Who’s taking care of me at the hemodialysis center?

Part 3 (of 8): Social Workers

What is a renal/dialysis social worker?

A renal social worker is a support person for patients both before and after they start dialysis. Social workers are highly educated and trained to help patients and their families by providing support in all areas of their lives including: emotional, financial, career, lifestyle adjustment and more.

Social workers at DaVita dialysis centers generally have a master’s degree in social work (MSW). Some states require social workers to have a license as well.

What do social workers do?

The main duty of the social worker is to help patients and their families learn how to cope with kidney disease. They teach people how to adjust to the changes that come with dialysis or a kidney transplant. Other social worker tasks include helping patients to:

  • Talk about their emotional needs and enhance their coping skills
  • Learn about kidney disease, dialysis and kidney transplant
  • Strengthen their family and support system
  • Adjustment to treatment plans and diet changes
  • Find community resources for transportation, home health services, nutrition and more
  • Keep or get insurance
  • Apply for possible financial assistance
  • Keep or get a job
  • Enjoy activities they’ve always enjoyed
  • Set goals and look to the future
  • Arrange for dialysis treatments in a visiting center when traveling
  • Understand their Rights, Responsibilities, Code of Conduct and Grievance Procedure within their center

Social workers help patients adjust to life on dialysis. Teaching patients about kidney disease and their treatment options (dialysis and kidney transplant) helps them understand what is happening to their bodies and make informed decisions about their care. Assisting patients who are able to work provides a source of income and lets them maintain a more normal life. Finding health insurance to help pay for dialysis can help patients avoid financial hardship due to kidney disease. Lending an ear and encouraging patients to resume favorite activities can help them work out their feelings and show them that life can return to normal. Having a social worker to educate and support patients in these ways helps them enjoy a better quality of life.

Social workers also work with other members of the dialysis team to teach them about the emotional aspects of dialysis and how to interact with patients and fellow team members in a positive and professional way. By presenting a full picture of all the patient’s needs to the dialysis team, social workers help ensure the best decisions will be made regarding the patients overall health and well being. Social workers are also helpful in explaining the grief process that patients and team members may experience in the dialysis setting.

How do social workers do their jobs?

Listening is a social worker’s most important skill. When first meeting with their social worker, a new patient will answer many questions. The social worker wants to learn as much as possible about the patient in order to provide the best support. For example, the social worker will want to know if a patient has a strong family support system, if they have other diseases (such as diabetes or high blood pressure) and how much they understand about kidney disease and dialysis. Social workers also help patients who have mental, emotional or substance abuse issues to get the proper care. 

In addition to talking with the social worker, patients receive written information about kidney disease and dialysis they can read at their leisure.

Social workers are experts in finding ways to pay for treatments. They try to get insurance for their patients, as well as maintain coverage for those who are already insured. Some patients have insurance through their jobs. When patients are unable to work, social workers are aware of other insurance options, such as the federal Medicare plan and individual state programs. With professional connections to organizations, such as the American Kidney Foundation, social workers can also look for financial help for their patients. Sometimes, a patient has insurance coverage for their medical needs, but not for their prescription medications. Social workers help these patients get financial assistance with medications, so they can follow their doctor’s orders and feel better.

As a patient advocate, social workers provide support. They discuss available resources with their patients and work to get them the services they need. Social workers can explain work place rights and programs such as COBRA, FMLA, and disability.  The social worker supports patients by teaching them about their rights and responsibilities, the code of conduct, and the grievance procedure.  Social workers help to protect patients who are at risk of being abused or neglected by working with state social service departments.

What else does the social worker do?

Documenting each patient’s progress is a big part of the social workers duties.

Some of the documentation includes:

Initial (and then yearly) psychosocial assessments to determine patient’s strengths and needs. Areas of interest include:

  • social interaction and family support
  • medical information
  • treatment modality interest (hemodialysis, peritoneal dialysis, transplant)
  • legal information, such as advance directives
  • insurance and financial issues
  • physical functioning
  • mental health/substance abuse issues
  • emotional well being

Interdisciplinary Care Plan is important to the entire dialysis care team, as it helps them know how the patient is progressing. This includes:

  • physical abilities
  • mental processes
  • general emotional state
  • insurance and financial needs

A social work Progress Note done quarterly covers whether the patient’s condition is stable, if there have been any life changes such as with: living situation, insurance, hospitalization and emotional adjustment to treatment. The purpose of the Progress Note is to assist the social worker in determining the areas where a patient needs help coping with changes.

An annual Life Plan or Long Term Care Plan states the patient’s current mode of dialysis, transplantation information and wishes for an advance directive (similar to a living will). These issues are discussed yearly to determine if the patient wants to try another form of dialysis or be placed on a transplant list and what their wishes are regarding their care as well as who will make decisions on the patient’s behalf, if they are unable.

Talk to your social worker

Many people rely on social workers for support in many areas of life. Those with kidney disease, their family members, caregivers and even other members of the dialysis care team turn to social workers for help in making life better. Your social worker is an advocate for you and is willing to help you. Feel free to talk to your social worker about any issues you may have regarding dialysis or other areas of your life.

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