Case management in long-term care: it can be ethical and efficacious

Area of Science:

• Healthcare Management
• Ethics in Medicine
• Social Work

Background:

• Case management in long-term care integrates advocacy and gatekeeping, creating inherent ethical tensions.
• These dual roles can lead to difficult ethical situations for case managers.
• Existing models struggle to effectively separate these functions.

Purpose of the Study:

• To explore the ethical challenges in contemporary case management.
• To identify conditions necessary for balancing advocacy and gatekeeping functions.
• To evaluate the success of different case management models in mitigating ethical conflicts.

Main Methods:

• Conceptual analysis of case management roles.
• Review of ethical frameworks in healthcare and social services.
• Examination of long-term care program structures and funding mechanisms.

Main Results:

• Ethical tension arises from the dual advocacy and gatekeeping roles in case management.
• Sufficient and committed funding is essential for ethical case management.
• Fair distribution of services among recipients is a key component of ethical practice.
• Current models show varied success in separating advocacy and gatekeeping.

Conclusions:

• Balancing advocacy and gatekeeping in case management requires adequate financial resources and equitable service allocation.
• Long-term care programs must ensure dedicated funding to avoid ethical compromises.
• Further development of case management models is needed to successfully address these ethical dualities.