Care Dimensions Social Worker Angela Swift shares a laugh with hospice patient Ken “Woody” Wooldridge.

The Rewards of Hospice Social Work

In observance of Social Work Month, two Care Dimensions social workers, Angela Swift and Tracy Ng, discuss what attracted them to their profession, lessons learned, and what they’ve found fulfilling about hospice social work. Angela has been with Care Dimensions since 2003; Tracy joined our team in January 2022 and has helped people receiving palliative care or hospice since 2011.

Why did you become a hospice social worker?

Angela Swift – I don’t think I ever intended to be a hospice social worker. I was directing a residential school for juvenile offenders, which was located where Care Dimensions’ Kaplan Family Hospice House is now. I was looking for another job and a therapist who was renting space in our building shared that Hospice of the North Shore (Care Dimensions’ original name) had posted openings for social workers. I was reluctant to pursue it because I did not think I could work with terminally ill patients. I interviewed and then spent the day with the company’s only full-time social worker, going to homes and providing support to patients and families. I was hooked and never looked back. I enjoy meeting patients and families where they are now, helping them navigate what is to come and not focusing on the past. 

Tracy Ng – I became a medical social worker after graduating from social work school in 2011 but switched to palliative care later that year. I realized early on that I was good at being present for the patient without getting lost in their sorrow and that this was a good skill to have. I love sitting and talking with patients and families. They have to process a lot of information provided by their doctors and it can be overwhelming. I enjoy helping them get the information they need based on their goals of care and guiding them along their journey.

What are some lessons you’ve learned as a hospice social worker?

Angela – One of the biggest lessons I’ve learned is to be flexible and open to change. As a member of the interdisciplinary team, we address many issues in the day, and the perfectly designed schedule can often be thrown out the window if someone needs you. I try to remember to take as much time as I need with the patient and family in crisis. Sometimes that might mean rescheduling a meeting with another family, which might be disappointing for them. But I will get to back to them quickly, and I know that they will get the same care and attention when they have a crisis and need that extra time and focus.

The second lesson is to remember that we are guests in our patients’ homes. We are invited and often welcomed to bear witness to an important transition in a patient’s life. As a social worker, I can make suggestions, answer questions, and offer compassion and education, BUT it is the patient and family who will make decisions that are best for them. The family will have this one chance to provide care for their loved one at the end of their life and it is important to honor their wishes and values.

Tracy – Family is extremely important. We connect with family members and the patient on such a deep level. Having conversations with the patient about who they are help shape decisions about goals of care and what’s important to them, and family members need to know that. And on a personal note, the importance of family pushed me to return to Greater Boston three years ago after having been in New York and Seattle for college and work. I wanted to spend time with my parents while they’re in good health and to make memories with them and my child.

I’ve also learned to have confidence in my skills. Before coming to Care Dimensions, I worked with Kristen Schaefer, MD, on a palliative care team embedded with cardiac care at Brigham and Women’s Hospital. (Dr. Schaefer is now Care Dimensions’ Medical Director for Greater Boston.) We were staking a claim in a department that didn’t know what to do with us, but we knew we could offer patients and families expertise that the cardiac team didn’t have. Being confident in my skills helps me interact with patients and families so they can see our value and accept our services.

What do you find most fulfilling about hospice social work?

Angela – The people! I cannot say enough about all I have learned from the patients and families I have met throughout my career as a hospice social worker. I often wish that I had known them when they were younger, or before they were ill. I cannot get enough of the stories of how couples met – so many met at dance halls and fell in love. I continue to be humbled by those veterans who served our country and feel honored when they share their stories both of triumph and struggle.

I also could not do this job every day without the support of the most wonderful team. I can count on phone calls from my manager, nurses, fellow social workers, and chaplains to check in, offer updates on patient visits, and collaborate on ways we can support patients and each other. Our hospice aides share valuable information from their visits, as do our volunteers and complementary therapists. Through collaboration, we offer the best patient care possible.

Tracy – I enjoy the ability to connect with other people when they’re most vulnerable. It’s such an honor to meet people and hear their stories. Hospice patients often want to open up and take stock in their lives. I’m glad to be part of their journey and help them achieve the end-of-life experience they want.

What’s one of your favorite memories with a patient?

Angela – I can’t say that I have one favorite memory as each patient’s life circumstance is unique. I have enjoyed 95^th and 100^th birthday parties, facilitated patients playing with and holding puppies, patients talking with their family in another country over Facetime, military service members getting home in time to be with patients prior to passing away, and assisting with weddings so that patients can be part of the special day. The most memorable times are the ones when I can sit with a patient who feels alone and assure them they are not.

Tracy – I remember a patient who had two young children. We worked with Child Life Services and made a video of her children visiting her in the hospital. They piled onto the bed with their mom, and everyone was giggling and happy to be together. It was heartwarming to see them like that.

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