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·     Evaluates the psychosocial needs of each patient and family care unit.

·     Develops and implements the psychosocial plan of care in response to the needs of the patients and families. 

·     Travels to patient residence and performs initial assessment. Identifies and assesses the psychosocial needs of the patient and family, and the care giving relationships and dynamics between the patient and family for the patient interdisciplinary care plan.

·     Assists the patients and families with obtaining financial resources.

·     Provides services as determined by interdisciplinary team and reports back to registered nurse regarding assessment and need for other organizational resources.

·     Communicates with care givers and make referrals for intra-organizational services and community resources such as Medicaid, Salvation Army, and food banks.

·     Provides education and assistance in completing Advance Directives.

·     Provides counseling to patient or family care unit on individual or group basis.

·     Interacts with facility/hospital case managers to provide appropriate hospice services.

·     Evaluates family care unit bereavement needs at the time of admission throughout the hospice process to the patient’s death. Completes referral to Bereavement Department and documents appropriately.

·     Maintains appropriate professional documentation related to the patient/caregivers as part of the Plan of Care in the electronic medical record.  Ensures accurate and timely completion.

·     Participates as a member of the assigned interdisciplinary team and attends all scheduled meetings.

·     Assesses the need for volunteer assistance.