CHP-SW key terms

Comfort-focused care for people with a terminal illness and a prognosis of six months or less, delivered by an interdisciplinary team. It emphasizes symptom relief, emotional and spiritual support, and quality of life rather than curative treatment.

Care that relieves suffering and improves quality of life for people facing serious illness at any stage. It can be given alongside curative treatment and does not require a terminal prognosis or stopping disease-directed therapy.

A group of professionals from different disciplines who jointly plan and deliver patient and family care. In hospice it typically includes a physician, nurse, social worker, chaplain, aide, and volunteers, with social work central to psychosocial assessment.

The eligibility standard for hospice under Medicare and most insurance: a physician certifies that the illness will likely run its expected course within six months if it does not improve. Patients may be recertified for additional benefit periods if eligibility continues.

The process of renewing hospice eligibility at the end of a benefit period. It requires physician review and documentation that the patient still meets the six-month prognosis standard, and later periods require face-to-face encounters.

Systematic assessment and treatment of distressing physical symptoms such as pain, dyspnea, nausea, constipation, and fatigue. Social workers contribute by identifying barriers to relief, addressing fears, and supporting adherence to the plan.

The idea that suffering in serious illness has physical, emotional, social, and spiritual dimensions that interact. Effective relief requires attention to all four, not only to bodily symptoms, which is why psychosocial assessment matters.

The outcomes a patient values most and wants treatment to pursue, such as comfort, time at home, or longevity. Clarifying goals guides decisions about hospitalization, resuscitation, and other interventions.

An ongoing conversation and documentation process in which a person states preferences for future care and names someone to speak if they cannot. It produces documents such as living wills and health care proxy forms.

A written legal document that records a person's wishes about medical treatment or designates a decision-maker for when they lose capacity. Living wills and durable powers of attorney for health care are common forms.

A person named in a legal document to make medical decisions on behalf of someone who can no longer decide for themselves. The proxy is expected to follow the patient's known wishes or, if unknown, best interests.

Anyone authorized by law or custom to decide for an incapacitated patient, whether a named agent, a default family member under state law, or a court appointee. The surrogate applies substituted judgment before best interests.

A decision standard in which the surrogate chooses what the patient would have wanted, based on prior statements, values, and life patterns. It is preferred over best interests when the patient's wishes are reasonably known.

A decision standard used when a patient's wishes are unknown, asking what a reasonable person would choose given the benefits and burdens. It is a fallback behind substituted judgment in most surrogate frameworks.

A clinical judgment that a patient can understand relevant information, appreciate the consequences, reason about options, and communicate a choice. Capacity is task-specific and assessed by clinicians, unlike legal competence decided by courts.

A patient's voluntary agreement to a treatment after receiving and understanding information about its nature, risks, benefits, and alternatives. It requires capacity, disclosure, comprehension, and freedom from coercion.

A physician order directing that CPR not be attempted if the patient's heart or breathing stops. It must be documented and communicated across settings, and it does not restrict other comfort-focused treatments.

A portable medical order form, also called MOLST in some states, that records treatment preferences for seriously ill patients, such as CPR, hospitalization, and antibiotics. It travels with the patient across care settings and requires a clinician's signature.

A structured evaluation of a patient's and family's emotional, social, financial, cultural, and spiritual needs and strengths. In hospice social work it underpins the care plan and identifies risks such as caregiver strain or unsafe housing.

The written, regularly updated document that sets out problems, goals, interventions, and who is responsible for each. Hospice rules require interdisciplinary review and revision as needs change, with the patient and family involved.

Organizing services and communication among providers, settings, and family so care is continuous and non-duplicative. Social workers often lead this by arranging equipment, transportation, referrals, and information flow.

A collaborative process of assessing needs, planning, facilitating, and advocating for services and resources to meet a person's goals efficiently. It emphasizes linking patients to benefits, providers, and community supports.

The physical, emotional, financial, and social strain experienced by someone caring for an ill person. Signs include exhaustion, isolation, resentment, and missed work; assessment and respite services are core social work responses.

Short-term temporary care that gives family caregivers relief from caregiving duties. In hospice it may be provided in the home or an inpatient facility, and it is a key intervention for preventing caregiver burnout.

A facilitated conversation among the patient, family, and care team to share information, clarify goals, and resolve disagreements. Social workers often organize and mediate these meetings to reduce conflict and align expectations.

Services offered to family and others after a death to help them cope with grief and adjust to loss. Hospice programs commonly provide follow-up contacts, counseling, and referrals for at least a year.

The natural emotional, cognitive, physical, and social response to loss. It varies widely in expression and timing across cultures and is not a disorder unless it is persistently disabling.

Grief experienced before an expected death, including mourning losses already occurring and imagining life without the person. It can coexist with caregiving strain and may ease or complicate later bereavement.

A prolonged, intense grief reaction that persists well beyond expected norms and impairs functioning. Features include persistent yearning, avoidance, bitterness, and difficulty re-engaging with life; it warrants targeted treatment.

Suffering arising from threats to a person's meaning, purpose, faith, or connection, often expressed as anger, despair, or questioning. It is distinct from depression and calls for respectful exploration and chaplain collaboration.

An ongoing self-reflective stance in which a clinician recognizes their own biases and remains open to the patient's cultural values and preferences. It supports culturally congruent care at end of life rather than assuming group norms.

A person's ability to obtain, understand, and use health information to make decisions. Low health literacy affects comprehension of prognosis and consent, so clinicians should use plain language and confirm understanding.

Working jointly with professionals from other disciplines, sharing information and coordinating roles toward shared goals. It requires clear communication, mutual respect, and defined responsibilities to avoid gaps and duplication.

A structured approach to disagreements among patients, families, and providers, using listening, reframing, and negotiation to reach workable agreements. In hospice it often concerns goals of care or family roles.

A situation in which two or more legitimate moral obligations conflict, so any choice sacrifices something of value. Common hospice examples involve autonomy versus beneficence, truth-telling, and allocation of limited resources.

The ethical and legal principle that capable people have the right to make their own choices about care, including refusing treatment. It grounds advance care planning and informed consent.

The ethical obligation to act for the patient's benefit and promote their welfare. In hospice it is balanced against autonomy and nonmaleficence when weighing burdens and benefits of interventions.

The ethical duty to avoid causing harm, including unnecessary or burdensome treatment. It supports careful weighing of side effects and stopping interventions that no longer serve the patient's goals.

Consistency and connectedness of care over time and across settings, so the patient's history and wishes are known to each new provider. It reduces errors and distress during transitions such as hospital to home.

Movement of a patient between settings or levels of care, such as hospital to hospice or home to inpatient unit. Poorly managed transitions raise risks of medication errors, conflicting instructions, and unmet needs.