The strengths model in long-term care: linking cost containment and consumer empowerment

This article outlines how the strengths model of case management can be applied to long-term-care case management. The strengths model was first articulated in the early 1980s as an alternative to brokered case management in mental health. The strengths approach to social service practice focuses on helping people and communities discover and develop their own capacities, talents, skills, and interests, and on connecting them with the resources needed to achieve their goals. This article explicates the components of the strengths model as adapted to long-term care. The authors explore the link between the application of strengths-based strategies at critical intervention points and cost containment, giving examples of how case managers serving older adults through Medicaid waivers have implemented the strengths approach and delayed nursing facility admissions. Finally, the authors describe ways that cost-containment methods can be interfaced with a consumer-driven empowerment orientation. Initial responses gathered from consumers and long-term-care case managers trained in the strengths model support its applicability to older adults. Clear articulation of how the strengths model of case management can be adapted for use with adults in need of long-term care is basic to further implementation and evaluation.