Continuing care in Partnership: Nancy Gifford, hospice social worker

By Kyra Kitlowski August 14, 2006

Martinez, CA—"I'm sorry," Gifford says between phone calls. "Something has come up with a patient that I need to take care of right now. Our plans are going to change."

When you're job is taking care of dying patients, a hospice employee has to be prepared for anything.

Gifford calls her manager and then calls for a nurse to meet at the patient's home. The situation involves a 50-year-old woman dying from cancer. The patient's mother fired an outside caregiver, who was taking care of her daughter. The mother is physically unable to care for her daughter alone and it's crucial that she receive the additional care.

As a hospice social worker, Gifford advocates for her patient's wishes and needs. She helps plan for long-term care and will help patients and their families plan for end-of-life arrangements. There are times, Gifford explains, that what the patient wants isn't quite what the family has in mind. A social worker's job requires striking a delicate balance between the two.

And among many other things, she also is a counselor.

On this particular day, she met with a young man in his 30s. He is dying and just recently lost his eyesight. Pictures of his 5-year-old son were hung up next to him.

"He is so handsome," Gifford says to her patient. "He looks just like you. Tell me about him."

He quietly and slowly mentions his son's sweetness and amazement over how fast he's growing. Then he stops talking and Gifford holds his hand, asking him if he wants to do a relaxing technique.

Gifford would describe later why she asked him to talk about his son.

"He needs to know that things are going to be OK," she says. "He doesn't need to be worried about anything right now. He should be proud of all he's contributed to his life and needs to have a sense of peace. That is so important."

While it's a job many people couldn't deal with, Gifford can't imagine doing anything else. Her mother volunteered for terminally ill patients and her grandmother was a nurse.

Partnership is part of the job

The good thing about social workers is that the idea of Partnership is a social work motto, explains Gifford's manager, Joan Engelbart.

"The meaning behind Partnership is what social workers stand for: this idea of identifying issues and working on them together and the concepts behind corrective action. All of this should come naturally to us," she says. "It's a revolutionary idea in the workplace and I wish more people would adapt to it. It's a difficult concept for some."

Aside from weekly case meetings with Hospice employees, she makes a point to require monthly meetings with the social workers in her department. But the majority of her communication with the social workers is still done on the phone.

"And that's actually good," Engelbart says matter-of-factly. "I want our social workers to be independent—they have to in this field. These social workers are very professional, extremely reliable, and they are good at what they do."