Social Services

Hughes

Where do social services fit in?


Campbell

Well, certainly for somebody who has just taken an antibody test and found out that they're positive, I emphasize the importance of being in a group in which they can talk to other people who are seropositive, through some seropositive groups in the city, or through AIDS Health Project, and make sure that they're becoming adapted psychologically. Social service comes in at a time of retirement. That's another step. Another step is when activities of daily living become difficult, and somebody has to come into the house to help out.


Hughes

You consider part of your responsibility to link patients with these services?


Campbell

Yes. And very frequently, the hospital social worker will be helpful for people who need help at home. People need benefits counseling when they are trying to decide whether to retire or not. I think several steps are identifiable as social crises: the antibody test, coming out to an employer or whatever, or retiring, the diminished activities of daily living, and finally the dying process.


Hughes

I read that case management in San Francisco was not formalized nor centralized until 1986. Is that your experience?


Campbell

You mean how long people should stay in the hospitals?


Hughes

Yes, but also coordination of hospital discharge and community social services.


Campbell

I don't know if it occurred at any specific time, but it just seems like over the years, there has slowly been a movement away from the hospitals, with more and more things done by home infusion services and visiting nurses.