Hospice & Palliative Care Social Workers in California

Written by Kim Borwick

hospice and palliative care

Hospice and palliative care social workers are part of the interdisciplinary team that cares for seriously and terminally ill patients, providing emotional, psychological, and social support to patients and families during some of the most difficult moments of their lives.

Sometimes referred to as medical social workers, health care social workers, or licensed clinical social workers (LCSW), hospice and palliative care social workers perform their duties under the guidance of California law, including Medi-Cal eligibility criteria, and the National Association of Social Workers (NASW) ethical standards for palliative and end of life care.

Compassionate Hospice and Palliative Social Work in California

According to 2020 data from the US Census Bureau, California is the second most diverse state in the country and has the nation’s largest Hispanic and Latino population.

Thus, social workers who offer palliative and end-of-life care services in the state must strive to meet a higher bar for cultural competence in their practice. They should possess a broad and deep knowledge of the traditions, values, and family systems of the distinctive groups that make up California’s inclusive communities.

California has a long history of embracing hospice care as an integral part of the health care system and values the contribution of hospice social workers to an interdisciplinary team that prioritizes the comfort, dignity, and well-being of those facing life-limiting illness and end-of-life issues.

What Do Hospice & Palliative Care Social Workers Do?

Hospice care and palliative care are different types of care applied in specific circumstances. Social workers in these health care settings are trained to provide support that is appropriate to the specific needs of patients and their families.

Hospice Care vs. Palliative Care

Type of Care

Characteristics

Social Work Intervention

Hospice Care

  • Intended to relieve pain and increase comfort in the final stages of terminal illness for patients who have fewer than six months to live
  • Focuses on optimizing the patient’s quality of life, providing comfort, and alleviating suffering
  • Preparing the patient and family for the end of life

Palliative Care

  • Provides pain relief and symptom management to patients with serious illnesses that may or may not be life-threatening
  • May include therapeutic treatment, such as chemotherapy
  • Boosting the patient’s morale as they take the necessary steps for recovery
  • Preparing the patient and family for the end of life

In both cases, a hospice and palliative care social worker provides counseling, access to resources, and assistance with end-of-life decisions or treatment decisions that align with a patient’s goals.

They are also trained in:

Social work interventions address a range of factors, from practical matters such as living wills and funeral arrangements to psychosocial elements including conflict resolution, cultural practices and beliefs, and controversial issues concerning death and dying.

In addition to their patient-centered responsibilities, hospice and palliative care social workers help caregivers and family members plan for changes in a loved one’s health, set boundaries, and cultivate empathy and resilience so they can manage the stress of taking care of the patient without sacrificing their own physical and mental well-being.

Hospice Social Workers & California Law

California hospice and palliative care social workers should be knowledgeable about state laws and legal documents.

End of Life Option Act

California is one of ten jurisdictions in the United States where physician-assisted suicide is permitted for people with a terminal illness and a prognosis of six months or fewer to live.

The End of Life Option Act requires that the patient meet certain requirements, and, according to the California Department of Public Health, some requirements have changed since the law was first passed. For example, the waiting period between the first and second oral request is now 48 hours, and patients no longer need to submit the Final Attestation for Aid-in-Dying Drug form.

For social workers who practice in hospice and palliative care settings, knowledge of this state law is essential to delivering appropriate care and advocating for their clients, who have the right, as the National Association of Social Workers asserts, “to self-determination and dignity.”

Advance Directives

California’s Advance Directive Health Care form allows a person to document their wishes regarding physical and mental healthcare and to select someone to make health care decisions when they are unable to do so. In California, an advance directive includes:

  1. Appointment of an agent for health care
  2. Individual health care instructions
living will or advance directive

Hospice and palliative care social workers who are familiar with this form and other such contracts recognized under California law, are better equipped to advocate for patients, communicate their wishes to the health care team and others, and guide patients through advance care planning.

Identifying Barriers to Access and Fraud

Social workers in palliative care and hospice settings are in a unique position to mitigate fraud and assist marginalized populations with accessing treatment.

A 2021 article in California Health Report noted that “The cost of services, inability to take time off from work, and transportation barriers are among factors that make hospice and palliative care inaccessible to Indigenous communities in the state and nationwide” and that health care providers’ lack of cultural sensitivity also plays a role in the communities’ challenges with access to end-of-life care.

Another article that same year revealed that California’s roughly 1,200 Medicare-certified hospice providers are for-profit facilities that are regulated by private accrediting agencies. Hospice and palliative care social workers in the state have the opportunity and responsibility to ensure that these facilities adhere to the highest standards of palliative and end-of-life care as established by the NASW.

Becoming a Hospice & Palliative Care Social Worker in California

People who aspire to a career in hospice and palliative care social work in California must meet the state’s educational requirements to demonstrate that they have the knowledge and skills necessary to provide the best possible care to patients and their families.

The path to becoming a palliative care and hospice social worker typically includes obtaining a master’s degree in social work and a license to practice as a clinical social worker (LCSW).

Bachelor’s Degree

A bachelor’s degree in social work (BSW) or a related field is the starting point for those interested in this profession. A BSW program typically takes four years to complete and provides a foundation in social work principles, human behavior, and generalist social work practice.

Master’s Degree

Most hospice and palliative care social workers hold a master’s degree in social work (MSW). MSW programs in California delve deeper into clinical social work practice, ethical considerations, and specialized areas, including palliative care and hospice. These programs typically take two years to complete, though some California schools and universities offer accelerated programs.

studying alone in the campus grass

 

Specialized Training

While not a formal requirement, many hospice social workers choose to pursue additional training or certification in palliative and hospice care. The NASW Specialty Certification program and the National Hospice and Palliative Care Organization (NHPCO) offer the bachelor’s level national certification Certified Hospice and Palliative Social Worker (CHP-SW) to demonstrate expertise in this field.

Licensure

After completing an MSW program, aspiring social workers must obtain licensure to practice in their state. In California, licensing requirements include earning an MSW degree, passing the Board of Behavioral Science’s California Ethics Exam and the ASWB’s Clinical Exam, and completing 3,000 hours of supervised clinical practice.

Continuing Education

Social workers in hospice and palliative care are encouraged to engage in continuing education to stay current with best practices and emerging research. This ongoing learning helps them provide the highest quality care to patients and their families, and in California, continuing education is required for obtaining and renewing licensure.

Salaries for Hospice & Palliative Care Social Workers in California

Health care social work salaries in California are the highest in the nation, with metro areas in the state paying average annual wages that exceed $100,000, according to the U.S. Bureau of Labor Statistics.

Other sources with information on hospice and palliative care social worker salaries include:

California Employment Development Department (EDD): The EDD in California may also provide information on employment and wage statistics for various professions in the state, including social workers. You can visit their website or contact their offices for the most up-to-date information. You can also visit CalJOBS or CalCareers to search for social work job opportunities with private, nonprofit, and state agencies.

Professional associations: The National Association of Social Workers (NASW) and the California Society for Clinical Social Work often conduct salary surveys and may provide information on average earnings for social workers in hospice and palliative care settings in California.

Salary data platforms: Salary.com, Glassdoor, Indeed, and Payscale provide salary information for California social workers. Search for “hospice social worker,” “licensed clinical social worker,” or “social worker” to find salary estimates.

Local hospice and palliative care agencies: Contacting local hospice agencies or healthcare providers in California may provide you with specific information about the salary range for hospice social workers in the region. They may also have insights into the current job market and demand for such positions.

When researching salary information, keep in mind that salaries can vary based on factors such as location within California, experience and education level, and the health care or hospice agency that employs you.

FAQs

What do social workers do in end-of-life care?

The NASW Standards for Palliative and End-of-Life Care include:

These standards are applied in settings including health and mental health facilities, hospitals, hospices, patient homes, nursing homes, senior centers, schools, courts, child welfare and family service departments, correctional systems, immigrant and refugee programs, substance abuse programs, as well as among researchers and policymakers at the macro level.

Is hospice social work stressful?

Hospice social work can be physically and emotionally stressful for practitioners. The demands of the job range from becoming knowledgeable about medical matters and justifying the value of social work in these settings to managing the emotional stress of accepting loss as a natural and continual part of the job.

Self-care is essential for a hospice social worker’s well-being and resilience. They must set clear boundaries with clients, take time off as needed, and nurture their personal relationships to protect against secondary trauma, burnout, and compassion fatigue.

work life balance

 

What social work theories are used in hospice care?

Palliative care and hospice social workers employ a variety of social work theories and practice models based on these theories to address loss, grief, conflict, bereavement, and separation. Several psychosocial factors, such as complex family systems, come into play for hospice care patients and families.

For example, a study of hospice family caregivers that was designed to advance family conflict theory at the end of life emphasized “the often unseen suffering of family caregivers involved with family conflict at the end of life.”

Social work theories used in hospice care include:

These are just a few of the social work theories relevant to terminally ill patients and their families. Hospice and palliative care social work practice involves interdisciplinary and multidimensional assessment and intervention.

2022 US Bureau of Labor Statistics job market trends and salary figures for child, family, and school social workers, healthcare social workers, mental health and substance abuse social workers, and social workers (all other) are based on national data, not school-specific information. Conditions in your area may vary. Data accessed December 2023.

 

Discover more about other social work specializations in California.