Balancing formal and informal care for older persons: how case managers respond

Area of Science:

• Healthcare Management
• Gerontology
• Social Work

Background:

• Home and Community Care (H&CC) is a critical sector supporting individuals outside of hospital settings.
• Informal caregivers play a vital role in H&CC, yet their integration into care planning is not fully understood.
• Understanding case manager perspectives is key to optimizing H&CC service delivery.

Purpose of the Study:

• To explore how H&CC case managers perceive the role of informal caregivers.
• To identify factors influencing H&CC case managers' decisions on resource allocation.
• To examine the variability in H&CC service recommendations.

Main Methods:

• Secondary analysis of Balance of Care (BoC) simulations across nine Ontario regions.
• In-depth interviews with participating BoC case managers.

Main Results:

• Case managers unanimously recognize the patient and informal caregiver as the unit of care in H&CC.
• Significant variation was observed in the types and volume of H&CC services recommended.
• This variability may stem from the absence of standardized regulations, best practices, and accountability frameworks.

Conclusions:

• The H&CC sector requires standardized guidelines to ensure consistent and equitable care.
• Addressing the lack of regulations can mitigate decision-making variability among H&CC case managers.
• Integrating informal caregivers as a core component of the care unit is a recognized practice.