The Role of the Clinical Social Worker in the MDA Clinic

Presented by: Kristy Walgren, MSW, LCSW and Destiny Pistone, MSW Intern

The Clinical Social Worker provides two main services to patients of the MDA Clinic.

Individual, couples, family and group Counseling:

Resource and Referral:

Why would I need individual, couples, family or group counseling?

There are a number of reasons counseling can be a

good idea for either the patient or the caregiver at

times during a complicated or extended illness such as

a Muscular Dystrophy.

When diagnosis is given, there is a period of adjustment when both parties experience grief/loss.

Caregiver burnout – that feeling that you just can’t do this any longer. You begin to wonder how long until your loved is going to pass. Then, you feel guilty that you even would have those thoughts.

Reasons to seek counseling…

If the person with the diagnosis is a child, the family dynamics are often totally disrupted because parents are suddenly left not knowing how to parent a child who is not going to live very long. Soon, the family structure is in total chaos. Some people experience a great amount of

anxiety over needing to file for disability. A couple of counseling sessions to get guidance through the applications and information on what to do next goes a long way toward easing that anxiety.

Reasons to seek counseling…

Because most Muscular Dystrophies are progressive in nature, both the patient and the caregiver(s) experience loss, and therefore grief, with each new loss of function. This can be a time when counseling can be helpful. If the main caregiver is the spouse, this role can

cause a huge stressor on the spousal relationship, causing a marital relationship that was good to feel stressed. If the marital relationship was strained before the diagnosis, this caregiver role can push the marriage over the edge. Couples counseling early may help.

Reasons to seek Counseling…

As you can see, there are a number of reasons people use counseling to help improve their lives. Some issues were present before the diagnosis of a serious illness, but are exacerbated by the onset. Some are brought on by the diagnosis. Some issues may take only two or three sessions to resolve, others take longer. Either way, many people find counseling to be very useful. And, it is often covered by your insurance.

Resource and Referral

What kind of resources do you have access to?

Resource and Referral

Income and Insurance resources and referrals. I can give you information to get you started in applying for

employer sponsored disability (ie: short-term and long-term disability) and Social Security Disability Insurance.

I can provide you with information about COBRA, Medicare, Medicaid and other health insurance options and how having one impacts the others.

I have created handouts to help you navigate these issues, but if you are anxious about going through this process you may schedule a counseling appointment with may. This will be billed through your insurance as a counseling visit.

Resource and Referral

Help with basic needs.Having a chronic illness can put a financial strain on a family, causing them to have to make a decision between medical needs and other basic needs. Where do you go when you need help with food, clothing, utilities, shelter, etc.?

I use the internet a lot to find resources. Google can be your best friend!

United Way’s 211 Helpline can help you locate resources for all of these things in your local area.

The “All About Seniors” book. It’s not just for seniors. Your local Department of Social Services. Again, you can use

Google to find the phone number, or it is usually in the front of the phone book.

Resource and ReferralMedical Necessities.When a loved one has a serious and chronic medical condition, theExpenses mount quickly. This can include everything from durablemedical equipment to in-home nursing care. How do I find helpwith those expenses? First, utilize your medical insurance to the fullest. Get the help

of your treatment team if you need a Letter of Medical Necessity, etc.

Second, seek the help of family and friends. In-home nursing care is rarely covered by private insurance or Medicare. So, home care usually has to be coordinated and managed by the family.

Third, be creative. Seek out organizations that help people with medical necessities. This is another area where the internet can be helpful.

Estate Planning

As the Clinical Social Worker, I can assist you with making sure your medical documents are in order so you are prepared in the event you are unable to make your own healthcare decisions, or unable to communicate your decisions.

These documents are collectively referred to as Advanced Directives. Individually, they are called the Healthcare Power of Attorney and Living Will.

You do not need an attorney to complete these documents. In NC, they need to be notarized and witnessed by two people who meet certain criteria. In SC, they only need to be witnessed by two people (although I strongly advise people to have their documents notarized).

Estate Planning

The Healthcare Power of Attorney.

This is the document which you prepare that assigns the power to at least one, and up to three, other person(s) to make healthcare decisions on your behalf, and as if they were you, in the event that you are unable to make your own healthcare decisions or unable to communicate your healthcare choices.

Estate Planning

Living Will.

This is the document which you prepare that give guidance to your healthcare power of attorney and your physicians regarding what healthcare procedures you do and do not want performed on you in the event you are unable to make or communicate your own healthcare decisions.

Estate Planning

Important things to consider regarding Advanced

Directives. Everyone over the age of 18 years should complete these

forms to ensure their healthcare wishes are followed.

Once completed, these documents should be given to each person listed as your healthcare agent and each of your treating physicians.

Talk to all your family members about your healthcare wishes, whether they are listed as an agent or not. This will increase the likelihood of your wishes being known and followed.