My interest in the psychosocial experience of people facing serious illness is what first drew me towards a career in clinical social work. During my MSW graduate studies and for the first ten years that followed, I worked as part of several interdisciplinary teams in home, nursing home and hospital settings, where I helped patients and families to navigate the psychological, emotional and spiritual ramifications of illness and mortality, as well as the difficult decisions that accompany serious illness.
Since starting my own practice I have continued to provide private, office-based palliative care consultation to people living with serious illness, helping them and those in their close circle to cope with the day-to-day struggles (and successes!) and to piece together a plan of care that best adheres to their personal values, priorities and limits.
Relevant palliative care work history:
Center to Advance Palliative Care (New York, NY)
Consultant
January 2014 – present
Invited faculty, Generalist Palliative Care Training E-Learning Initiative
Lead course author, Assessing and Supporting the Family Caregiver
Discussant, Monthly Virtual Office Hours: Team Wellness, The Role of Social Work
Invited faculty, CAPC Annual Assemblies
Adult Palliative Care Service, Dana-Farber/Brigham & Women’s Cancer Center, Brigham & Women’s Hospital (Boston, MA)
Director of Palliative Care Outreach, Senior Clinical Social Worker
June 2007 – August 2014
Provided specialized psychosocial assessment and intervention to a clinically complex population of patients and families facing advanced disease, in collaboration with interdisciplinary consult team.
Coordinated hospital-wide outreach to identify patients appropriate for palliative care consultation, including ICU, cardiology and general medicine populations.
Met regularly with department administrators to define and develop the distinct role of the palliative care social worker within both the palliative care and social work programs.
Coordinated with other Adult Palliative Care Fellowship faculty in educating physician Fellows on psychosocial aspects of end-of-life care and bereavement.
Participated in daily team rounds, biweekly teaching rounds and department-sponsored educational conferences.
Mentored junior palliative care social workers on palliative care screening, assessment and intervention.
Provided formal and informal staff education on hospice, palliative care, end-of-life communication and related issues.
Provided individual weekly supervision to junior oncology social workers to develop skills in psychosocial assessment and intervention with cancer patients and their families.
Chaired DFCI bereavement taskforce responsible for developing and implementing Institute-wide bereavement initiatives.
Special projects
Integrated Patient-Centered Care in Chronic Critical Illness (September 2013-May 2014)
Internal grant-funded pilot study to improve discussion, documentation and continuity of goals of care for chronically critically patients transitioning between Medical Intensive Care Unit (MICU) and Spaulding Hospital Cambridge (SHC) Long-Term Acute Care, via a unique medical intensivist and palliative care social worker Continuity Team model.
Screen all MICU patients with LOS>10 days or likely discharge to SHC for goals-of-care and other palliative care needs.
Participate in and document goals-of-care conversations both in MICU and at SHC.
Weekly videoconference rounds with SHC staff on pilot study patients, as well as biweekly on-site visits with pilot study patients and families at SHC.
Hospitalist Medicine Initiative (June 2012-January 2013)
Targeted intervention on Hospitalist Medicine service aimed at improving physician and nurse competence in identifying palliative care needs, and improving and documenting goals-of-care conversations with chronically ill, medically complex patient population.
Developed triggers and palliative care consult algorithms specific to palliative care consultation within medicine patient population.
Rounded daily with staff nurses and nurse management to identify patient palliative care needs.
Coached nursing staff on clearly delineating patients’ palliative care needs and advocating for palliative care involvement to hospitalists and housestaff.
Partnered with hospitalists and housestaff in conducting and documenting goals-of-care conversations with patients and family members.
University HealthSystem Consortium P4P Initiative (April 2008-December 2009)
Hospital-wide, external grant-funded quality improvement initiative to improve access to palliative care expertise in select high-risk critical care, cardiac and other non-oncology populations.
Developed screening tools and algorithms to streamline referral, assessment and data collection.
Attended daily rounds with critical care and other providers to identify patients appropriate for psychosocial- and/or medical-based palliative care consultation.
Exceeded anticipated increase in palliative care consultation from 25% to over 50% of target populations
Palliative Care Service, Montefiore Medical Center (Bronx, NY)
Senior Social Worker March 2005 – June 2007
Functioned as part of an interdisciplinary consult team to facilitate communication between patients, families and medical staff; negotiate complex family dynamics and establish clear goals of care; and provide referral and guidance to achieve appropriate palliative care plans.
Identified and managed psychosocial and emotional stressors in a clinically diverse population of patients and families facing critical or terminal illness in a complex, urban medical setting.
Educated hospital- and community-based social workers and other disciplines on effective assessment and intervention with psychosocial aspects of hospice, palliative care and advance care planning.
Supervised social work interns, program volunteers and research assistants in providing ancillary patient and family supports and collecting psychosocial program data.
Collaborated with Office of the Medical Director, Bioethics Team and Complex Case Review Committee to resolve complex end-of-life cases and refine institutional policies involving EOL care.
Managed comprehensive bereavement program, which included 12-month family follow-up, individual counseling, and family and staff support groups.
Visiting Nurse Service of New York Hospice (NY, NY)
Admissions Liaison December 2005 – June 2007
Performed comprehensive psychosocial assessments and initiated first-line crisis intervention and problem solving for patients and families enrolling in hospice.
Coordinated with admission and primary hospice teams to provide patients and families with access to psychosocial, emotional and spiritual supports.
Palliative Home Care Service, Beth Israel Medical Center (NY, NY)
Social Work Coordinator July 2003 – March 2005
Developed and implemented a grant-funded community-based initiative aimed at increasing palliative care access in a diverse population of medically ill, underserved elderly patients.
Provided home-based psychosocial and emotional supports, case management, education, advocacy and referral to palliative care patients, families and caregivers, while promoting interdisciplinary communication, collaboration and continuity of care between care settings and providers.
Recruited, trained and supervised volunteers visiting homebound palliative care patients.
Worked in close conjunction with team nurse practitioner to assist primary care providers in managing complex psychosocial stressors and end-of-life issues.
Educated hospital social workers, staff and community organizations on hospice and palliative care.
Coordinated weekly case finding and patient intake, generating over 260 referrals in the program’s first eighteen months and an average daily census of over 50 patients.
Calvary Hospital (Bronx, NY)
Social Work Intern Sept. 2002 – June 2003
Provided diagnostic and treatment services to terminally ill cancer patients and their families in an acute, palliative care hospital setting.
Evaluated and addressed complex emotional and psychosocial stressors of patients and families.
Collaborated with interdisciplinary team and external agencies to achieve optimal level of care.
Facilitated patient support groups, family support groups, and bereavement groups.
The Center to Improve Care of the Dying (Washington, DC)
Patient and Family Care Coordinator Aug. 1998 – Aug. 1999
Provided telephone counseling, education and advocacy for terminally ill patients and families to facilitate psychosocial and emotional coping and improve access to services.
Reviewed and consolidated literature for research initiatives on improved end-of-life care.
Planned and participated in monthly professional seminars on current end-of-life issues.
As core production team member for Handbook for Mortals and Sourcebook on Dying, edited and maintained book drafts; managed copyrights and permissions; and served as liaison with publisher.