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Exploring influences on community-based case managers' advance care planning practices: facilitators or barriers?
1School of Social Work, College of Education, University of South Florida-Sarasota/Manatee, Sarasota, FL 34243, USA.
Home Health Care Services Quarterly
|June 1, 2007
Summary
Geriatric case managers face barriers to advance care planning for frail elders. Factors like family involvement, professional proficiency, client receptivity, and provider communication significantly influence their practices.
Area of Science:
- Gerontology
- Healthcare Management
- Social Work
Background:
- Community-based geriatric case managers support a growing population of frail older adults.
- Advance care planning (ACP) is crucial for end-of-life care but factors influencing case managers' practices are not well understood.
Purpose of the Study:
- To explore community-based geriatric case managers' perceptions of facilitators and barriers to advance care planning (ACP).
Main Methods:
- Qualitative study utilizing four focus groups with 27 case managers.
- Thematic analysis was employed to identify key influences on ACP practices.
Main Results:
- Five key themes emerged: (1) paradox of case management and programmatic realities, (2) family presence and involvement, (3) case manager proficiency in ACP, (4) client receptivity to planning, and (5) limited communication with providers.
- These factors significantly influence whether ACP practices are assisted or impeded.
Conclusions:
- Case managers' ACP practices vary due to differing perceptions of clients, families, professional expertise, program constraints, and inter-provider communication.
- Further research is needed to clarify factors influencing divergent ACP practices and enhance professional performance.
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