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A study of case managers' decision-making processes.

W P Crook1, L Vinton

  • 1Florida State University School of Social Work, Tallahassee, Florida 32306-2570, USA.

Care Management Journals : Journal of Case Management ; the Journal of Long Term Home Health Care
|October 30, 2001
PubMed
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Case managers prioritize client information during assessment but not always in decision-making. Safety often guides choices over client freedom, impacting elder care strategies.

Area of Science:

  • Gerontology
  • Social Work
  • Healthcare Management

Background:

  • Community-based aging network agencies provide crucial support for elders.
  • Effective elder care decision-making balances client autonomy with safety and lifestyle considerations.
  • Understanding case manager practices is vital for improving elder support services.

Purpose of the Study:

  • To investigate decision-making processes employed by case managers in elder care.
  • To determine the extent to which a consumer-driven model is utilized in elder assessment and decision-making.
  • To identify guiding principles influencing case manager decisions.

Main Methods:

  • A survey was conducted with 122 case managers from community-based aging network agencies.
  • Data were collected on the frequency of using client input during assessment and decision-making.

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  • Case managers reported on the guiding principles (e.g., safety, freedom) influencing their decisions.

    • Main Results:

    • Approximately 80% of case managers consistently used client information during assessment.
    • Less than half consistently incorporated client recommendations into decision-making.
    • Safety was a more frequent guiding principle than least restrictive alternative, lifestyle disruption, or freedom.

    Conclusions:

    • Case managers adopt a consumer-oriented approach during client assessment but less so during decision-making.
    • The prevailing principle in decision-making prioritized safety over client autonomy or freedom.
    • Further research may explore strategies to better integrate client preferences into final care decisions.