By Darren Smith, Weekend Contributor

Most individuals at some point in their lives will for themselves or a close family member require the services of a social worker. While we usually think of social workers as state or hospital employees, there are significant benefits in hiring a private social worker to better protect and advocate for the loved one.

This article will introduce the reader to a few of these benefits.

Of probably the most daunting problem facing an individual needing entry into the long term healthcare realm can be the overwhelming and complex bureaucracy manifest with the current system of the federal level and those of the various states. It is one that many officials within the field often struggle with, which has necessitated the creation and utilization of the social work profession. The information could be said to be available but much of it is displaced, sometimes contradictory, and replete with pitfalls if erroneous decisions are made.  The best care can often be fleeting and the system often fails those without proper training. Usually individuals fall into the system rather than plan for the possibility or eventuality.

My limited experience within this realm–first hand and through the words of others–involves the health care and aging issues. To exemplify the example of a private social worker, I believe it is best shown by way of a brief introduction to a few generic social worker roles.

The Hospital Social Worker

In this example, the worker serves as an employee of a medical facility. The duty they attach themselves is to that primarily of the hospital and secondary to the patient’s needs. Of the various services they provide they may assist in finding placement for an elderly or disabled person who might no longer require inpatient hospital care but needs referral to a long-term care facility such as an Adult Family Home, Nursing Home or Assisted Living.

While they do provide a necessary service. The primary goal of the hospital social worker in this case is to discharge the patient quickly to facilitate the admittance of incoming patients. A patient awaiting placement in a nursing facility is a cost liability for the hospital and has significant comparative disadvantage to higher-insured patient awaiting surgery or other upcoming treatment. Turnaround for hospitals is intrinsic toward controlling costs and revenue capture. While it surely is in both the interests of the hospital and the patient to receive a quick placement into another facility. The receiving facility, what could be considered the ideal choice is different for both. For the patient, the facility has what they need yet for the hospital the facility is ideally one that has room to accept the patient quickly. Bear in mind that no matter how benevolent the social worker, the guiding hand favors their employer.

The Social Worker of a Nursing Facility or Referral Service

While these two are different manifestations of the same profession, for the purpose of our discussion we can collate these together. A basic function of these social workers is to bring clients to either the facility they are employed or contract with, the latter being in exchange for a commission or a fee. One can benefit form this in the sense that the patient often does not incur a direct charge for the social work in finding placement and they will be helpful in selecting a match between the client and an agreeable facility. But it is important to recognize the patient receives a limited number of options and preferential steering might occur. Moreover, much of this involves traditional salesmanship and human nature being what it may, objectivity might suffer. Furthermore, most individuals cast into the system unexpectedly might not know what their needs may be, what to look for, or which questions to pose. And with time pressures decisions might be cemented with years long outcomes that might not always be positive.

The Government Social Worker

Availability and quality of government social work varies immensely among the various states and counties. When we needed to involve a state social service agency to facilitate the care of a disabled family member I was certainly apprehensive; at the very least I needed to summon a great amount of self-restraint to allow the leap of faith for me to initially trust such an agency. Overall I believe they’ve performed their duty acceptably. Though it is important again to recognize who the government social workers essentially serve.

Budgets, agency rules, and caseload preeminently dictate the undertone despite whatever noble intentions an individual state social worker may have. As dedicated as they may be, they are often overloaded with case files. For the patient, ideally the social worker will apply the complex web of governing rules exactly without arbitrary application. At least with this strategy there are no surprises and mistakes by the patient or family can be self-correcting. But again the human factor intercedes. They do not necessarily work directly for the patient’s best interests alone.

The Private Social Worker

While certainly the above classifications of social workers are of benefit to the individual patient or family, the foundation of each truly remains to whom they are “loyal”.  Generally one can hire a social worker to work and advocate directly for the patient. Of those I have personally contracted with, on behalf of other family members, they bring to the table many collective years of service with either government agencies and private nursing facilities and as a direct result command expert ability to network and derive benefits for their clients. They provide objectivity and an no-risk authority to ask questions without damaging the interests of the patient for mis-speaking. And one such under-recognized advantage is they can be the surrogate through which a family can make difficult decisions.

Our family faced the eventuality for most of having to move a dependent, disabled family member into a nursing facility of some form, as their needs exceeded our ability to provide. It was one that was years-coming, yet it seemed to become one in which we faced with increasing trepidation. It was one where I would rather not have to endure but was a necessary responsibility. We hired a private social worker earlier to ascertain the best placement for the family member. 

Like most people I had nearly zero experience in such matters. But one the recommendation of a college I hired the social worker. Bringing all the dependent person’s medical records we met the S.W. and derived each of the patient’s needs and goals and discussed different placement options. It was nearly a two hour meeting if memory serves me correctly. Next the S.W. over the next week coordinated finding placement for our family member, offered me sound advice on navigating the bureaucracy of the insurance and state benefit requirements, offered suggestions and education on the type and levels of care needed and accompanied us in experiencing walk-throughs of facilities. We located a facility that met our needs within the financial constraints allowable. And it was the best outcome for which we could expect. Her needs were met better than I had imagined.

We also asked the social worker if she would assist us in breaking the news of the skilled nursing facility and without going into specifics the experience ended absolutely better than I had anticipated. I’m sure we all felt as though a great burden had just shrugged from our shoulders.

Costs are probably as variant as the states for which there are but while government and insurance benefits might not indemnify the patient from the cost as this is somewhat a concierge type of practice, the advantages gained in my view greatly outweigh the cost.

Our example with the placement amounted to only a few hundred dollars in total. Most of us simply do not have the time, experience, or training to make life-changing decisions on behalf of others, or ourselves, to secure the best outcomes upon our own volitions. Simply avoiding mistakes justifies this cost notwithstanding the intangible emotional costs that can be assigned to a professional to address.  

Surely there are other services afforded by private social workers, but I can only relay my experience with care for the disabled. I am sure other realms of social work will find similar benefit through the hiring of your own social worker. I cannot recommend this service enough.

By Darren Smith

The views expressed in this posting are the author’s alone and not those of the blog, the host, or other weekend bloggers. As an open forum, weekend bloggers post independently without pre-approval or review. Content and any displays or art are solely their decision and responsibility.

Photo credit: Sailko