The Social Work Department is comprised of two offices. The primary office is located on the first floor of the hospital. The discharge planning nurse's office is in the "White House," the building next door. The department is staffed Monday through Friday, 8:00AM - 4:30PM. The social worker will meet with families at other hours by appointment. The social worker or discharge planning nurse may be contacted via phone by either the Nursing or Floor Supervisor, should a problem, question, or crisis arise after-hours.

The Social Worker provides services for patients from newborn through geriatric. However, due to the average age of patients admitted, and the nature of the services provided, Social Services patients are primarily geriatric.

The Social Worker uses High-Risk Screening criteria to assist in the identification of patients. This screening considers both medical and social indicators.

• Medical Indicators:
• CVA/TIA, as referred
• Congestive Heart Failure, as referred
• Chronic Obstructive Pulmonary Disease, as referred
• Diabetes Mellitus, as referred
• Orthopedic Problems (ie, fractured hip, multiple fractures, etc.)
• Terminal Illness
• Drug & Alcohol Abuse
• Neurological Disorders, as referred
• Senile Dementia
• End-Stage Renal Disease
• Head Trauma
• Amputations
• AIDS
• Metastic Cance
• Elective Orthopedic Procedures
• Social Indicators:
• Patients older than 75 who live alone or with an invalid
• Patients older than 85
• Patients suspected of being victims of abuse or neglect
• Patients who are transferred to the hospital from a nursing or personal care home
• Patients with frequent admissions
• Adult patients unable to perform activities of daily living

There are many services provided by the Social Services department:

Discharge Planning

Social Services provides coordinated discharge planning services to assist patients/families to develop appropriate and timely discharge plans, including, but not limited to, nursing home placement, rehabilitation placemant, in-home services, durable medical equipment, and transportation.

Crisis Intervention/Supportive Counseling

Social Service is available with any crisis situation necessitating immediate use of community resources, emotional support, or any services coordinated by the Department. Supportive Counseling is appropriate with terminal patients and families, patients facing crisis situations, etc. Support, education, and crisis intervention may assist patients and families to better utilize their medical care appropriately.

Education

Social Services provides education regarding Advance Directives, insurance coverage, finances, stress management, and discharge plans regarding placement and community resources.

Home Health

The Social Services Department provides medical social work services in the hame to improve or maintain the social, emotional, functional, and physical health status of the patient, as well as to enhance the coping skills of the family or caregiver(s).