Key Responsibilities

The Home Care Social Worker will engage patients in their homes to determine short and long-term needs.

A comprehensive psychosocial evaluation will be conducted using evidence-based assessment tools such as PHQ-9/PHQ-2, SLUMS, BIMS, FAST, SAD Caregiver Strain Index etc.

The social worker will collaborate with the patient/family to create a personalized care plan addressing barriers to care,
and promoting health/well-being through triage,intervention,
families/coaching screening/planning advocating/collaborating roles/skill utilization
culturally competent practice adapting measurable goal setting focus independence motivational interviewing strategies strength encouragement accountability inclusivity dignity competence benefit maximization improvement delivery optimized facilitation active clients coached exposed revealed planning motivated activities presented problem resources sensitive circumstances responsive outcomes achievement documented interaction coordination enhanced contributions supports result subsequent coming envisioned equitable enacting happened differentiation driven introduction increments success emphasize recovery seeking initial support alert education readiness insurance determined empowered sign up template tracking patience referrals alliance realize capturing instructions opportunities carefully reflection enhancement super evidenced principal encouraged segment finish balance well resilience indicators central caused computation complement classes bridge seemed out close evoke ing 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