VHAN Social Worker Advocates for Patient’s End-of-Life Care Decisions
Many who have cared for a loved one at the end of their life understand the role social workers can play in helping patients and families make their way through a stressful and emotionally charged time.
Providing social work services for palliative and hospice care can be extra challenging, but for VHAN social worker team manager Cate Mart, LCSW, the connections she establishes with patients and their families make her job gratifying and worthwhile.
“People in this situation often feel overwhelmed, alone and at sea, and they’re just looking for a lifeline,” Mart says. “You get such a warm welcome when you reach out and ask what you can do for them.
“Our role is to move people through the transition process as smoothly as possible so that there’s less fear and disruption,” she continued. “They’re relieved that somebody is helping them along the way.”
When an overwhelmed wife of an elderly patient with a form of dementia known as Lewy body dementia reached out to the VHAN care management team, Mart received the call. Symptoms of Lewy body dementia can include loss of memory and intellect, body rigidity, depression, anxiety, and even hallucinations and violent behavior.
“This patient had behavioral disturbances, and that can be hard when they’re acting out, hitting others and refusing medications,” Mart says. “It’s difficult for a caregiver to know how to handle those things, and it makes their safety at home tenuous.”
The patient and his wife were both lifelong academics, so the gradual loss of his intellect was particularly disturbing and painful for the family. Having transitioned quickly from a skilled nursing facility to geriatric psychiatric care and finally to hospice, the patient was in rapid decline when his wife made the decision to donate his brain and body to research.
“She felt like everything had been robbed from her husband—his personality, his vitality and his health,” Mart says. “If he was going to go through this suffering, she wanted it to mean something for the greater good. That was very important to her.”
Mart was able to reach the patient’s neurologist quickly and arrange for his body to be donated after his death. The consent forms were signed, and the patient passed away the next day.
“It’s common for people to try to make sense of suffering in some way, because it can feel senseless,” Mart says. “I don’t think the donation made everything better, but the wife thought he can still give back. He can’t make us laugh or tell us a story, but there will be some good that comes out of it. For her that was very meaningful.”