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Home Support Coping Social Work

Social Work

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Being diagnosed with cancer is a devastating and life changing event. People are oftentimes, immobilized by fear and uncertainty when this occurs. Naturally one may need some time to process the news but circumstances may not allow for this as certain diagnoses require immediate medical interventions be it surgery, chemotherapy, radiation or a combination of the three. Simultaneously while receiving the news of the diagnosis, the attending physician may be presenting treatment options and arranging for a start date in the immediate future. Therefore, this individual is literally going from their mundane daily routines to being thrusts into a healthcare setting over night.

Furthermore, in the mist of this whirlwind many thoughts and questions flood the mind of individuals who have been told they have cancer. Some thoughts that one might have may include; what’s the next step, am I going to die, do I have to quit my job to undergo treatment, how am I going to support my family if I can not work, how will I afford the treatment, who’s going to help me at home once I am discharged from the hospital, and so on and so forth.

This is a time in one’s life when support is imperative because of the journey that lies ahead. Some individuals are fortunate to be surrounded by supportive family and friends but others are not as fortunate. We at the University of Illinois Medical Center at Chicago recognize that people facing such an obstacle need support, guidance and assistance during this time. Our wonderful health care team comprised of physicians, nurse practitioners, a dietician, a social worker, nurse discharge planner, psychologist, and therapist (physical and occupational) are in place to accommodate the patient and help him or her adjust to the new diagnosis. As various needs arise in the patient the appropriate team member will loan their support and expertise. For example, if a patient is finding that they have a decreased appetite due to the affects of the disease and treatment the dietician will work with the physician and the patient to find a suitable remedy.

Likewise, the social worker on the health care team is in place to address any psychosocial needs of this patient population. Psychosocial needs are things such as a need for counseling, assistance in the home, assistance with completing FMLA/Disability paperwork, applying for medicaid, medicare, or social security benefits, transportation to follow clinic appointments, assistance locating financial grants to supplement family income, need to locate medication assistance programs and etc. To help identify potential needs the social worker completes a psychosocial assessment on newly diagnosed patients or patients transferring from outside hospitals. This consists of sitting with the patient and going through a series of questions to identify needs.

Some of the agencies that are often called on to assist this patient population include; American Cancer Society, Cancer Care, Leukemia & Lymphoma Society, Leukemia Research Foundation, Department of Aging, Department of Human Services, various hospice companies such as Vitas Hospice, Seasons Hospice, Odyssey Hospice, and a host of other companies. Each of these agencies provide a wonderful service to the individual diagnosed with cancer who is in need. Some provide small financial grants while others may assist with health care insurance premiums.

Regardless of the countless agencies that exist to help one during this time, an individual still may have questions, questions and more questions which need to be addressed immediately because of the impact the unanswered questions may have on the person’s daily lives. The following is a small sample of frequently asked questions (FAQs) by this patient population. Please note the answers which follow immediately after the questions.

FAQs

For patients who were employed or unemployed without health insurance at the time of diagnosis, the following questions are often asked.

1.

Question

How will I be able to afford the cost of treatment and the follow up care required shortly thereafter?

Answer

The University of Illinois Medical Center at Chicago has a department which is under the umbrella of the Health Social Work Department called Financial Case Management Unit (FCMU) which is dedicated to assessing patient’s eligibility for both Medicaid and social security benefits. Applications will be taking on those patients who are eligible for either benefit.

2.

Question

I started the application for social security disability benefits prior to being admitted to the hospital. How will I attend my scheduled interview while currently hospitalized?

Answer

The University of Illinois Medical Center at Chicago has an interactive Video System in room 1102-CA (1st Flr – Pre-Admission Lobby) in the Admitting Department which allows patients to apply for social security benefits and or follow-up on an application previously submitted. The video system is currently available on T & Th 10a – 2:30p.

3.

Question

How long does it take for social security to arrive at a decision concerning my eligibility for benefits?

Answer

Typically it takes social security about 3months to arrive at a decision. However, about 2 years ago the Social Security Administration (ssa) instituted a policy in which certain cancer diagnoses receive automatic approvals. This is referred to as the Quick Disability Decision (QDD). If one falls under this category they can expect to hear from ssa in a matter of days or weeks—no more than 3 weeks. Speak with your social worker to learn if your diagnosis would qualify you to receive an expedited decision.

Once a person is approved for social security benefits and deemed disabled they automatically qualify for Medicaid if they have applied. There are a few steps that need to be taken to obtain the approval but a financial case manager or social worker can assist the patient with these steps.

4.

Question

I need help at home. Is it possible to obtain a homemaker or personal attendant to assist me with activities of daily living (ADLs) such as bathing, cooking, cleaning, meals, and etc.?

Answer

The social worker can refer the patient to either the Department. of Aging (if 60 years or older) or the Department of Human Services-DORS (if 59 years or younger) for an evaluation for assistance in the home environment.

5.

Question

I have been approved for Medicaid with a spend-down. What is this and how do I meet the spend-down amount monthly?

Spend-down is the part of your medical expenses that the state cannot pay. Spend-down works like an insurance deductible. You can get a medical card for a month if you meet your spend-down amount for that month.

There are three ways to meet your spend-down.

  1. Use Medical Expenses- If you have current unpaid medical bills or receipts for medical bills you paid in the past six months you can use these expenses to meet spend-down.
  2. Pay-In Spend--down-You can choose to pay-in your spend-down if you do not have medical bills or receipts that meet your spend-down.
  3. Combine Medical expenses and Pay-in- A combination of letters a & b.

FAQs

For patients who were employed with health care insurance at the time of diagnosis the following questions are asked.

1.

Question

Can anyone assist me with completing FMLA/Disability paperwork for my employer as I need to be off work for an extended period of time to undergo treatment?

Answer

Yes. The social worker can facilitate this process. Paperwork will be completed by the patient’s physician and the social worker will forward it to the patient’s human resource department. If the patient prefers that a family member take the paperwork to the employer’s office the social worker will contact the family member once the paperwork is completed.

2.

Question

Can you arrange transportation for my follow-up clinic visits because my insurance doesn’t cover the cost of transportation?

Answer

The social worker can explore several options such as potential transportation services through the American Cancer Society or PACE paratransit service. The American Cancer Society has a volunteer program in which volunteers transport patients to clinic appointments. It also has a cab voucher program as well. The social worker will determine which program is better suited for the patient seeking assistance.

3.

Question

I’m having a difficult time paying for my monthly expenses such as my health insurance premiums. Are you aware of any social service agencies that could assist me?

Answer

The social worker can contact agencies on the patient’s behalf to explore the possibility of the patient receiving assistance. Certain cancer organizations have financial assistance grants which will provide assistance in this area.

4.

Question

My attending physician advised that I speak with the social worker about hospice care but I’m concerned that my health insurance policy does not cover this level of care.

Answer

Most health insurance plans cover hospice i.e. Medicare, Medicaid, private insurance and managed care plans. Medicare and Medicaid covers hospice at 100%. There is no out of pocket cost for the patient. If a patient is in doubt about services covered by their private insurance or managed care plan they can contact the customer service benefits line to review available benefits. The telephone number is normally listed on the back of the patient’s insurance card.

5.

Question

Both categories of patients may ask, “What is hospice care?”

Answer

Hospice care is a philosophy of care that provides medical services as well as emotional and spiritual support to a person in the last stages of a terminal illness. This level of care is normally recommended by the attending physician when medical interventions have been exhausted. Hospice care can take place in a patient’s residence, nursing home, or an inpatient hospice unit. If a patient is interested in meeting with a hospice representative the social worker can schedule a meeting.

Regardless of the amount of questions that one might have when coping with a cancer diagnosis, social work staff is available to assist and provide support. Social Workers can be called upon in the inpatient as well as the outpatient setting. When social work assistance is needed a patient can request this by contacting the UICH Health Social Work Department directly at (312) 996-0293 or notifying their physician and/or nurse.

We—the social workers in the oncology/hematology setting—understand the impact that this disease has on the patient and his or her family. As such we are committed to providing the needed support to help patients cope with their condition. We encourage patients and or their family members to contact us whenever a need should arise and we will handle your need/concern with special care

Tricia Stiger MSW, LSW