Description
Provide psychosocial support to patients with terminal illness and their families, focusing on comfort, dignity, and goals of care. Counsel, educate, and advocate; coordinate resources and advance care planning; and deliver case management and bereavement services to reduce barriers to end-of-life care and support caregivers.
- • Collaborate with the interdisciplinary hospice team to assess psychosocial needs and goals of care.
- • Conduct psychosocial assessments and develop documented hospice plans of care.
- • Provide individual and family counseling for coping, anticipatory grief, and adjustment to terminal illness.
- • Facilitate family meetings and mediate conflicts about care preferences and decision-making.
- • Educate patients and caregivers about end-of-life symptoms, caregiving strategies, and available supports.
- • Guide advance care planning, including health care proxies, advance directives, and POLST/DNR discussions.
- • Connect patients and families with resources such as respite, financial assistance, veterans benefits, transportation, meal programs, and funeral/cremation planning.
- • Identify and address home safety, caregiving capacity, and other environmental barriers to care.
- • Advocate for patient preferences and rights during care planning and crises.
- • Update and modify the psychosocial plan of care as conditions and goals change.
- • Monitor, evaluate, and document patient and caregiver outcomes per measurable goals.
- • Assist with hospice benefit education and required consent and eligibility paperwork.
- • Coordinate transitions between home, inpatient hospice units, hospitals, and long-term care settings.
- • Organize or lead caregiver and grief support groups and refer to specialized counseling when needed.
- • Provide crisis intervention for issues such as caregiver burnout, housing instability, or violence risk, following mandated reporting laws.
- • Collaborate with chaplains, aides, nurses, and physicians to ensure culturally sensitive, person-centered care.
- • Conduct bereavement risk assessments and provide or coordinate grief support for families up to 13 months after death.
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O*NET occupational data (work activities, skills, knowledge).
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Last reviewed: Jan 2026
