The role of social work in contemporary home care planning1

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Patients on home care are increasingly being required to assume responsibility for sophisticated medical technology. Social changes, such as deinstitutionalization, and financial trends, such as prospective reimbursement, serve to fuel the momentum of home care. Trends affecting the American family, such as increased mobility and changing women's roles, contribute to stress in the face of increasing responsibilities for home care. It is the role of the medical social worker to find creative solutions in coordinating transfer of the patient from a hospital-based team to a multiplicity of nursing agencies, vendors, and social service agencies providing care in the home. Counseling the patient and family in making temporary or permanent adjustments is essential in the preparation for home care. There is an acute need for further research on the psychosocial consequences of sophisticated medical care in the home.