Publication Date


Document Type

Masters Thesis

Study Type

Mixed methods


School for Social Work


United States. Patient Protection and Affordable Care Act, Social work with the terminally ill, Hospice care, Palliative care, Hospice, Social work, End-of-life care, Health care


This study was undertaken to explore how hospice social workers based at United States hospice agencies perceive changes in their work responsibilities in relation to the Patient Protection and Affordable Care Act (PPACA). Secondly, this study sought to explore hospice social worker support of the Patient Protection and Affordable Care Act healthcare policy reform.

A nonprobability sample of availability was used to find research participants. The researcher recruited participants through online social and professional networking groups and forums and by snowball sampling methods. Self-selected participants electronically confirmed their eligibility for participation in the study, prior to completing the 20-question online survey. Fourteen hospice social workers, representing 11 separate states, participated.

The findings of the research showed study participants did not identify any substantial changes in their work-related duties after the PPACA took effect. Within the five categories examined—clinical and counseling, case management, management and administration, advocacy, and spiritual and cultural competence—which vary widely in the amount of perceived change, participants reported experiencing the most increase and overall change in case management duties. The study also found that, overall, hospice social workers who responded to the survey supported the PPACA. Many hospice social workers commented on the ethical dilemma of delivering inadequate services within a health care model that does not meet the needs of all end-of-life care recipients and those in need of end-of-life care.




v, 141 pages. M.S.W., Smith College School for Social Work, Northampton, Ma., 2016. Includes bibliographical references (pages 100-118)

Included in

Social Work Commons