Ethical Issues and Approaches in Care Management for Older Adults: Interviews With Japanese Care Managers

The study aims to clarify the characteristics of and approaches to the ethical issues faced by care managers and to obtain suggestions for ethical care management through interviews with 16 care managers responsible for care management for older adults in Japan.

The subjects of this study were care managers responsible for care management of older adults in Japan, with at least 3 years of experience working at home care support offices or long-term care welfare facilities.

The research method was a qualitative study with a descriptive approach using semi-structured interviews, and a content analysis was conducted.

Four categories of ethical issues were extracted: those related to the care plan, those occurring when collaborating with other professionals, those occurring within the organization, and those occurring within the system. There were three categories of approaches to ethical issues: continue to be involved to the satisfaction of the client, continue to share and negotiate issues with other professionals, and collaborate for the best interests of older adults.

The core role of care managers is not being sufficiently fulfilled, such as care plans that prioritize the intention of the family or the interests of the care manager's own organization over respect for the autonomy and advocacy of older adults and a discrepancy between care management and social work. The two key implications for case management are that the very foundation for realizing person-centered case management lies in considering ethics, and that ethical issues must be addressed as organizational challenges.