August 17, 2020

Medical Social Worker/Bereavement Coordinator Tries to Stay Healthy Herself to Help Clients through Their Final Days

 

Hospice and bereavement work is difficult at the best of times, but the COVID-19 pandemic has placed an unprecedented burden on professionals in the field. NASW Virginia turned to member Alexis Stribbling, LCSW, a bereavement coordinator and recently licensed medical social worker for AT Home Care, for an idea of how she and her colleagues are coping as they continue to serve clients in their final days.

 

“I'm doing way better than I was,” says Stribbling. “… Obviously, we have a huge influx of COVID patients, so there's complicated grief. There are people who didn't get to see their loved ones if they've been in a facility. It's been a whirlwind, … but I am in a lot more stable place than I was back in March, even June.”

 

Many of her patients already had complications such as cancer or Alzheimer’s disease, but family was usually there to assist. However, COVID-19 fears prompted many people to allow only a nurse—not even an aide, social worker, or chaplain—to serve the patient. Those final last weeks or days are when team support is what’s really needed in end of life situations, Stribbling explains, so there’s “been a huge spectrum of grief.”

 

Currently, she estimates that 70% of her interactions are by video phone and 30% in person, while pre-March she estimates that telehealth was only 10% of her work. “I hadn't really done a lot of video counseling before the pandemic, … so I had to transfer a lot in a very short period of time,” she acknowledges.

 

When the 28-year-old is permitted into the patient’s home as a bereavement counselor, she takes precautions. “I actually take off my shoes before I enter their home,” says Stribbling. “I wear a mask, and I try to set up beforehand if we can sit six feet apart. I always end my sessions with a hug, but I'm not doing that anymore, so it is really hard.

 

“It's great when people want to see me in person, and I think people are clinging to that, so I’m trying to keep myself as healthy as possible, because I definitely have a lot of spouses right now who are isolated, who are not seeing family and friends, and who don't have their regular coping mechanisms,” Stribbling explains. “I'm the only one they're allowing in their house for bereavement, so I see a lot of dependency in that and a lot of responsibility on my part to hold up, keep myself healthy, take precautions, and wear my mask outside.”

 

She’s been adapting to these new approaches, though, to staying connected with patients. The six-week grief support groups she ran pre-pandemic were in person, but now she’s figuring out a HIPAA process that will let her run one virtually for four to eight people, knowing that it may not have the same effect as a physical presence.  

 

She may even open the group to more clients: “You get to a point where the [participants] are really leading the group, sharing their story, and connecting. I don't do a lot of talking.”

 

The pandemic also moved her away from office coworkers, whom she has missed dearly. Her agency, where she has worked for four years, has seven social workers who make up part of an emotionally closely team and are used to “hugging each other in the hallway.” They also had just hired two social work interns from Virginia Commonwealth University before COVID-19 hit the state.

 

Team meetings that include nurses’ aides, a chaplain, and the medical director have been virtual (at the time of this interview), so maintaining that connection has been “super, super challenging,” says Stribbling, because “after talking on the phone all day, I just want to see my team in person.”

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