Karen Loftus (Host): This is Community Connect: presented by Tampa General Hospital. I'm Karen Loftus. Joining me is Allegra Kartha, a licensed clinical social worker at Tampa General Hospital. Welcome to the podcast, Allegra.

Allegra Kartha: Thank you so much for having me.

Host: All right. We're here to talk about whole-person cancer care and what that looks like from the lens of a social worker. Allegra, as we get into this conversation, can you start by explaining what the role of a social worker is in a medical setting?

Allegra Kartha: Yeah. There are lots of different roles that social workers have, both inpatient and outpatient. We are licensed professionals. We do not only four years of a bachelor's degree, but also two years of a master program, which includes clinical rotations. And then, afterward, we have to do two years of experience to gain independent licensure.

So, we are clinically trained in lots of different therapeutic interventions, all different types of things just to be able to support patients and families. Within the medical setting, we're really advocates for our patients and families, helping them in navigating the healthcare system, which can be really convoluted.

In the inpatient side, helping a lot with people adjusting to their illness, their diagnosis, and helping them get connected with services on the outside once they are discharged from the hospital, and working with the care team to advocate for patients and families on their own goals of care, right? And identifying those with patients and families. On the outpatient side, it's not that much different, but we're also helping in coordinating care and services for people, especially at the Cancer Institute as far as their treatment and making sure that they have all they need to be able to come to treatment and all the support that they need while they're getting that as well.

Host: That's amazing. Such a critical piece in the care spectrum. So from your perspective as a social worker, how have you observed the ways a cancer diagnosis can impact someone's life?

Allegra Kartha: It really impacts everything in a person's life. I even talk with that with patients and families so much. It's something that really can just take patients and families for a whirlwind, right? It's something that's not always expected, and that comes with a lot of different challenges.

And it really just depends on the person too, right? Because everyone comes from a different background. And at Tampa General, we see patients and families from all over, not even just all over the Bay Area, but from all different walks of life, different experiences. So, all of those things factor into how it affects people.

Overall, I would say though it affects a lot of different things. People can't necessarily work, and that impacts people's financial security and sometimes their housing security, their food security, being able to access all of those things. And since we see patients from all over as well, sometimes people have to come really far for treatment, and sometimes people have to come multiple times a week. So, that just affects how they get to and from, and sometimes that's an insecurity or an issue that people already face. And also, just people's mental health too, right? It is not something that anyone ever expects, and it is really heavy to think about. And no matter where you are in your cancer journey, it's a lot to kind of think about and how it affects your health in the short and the long term.

And then, it also affects the families as well, depending on the family system that people come from. It's a lot to navigate. Maybe that person was the primary income provider for the household, and then them not being able to work affects the whole rest of the family, right? Or maybe that patient was the primary caregiver for their spouse, and now they can't take care of their spouse who maybe also has medical complications.

So, there are lots of different factors on how cancer affects someone's whole life, and that's kind of the advantage of having social workers in the inpatient and outpatient setting to help kind of bring all of those things together because all of those things affect someone's access to care.

Host: Yeah. There's so many facets, as you just outlined, that people may have no idea about it until they're walking in those shoes, right? What have you seen as maybe a facet of whole-person care in cancer patients specifically that falls through the cracks most often?

Allegra Kartha: It's hard to think of one thing specifically, because like I said, there are so many different things. I think just all those different social aspects too can come into play. We see patients and families from all over and from all different types of backgrounds. So, how that influences how they not only see the medical system, but how they access it. And I think a lot of the times, there may not be a lot of understanding around that or a lot of knowledge around that as well.

As far as people's family systems, religious backgrounds, race, ethnicity, gender, all those different things that all come into play. But then again, they impact all those different aspects. I would say overall most poignantly in the goals of care as well, you know, and understanding how people understand their diagnosis and how they are going to access treatment.

And there's a lot of different aspects that come into that as well. But I think that probably sometimes can not just maybe fall through the cracks. But there can be, I think, more understanding when it comes to that, and I think that's the unique role that we as social workers are able to provide because we do assessments with patients and are able to understand them as a whole person, right? Not just necessarily the medical aspect of it too. So sometimes that can fall through the cracks, but, it's really hard to say just overall because every person is unique.

Host: You've done a wonderful job explaining just the bigger picture of everything. Can you go into a little bit more of some of the ways that you specifically support patients in navigating cancer diagnosis and moving forward into treatments and beyond?

Allegra Kartha: Yeah. So, one way we really help is, like I said, we do assessments with people. We meet with people. I just like getting to know somebody, who they are, who else lives in their household, what they did for work, what their beliefs are, all different cultural aspects as well.

Those are all important aspects of the person. So, we really just meet with people and kind of get to know more about who they are and maybe where there may be some barriers to care. So, we meet with patients either in person or talk to them over the phone as well and learn more about them, and then are able to kind of identify areas where they may be able to be more support in helping them in accessing care, and that might be financial assistance. Like I said, a lot of people aren't able to work, and that can really impact just their whole life. So, helping them in navigating, different resources, as well as transportation is a big one as well if, like I mentioned, in them accessing care.

But most importantly, we are mental health professionals as well, so we're using various different interventions to be able to support patients in just adjusting to everything overall, coming into this type of diagnosis, people are meeting with so many different parts of the healthcare team, and it can get so overwhelming, and they're getting lots of information thrown at them. So, we're really able to meet with people and support them in understanding where they're at and understanding all that information and bridging the gap so that the team can work together to best support that patient.

And also, just supporting them, connecting them maybe with our other mental health resources like support groups. TGH has such great support groups for, our patients and families. and maybe if they want to see a therapist, connecting them in that, and just providing brief supportive counseling too, either while they're at their appointments at the infusion center or just over the phone and just adjusting to the whole whirlwind that got thrown at them when they were diagnosed with cancer.

So, that's maybe just a snippet of what we do, but it doesn't give a whole aspect of it, but that's just in a nutshell, I think, how we are able to support patients and families.

Host: Yeah. I'm sure we don't have enough time to actually get into all of the ways that you support patients. But that paints a very nice picture of the work you do. Now, looking beyond the patient, at times, we're talking about a whole support system involved. What does support look like for caregivers and families navigating that cancer diagnosis alongside the patient and the treatment as well?

Allegra Kartha: Yeah, that's a big one, and maybe that's something too that falls through the cracks sometimes too. We forget that this affects the caregivers as well. and that may be family. That may be someone's, neighbors maybe a church community. Their caregivers look different in all different sorts of aspects.

But it can weigh on them heavily too, especially if they're supporting in taking care of that patient full-time and/or working full-time, right, to be able to support the patient. Well, I think it's also just checking in with them and not only honoring that they are doing this work, and also that they know the patient pretty well too, and getting their insight on what would be helpful for the patient and what would be helpful for them in that moment.

I think there are also lots of different resources. Like I said, we do have the support group here at TGH. But especially as a social worker, we're here to help listen and help provide that support to them as well because it can be very overwhelming and maybe they need some supportive resources themselves.

Maybe they need to help find caregiver relief support so that they can be able to do the things that they need to do. Getting set up with different resources like home healthcare or maybe even just figuring out how to navigate the health system themselves, because that can be overwhelming for anybody. But any support that we're providing, we're not just looking at the patient, we're looking at their caregivers as well and helping provide that support as well.

Host: Once a patient gets a diagnosis of cancer and they're going in that journey, how do they access the resource of a social worker? Is that something that they need to ask for, or is that part of the care plan that's presented to them?

Allegra Kartha: I think it could be either/or. We are consulted by the treatment team if they are identifying, "Hey, this may be an issue or something that the social worker can help out with." And then, they'll tell the patient, "Hey, we'll have the social worker reach out to you." Or sometimes we'll get messages from the team while the patient is there saying, "Hey, can you get a chance to meet with this patient if you have a chance?" They may have some things that you may be able to help them out with." Or sometimes patients just reach out directly too.

So, we're really just accessible at any time. You can ask the treatment team to place a referral directly or call in any way we're accessible however patients want to get connected to us.

Host: Wonderful. Now, if you could leave our listeners with one main takeaway for cancer patients to remember in taking care of themselves, what would it be?

Allegra Kartha: I think I would say, as much as you can, take everything one thing at a time, because it gets so overwhelming. Like I said, we're a really big health system, and it's really amazing all the work that we do to support patients and families, and we have lots of different types of providers on the care team, right? Registered dieticians, nurses, medical assistants, chaplains, right? There's so many people involved, and it can just feel so overwhelming from when you even hear the words, "You have cancer," to "You have to figure out how you're going to treat that cancer." So, I would just say take everything as you can, as much as you can, one thing at a time, and reach out to the people who are your supports and ask for help when you need it. But the biggest thing I would say is just take everything one thing at a time.

Host: Thank you so much, Allegra, for being on our podcast and sharing this knowledge that you have with our listeners.

Allegra Kartha: Thank you so much for having me.

Karen Loftus (Host): That has been Allegra Kartha. For more information, please visit www.tgh.org/cancer. If you enjoyed this episode, please be sure to like, subscribe, and follow Community Connect: presented by TGH, on your favorite podcast platform. I'm Karen Loftus, and this is Community Connect: presented by TGH. Thanks for listening.