Above: RVNAhealth Social Worker Cynthia Merritt, LCSW, enjoys a laugh with a hospice patient (and his loyal pooch).
When an individual diagnosed with a life-limiting illness becomes an RVNAhealth Hospice patient, Cynthia Merritt, LCSW, is often the first member of our hospice team to meet and welcome the patient and family.
As a hospice social worker, Cindy’s role is all about supporting, comforting and educating patients and their families. This starts with introducing the roles of the Hospice interdisciplinary team and explaining the services available through hospice.
As Cindy will explain to each family, within five days of being admitted onto our care, a representative from each of the three core hospice services – skilled nursing, pastoral care and social work – will visit and assess each patient. (This is required by Medicare.) She notes that “The interdisciplinary team also includes medical directors, a music therapist, CNAs and volunteers.” The latter bring an array of talents ranging from simple companionship to dog walking, to assisting us in the office.
Assessing Needs, Identifying Resources
In collaboration with the RVNAhealth hospice medical director and nurses, our social workers identify ways to ensure that each patient’s needs are met. This may include counseling family members to help accept their loved one’s terminal illness, or identifying adjustments that will help the patient have a quality end-of-life experience.
Cindy explains that considerations might include, “Will the person be most comfortable with a wheelchair or hospital bed? If they have a lot of needs, would they benefit from a home health aide? Or perhaps physical therapy might help them become safer and more mobile.”
Notes RVNAhealth Chief Clinical Officer Keri Linardi, RN, “Cindy helps family members with vastly differing opinions all get on the same page, so they start rowing in the same direction in decision-making. She also coordinates care and check-in calls for patients who live alone. She is committed to helping put resources in place to allow people to stay at home and she helps with placement [in a facility] when that is the wish.”
Some patients can’t afford additional services that would make their end of life more comfortable. Some suddenly face financial or housing obstacles. In these cases, Cindy is comfortable with “getting creative.”
“I explore whether there are any veterans benefits available to the family, I look at any and all programs they might be eligible for, and I guide them through the application process,” she explains.
Support Beyond Physical Comfort
Hospice care isn’t just for medical comfort; and it isn’t solely about the patient. Hospice care tends to the psychosocial needs of the patient, and the family and loved ones as well.
“We make things happen for people. If the patient wants to see a grandchild in a special concert, but they need transportation, we arrange for that,” says Cindy.
“We’re mindful that there are big challenges, not only for the patient who is losing independence, but also for the family caregivers who’ve been trying to provide everything – they too need extra systems of support.”
That support extends to beyond the patient’s life and time in hospice. Our hospice social workers provide comfort and counseling to families upon their loss. Cindy also leads a monthly bereavement group and has hosted a four-week holiday bereavement group.
Keri notes that Cindy’s care and support extends to her hospice teammates. “She does so much for the entire team,” she says. “Hospice cases can be unpredictable and difficult, and Cindy works tirelessly to help our caregivers cope with the emotions they experience.”
Helping Navigate Feelings
Another important element of a hospice social worker’s role is helping patients and their families work through the many emotions they are facing. “This is a very vulnerable time,” says Cindy. “For many individuals it is new and unchartered territory.”
Cindy’s work does not go unnoticed.
“I just wanted to thank you for having an angel like Cindy Merritt on your team. She came to speak with my kids and I at our house yesterday and she just did such a beautiful job helping the girls (especially my oldest, who is 8) navigate some of these big, sad feelings about losing their grandmother. My daughter said it was really helpful and she’d like to speak with her again soon. I’m just so grateful for all of RVNA(health)’s support.”
The gratitude works both ways. To Cindy, it’s an honor to be brought into people’s lives and homes to help them understand and navigate this time of life.
“We plan so many things in our lives,” she says. “Vacations, weddings, all kinds of dinners. But most of us really don’t plan for our end-of-life. For me, it is truly an honor to be able to soften this road and time for others and help make them more comfortable in any way that I can.”