When a family’s loved one is near the end of life, it can force everyone to endure financial and emotional strain – creating the perfect environment for new conflicts to arise and old ones to resurface.

Ramona Hancock, a Hospice of Michigan social worker, said the stress of losing a loved one, coupled with family disagreements, caregiver demands, financial struggles, cultural beliefs or the fear of death, can ignite a fuse.

As a social worker, one of Hancock’s many roles is often to help patients and their families resolve conflicts.

“In hospice, a social worker is the go-to person for anything not related to symptom management,” Hancock said. “That often means performing the role of a counselor to patients and their caregivers – although given the time frame, solving conflict at end-of-life is a lot more like crisis management than long-term counseling. Our goal is to help both the patient and the caregiver find peace and allow the patient to die comfortably.”

Hancock said conflict during a patient’s final days can make the dying process more challenging. And unresolved issues typically lead to a more difficult grieving process for family members. These are just some of the reasons it’s important to solve family conflict before death.

“One of the most common conflicts I see is when the family and patient are in a different place,” Hancock said. “The patient has decided to forgo medical treatment and has accepted life is nearing the end – but the family isn’t ready.

“Another common conflict that arises is when the patient’s primary caregiver feels burned out or taken advantage of. The caregiver may direct anger at other family members who haven’t ‘stepped up. Sometimes the frustration is directed at the patient – and in these cases, anger is typically accompanied by guilt.”

Hancock said regardless of what’s causing the conflict, the first step in solving it is typically to listen to the patient and the family.

“While every situation is different, when I recognize conflict affecting a family, the first thing I usually do is talk to the patient and the family,” she said. “I offer support, but let them determine what that support is. Often, people just want to talk.

“I try to remind the patient and family members to recognize and consider what the other person is feeling. That simple step often goes a long way in bringing the family together.

“When recognition and consideration of feelings aren’t enough, we can arrange a family meeting – which might even involve the nurse and social worker.

“At the end of the day, we try to remind the patient and family members the end-of-life transition is a meaningful time. It’s important for the family to be on the same page so the focus can be placed on spending quality time together in the time that’s left.”

Hancock said that while HOM does everything in its power to bring a patient peace as the final days draw near, unfortunately, some conflicts are deeply rooted and too complicated to resolve.

“We walk into a small window of our patients lives. It’s important to recognize that there may have been a long history before we stepped in and events will continue to unfold after we’re gone,” Hancock said. “While we do all we can to help the patient and family find peace, we must recognize that there are some things we just can’t fix. In these situations we focus on listening to our patients and helping them find acceptance.”

March is National Social Workers Month, and the theme this year is “Forging Solutions out of Challenges.” Hospice of Michigan would like to thank and acknowledge the important role that social workers play in hospice and palliative care. For more information on Hospice of Michigan and its services contact 888-247-5701 or visit www.hom.org. For more information on Social Workers’ Month and the value social workers provide in health care, visit www.socialworkers.org.