, Timm H. Hospice Care: Between Existential and Medical Hope. Mortality. 2020; 26(3): 326-342. doi: 10.1080/13576275.2020.1803249
20. Empeño J, Raming NTJ, Irwin SA, et al. The Impact of Additional Support Services on Caregivers of Hospice Patients and Hospice Social Workers. OMEGA - Journal of Death and Dying. 2013; 67(1-2): 53-61. doi: 10.2190/om.67.1-2.f
21. Joolaee S, Ho A, Serota K, et al. Medical assistance in dying legislation: Hospice palliative care providers’ perspectives. Nursing Ethics. 2021; 29(1): 231-244. doi: 10.1177/09697330211012049
22. Jones TM, Brody AA. Adaptation and Piloting for Hospice Social Workers of Aliviado Dementia Care, a Dementia Symptom Management Program. American Journal of Hospice and Palliative Medicine. 2020; 38(5): 452-458. doi: 10.1177/1049909120962459
23. Kleinpell R, Vasilevskis EE, Fogg L, et al. Exploring the association of hospice care on patient experience and outcomes of care. BMJ Supportive & Palliative Care. 2016; 9(1): e13-e13. doi: 10.1136/bmjspcare-2015-001001
24. Boyd C, DiBartolo MC, Helne D, et al. Implementing a Standardized Workflow Process to Increase the Palliative Care to Hospice Admission Rate. Journal of Nursing Care Quality. 2022. doi: 10.1097/ncq.0000000000000682
25. Lai D, Cloyes KG, Clayton MF, et al. We’re the Eyes and the Ears, but We Don’t Have a Voice. Journal of Hospice & Palliative Nursing. 2018; 20(1): 47-54. doi: 10.1097/njh.0000000000000407
26. Nuñez A, Holland JM, Beckman L, et al. A qualitative study of the emotional and spiritual needs of Hispanic families in hospice. Palliative and Supportive Care. 2017; 17(2): 150-158. doi: 10.1017/s1478951517000190
27. Hughes MC, Vernon E. “We Are Here to Assist All Individuals Who Need Hospice Services”: Hospices’ Perspectives on Improving Access and Inclusion for Racial/Ethnic Minorities. Gerontology and Geriatric Medicine. 2020; 6. doi: 10.1177/2333721420920414
28. Ellington L, Cloyes KG, Xu J, et al. Supporting home hospice family caregivers: Insights from different perspectives. Palliative and Supportive Care. 2017; 16(2): 209-219. doi: 10.1017/s1478951517000219
29. Russell D, Luth EA, Baik D, et al. On board: interdisciplinary team member perspectives of how patients with heart failure and their families navigate hospice care. Journal of Hospice & Palliative Nursing. 2020; 22(5), 351-358. doi: 10.1097/njh.0000000000000683
30. Pawłowska I, Pawłowski L, Lichodziejewska-Niemierko M. The role of a pharmacist in a hospice: a nationwide survey among hospice directors, pharmacists and physicians. European Journal of Hospital Pharmacy. 2015; 23(2): 106-112. doi: 10.1136/ejhpharm-2015-000730
31. Kaye EC, Gattas M, Kiefer A, et al. Provision of Palliative and Hospice Care to Children in the Community: A Population Study of Hospice Nurses. Journal of Pain and Symptom Management. 2019; 57(2): 241-250. doi: 10.1016/j.jpainsymman.2018.10.509
32. Dingfield L, Bender L, Harris P, et al. Comparison of Pediatric and Adult Hospice Patients Using Electronic Medical Record Data from Nine Hospices in the United States, 2008–2012. Journal of Palliative Medicine. 2015; 18(2): 120-126. doi: 10.1089/jpm.2014.0195
33. Weng TC, Yang YC, Chen PJ, et al. Implementing a novel model for hospice and palliative care in the emergency department. Medicine. 2017; 96(19): e6943. doi: 10.1097/md.0000000000006943
34. Cabin W. “It’s Just Too Much”: The Financial Calculus in Medicare Hospice. Home Health Care Management & Practice. 2022; 35(2): 86-96. doi: 10.1177/10848223221102544
35. Yapp KA. Culture and End-of-Life Care. American Journal of Hospice and Palliative Medicine. 2011; 29(2): 106-111. doi: 10.1177/1049909111410294
36. Ganz FD, Sapir B. Nurses’ perceptions of intensive care unit palliative care at end of life. Nursing in Critical Care. 2018; 24(3): 141-148. doi: 10.1111/nicc.12395
37. Gardner DS, Doherty M, Bates G, et al. Racial and Ethnic Disparities in Palliative Care: A Systematic Scoping Review. Families in Society: The Journal of Contemporary Social Services. 2018; 99(4): 301-316. doi: 10.1177/1044389418809083
38. McNeil R, Guirguis-Younger M, Dilley LB, et al. Harm reduction services as a point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs: a qualitative analysis. BMC Public Health. 2012; 12(1). doi: 10.1186/1471-2458-12-312
39. Semlali I, Tamches E, Singy P, et al. Introducing cross-cultural education in palliative care: focus groups with experts on practical strategies. BMC palliative care; 2020.
40. Milberg A, Torres S, Ågård P. Health Care Professionals’ Understandings of Cross-Cultural Interaction in End-of-Life Care: A Focus Group Study. PLOS ONE. 2016; 11(11): e0165452. doi: 10.1371/journal.pone.0165452
41. Hoff T, Trovato K, Kitsakos A. Hospice Satisfaction Among Patients, Family, and Caregivers: A Systematic Review of the Literature. American Journal of Hospice and Palliative Medicine. 2023; 41(6): 691-705. doi: 10.1177/10499091231190778
42. Dennis MK, Washington KT, Koenig TL. Ethical Dilemmas Faced by Hospice Social Workers. Social Work in Health Care. 2014; 53(10): 950-968. doi: 10.1080/00981389.2014.950402
43. Entwistle VA, Carter SM, Cribb A, et al. Supporting Patient Autonomy: The Importance of Clinician-patient Relationships. Journal of General Internal Medicine. 2010; 25(7): 741-745. doi: 10.1007/s11606-010-1292-2
44. Feijoo-Cid M, Arreciado Marañón A, Huertas A, et al. Exploring the Decision-Making Process of People Living with HIV Enrolled in Antiretroviral Clinical Trials: A Qualitative Study of Decisions Guided by Trust and Emotions. Health Care Analysis. 2023; 31(3-4): 135-155. doi: 10.1007/s10728-023-00461-z
45. Susilo AP, Marjadi B. Patients’ decision-making in the informed consent process in a hierarchical and communal culture. The Asia Pacific Scholar. 2019; 4(3): 57-66. doi: 10.29060/taps.2019-4-3/oa2085
46. Ho A. Relational autonomy or undue pressure? Family’s role in medical decision‐making. Scandinavian Journal of Caring Sciences. 2008; 22(1): 128-135. doi: 10.1111/j.1471-6712.2007.00561.x
47. Hochwald IH, Yakov G, Radomyslsky Z, et al. Ethical challenges in end-stage dementia: Perspectives of professionals and family care-givers. Nursing Ethics. 2021; 28(7-8): 1228-1243. doi: 10.1177/0969733021999748
48. Kleiderman E, Avard D, Black L, et al. Recruiting Terminally Ill Patients into Non-Therapeutic Oncology Studies: views of Health Professionals. BMC Medical Ethics. 2012; 13(1). doi: 10.1186/1472-6939-13-33
49. Klingemann J, Świtaj P, Lasalvia A, et al. Behind the screen of voluntary psychiatric hospital admissions: A qualitative exploration of treatment pressures and informal coercion in experiences of patients in Italy, Poland and the United Kingdom. International Journal of Social Psychiatry. 2021; 68(2): 457-464. doi: 10.1177/00207640211003942
50. Rego S, Grove ME, Cho MK, et al. Informed Consent in the Genomics Era. Cold Spring Harbor Perspectives in Medicine. 2019; 10(8): a036582. doi: 10.1101/cshperspect.a036582
51. Lin ML, Huang CT, Chiang HH, et al. Exploring ethical aspects of elective surgery patients’ decision-making experiences. Nursing Ethics. 2012; 20(6): 672-683. doi: 10.1177/0969733012448967
52. Unroe KT, Stump TE, Effler S, et al. Quality of Hospice Care at Home Versus in an Assisted Living Facility or Nursing Home. Journal of the American Geriatrics Society. 2018; 66(4): 687-692. doi: 10.1111/jgs.15260
53. El‐Jawahri AR, Abel GA, Steensma DP, et al. Health care utilization and end‐of‐life care for older patients with acute myeloid leukemia. Cancer. 2015; 121(16): 2840-2848. doi: 10.1002/cncr.29430
54. Wang YL, Yang ZW, Tang YZ, et al. A qualitative exploration of “empathic labor” in Chinese hospice nurses. BMC Palliative Care. 2022; 21(1), 23. doi: 10.21203/rs.3.rs-862565/v1
55. Ruff H, Jacobs RJ, Fernandez MI, et al. Factors Associated With Favorable Attitudes Toward End-of-Life Planning. American Journal of Hospice and Palliative Medicine. 2010; 28(3): 176-182. doi: 10.1177/1049909110382770
56. Wang S, Aldridge MD, Gross CP, et al. Transitions Between Healthcare Settings of Hospice Enrollees at the End of Life. Journal of the American Geriatrics Society. 2016; 64(2): 314-322. doi: 10.1111/jgs.13939
57. Hwang D, Teno JM, Clark M, et al. Family Perceptions of Quality of Hospice Care in the Nursing Home. Journal of Pain and Symptom Management. 2014; 48(6): 1100-1107. doi: 10.1016/j.jpainsymman.2014.04.003
58. Jin Z, Northridge ME, Metcalf SS. Modeling the influence of social ties and transportation choice on access to oral healthcare for older adults. Applied Geography. 2018; 96: 66-76. doi: 10.1016/j.apgeog.2018.05.005
59. Dash NR, Taha MH, Shorbagi S, et al. Evaluation of the integration of social accountability values into medical education using a problem-based learning curriculum. BMC Medical Education. 2022; 22(1), 181. doi: 10.21203/rs.3.rs-958792/v1
60. Carmack HJ. “What Happens on the Van, Stays on the Van”: The (Re)Structuring of Privacy and Disclosure Scripts on an Appalachian Mobile Health Clinic. Qualitative Health Research. 2010; 20(10): 1393-1405. doi: 10.1177/1049732310372618
61. Berkowitz SA, Terranova J, Hill C, et al. Meal Delivery Programs Reduce the Use of Costly Health Care in Dually Eligible Medicare And Medicaid Beneficiaries. Health Affairs. 2018; 37(4): 535-542. doi: 10.1377/hlthaff.2017.0999
62. Valentijn PP, Schepman SM, Opheij W, et al. Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care. International Journal of Integrated Care. 2013; 13(1). doi: 10.5334/ijic.886
63. Boateng L, Nicolaou M, Dijkshoorn H, et al. An exploration of the enablers and barriers in access to the Dutch healthcare system among Ghanaians in Amsterdam. BMC Health Services Research. 2012; 12(1). doi: 10.1186/1472-6963-12-75
64. Chung K, Jahng J, Petrosyan S, et al. Assessment of Levels of Hospice Care Coverage Offered to Commercial Managed Care Plan Members in California. American Journal of Hospice and Palliative Medicine. 2014; 32(4): 440-447. doi: 10.1177/1049909114526298
65. Mitra S, Vadivelu N. Multidisciplinary approach and coordination of care. In Essentials of palliative care (pp. 7-21). New York, NY: 2012. Springer New York.
66. O’Brien N, Durkin M, Lachman P. Lessons post-COVID from national and international approaches to safety and quality in healthcare. Future Healthcare Journal. 2021; 8(3): e602-e608. doi: 10.7861/fhj.2021-0158
67. Braithwaite J, Ludlow K, Testa L, et al. Built to last? The sustainability of healthcare system improvements, programmes and interventions: a systematic integrative review. BMJ Open. 2020; 10(6): e036453. doi: 10.1136/bmjopen-2019-036453
68. Lennox L, Maher L, Reed J. Navigating the sustainability landscape: a systematic review of sustainability approaches in healthcare. Implementation Science. 2018; 13(1). doi: 10.1186/s13012-017-0707-4
69. Cavicchi C, Oppi C, Vagnoni E. Back and Forth on Sustainable Development: A Focus on Healthcare Organisations. Sustainability. 2022; 14(9): 4958. doi: 10.3390/su14094958
70. Manyazewal T. Using the World Health Organization health system building blocks through survey of healthcare professionals to determine the performance of public healthcare facilities. Archives of Public Health. 2017; 75(1). doi: 10.1186/s13690-017-0221-9
71. Kim SH, Joo HJ, Kim JY, et al. Healthcare Policy Agenda for a Sustainable Healthcare System in Korea: Building Consensus Using the Delphi Method. Journal of Korean Medical Science. 2022; 37(39). doi: 10.3346/jkms.2022.37.e284
72. Kang CW, Imran M, Omair M, et al. Stochastic-Petri Net Modeling and Optimization for Outdoor Patients in Building Sustainable Healthcare System Considering Staff Absenteeism. Mathematics. 2019; 7(6): 499. doi: 10.3390/math7060499
73. Rogers AJ, Hamity C, Sharp AL, et al. Patients’ Attitudes and Perceptions Regarding Social Needs Screening and Navigation: Multi-site Survey in a Large Integrated Health System. Journal of General Internal Medicine. 2020; 35(5): 1389-1395. doi: 10.1007/s11606-019-05588-1
74. Valley MA, Stallones L. Impact of a Mindfulness Intervention on Hospice Care Worker Safety and Well-Being. OBM Integrative and Complementary Medicine. 2021; 06(03): 1-1. doi: 10.21926/obm.icm.2103029
75. Kumar V, Ankuda CK, Aldridge MD, et al. Family Caregiving at the End of Life and Hospice Use: A National Study of Medicare Beneficiaries. Journal of the American Geriatrics Society. 2020; 68(10): 2288-2296. doi: 10.1111/jgs.16648
76. Chi NC, Demiris G, Pike KC, et al. Exploring the Challenges that Family Caregivers Faced When Caring for Hospice Patients with Heart Failure. Journal of Social Work in End-of-Life & Palliative Care. 2018; 14(2-3): 162-176. doi: 10.1080/15524256.2018.1461168
77. Sanders S, Swails P. Caring for individuals with end-stage dementia at the end of life. Dementia. 2009; 8(1): 117-138. doi: 10.1177/1471301208099049
78. Fattori A, Pedruzzi M, Cantarella C, et al. The burden in palliative care assistance: A comparison of psychosocial risks and burnout between inpatient hospice and home care services workers. Palliative and Supportive Care. 2022; 21(1): 49-56. doi: 10.1017/s1478951521001887
Refbacks
- There are currently no refbacks.
Copyright (c) 2025 Author(s)
License URL: https://creativecommons.org/licenses/by/4.0/

This site is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).

Prof. Kittisak Jermsittiparsert
University of City Island, Cyprus




Title: Economic Sustainability and Innovation
Deadline: June 30, 2025.