Geriatric case management is a term that surfaces much in the modern times. With a larger percentage of the population expected to be composed of old people in the next thirty years, their care is imperative. This fact has led to the advancement of geriatric care and all the elements that make it successful. The definition of geriatric case management may be difficult because there is no single comprehensive description. This research paper is aimed at discussing the components of geriatric case management and application to long-term care.
Literature Background
In general, case management may be described as a collaborative process of assessment, planning, implementation, and evaluation of the procedures and services aimed at meeting the health and human service needs of a client. The main objective of this concept is to transform lives of the clients through individualized care and services. Many concerns arise about the quality of life of the elderly as they are frail and become dependent as time passes ( Powell & Tahan, 2018) . Geriatric case management helps the older adults regain their autonomy by offering safe dwelling arrangements in their homes to enhance comfort and privacy. This comes in a time when nursing homes and other institutional settings are not conducive for their living.
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Thus, the concept revolves around comprehensive and individualized needs assessment of the each client and developing a unique solution to the problem that is tailored to meet their requirements. The program entails working with the older adults and their families in referring, rendering, and managing various forms of health and social care services. The professionals who are involved in offering geriatric case management are primarily nurses and social workers. In addition, there may be involvement of some mental health counselors or any other professional who is into the delivery of services to the elderly and their kin.
Components of Geriatric Case Management
Geriatric case management takes place in steps that involves going through four key components. A successful process involves intake, needs assessment, service planning, and monitoring and evaluation. Organizations that are involved in the delivery of human services, regardless of the sizes, need the correct strategy of implementing the four components in order to realize client success.
Intake
The first step of geriatric case management involves the meeting between the new client and a case manager. The encounter takes place preferably in the client’s home and it may include the family. The case manager collects data on demographics, health, psychological needs, daily living skills, exercise, and diet ( Powell & Tahan, 2018) . Previous and present care is assessed and the manager determines the safety of the environment for ease and safety of living. It is also essential to determine any immediate needs while the parties build a relationship and establish trust. This first meeting is essential in determining whether the client with benefit from the services that the agency offers. This is to help move to the next steps of the process of needs assessment. If the needs of the client fall outside the capabilities of the organization, then the manager has to refer them to the appropriate agency.
Needs Assessment
The second stage seeks to build on the information obtained from the first step of intake. In this section, the manager goes deeper into the challenges and goals of the client ( Powell & Tahan, 2018) . The core objective of this stage is to determine the problems, interests, and the barriers to successful case management process. The clients have to go through this process once they first meet the organization. However, the step has to be redone as time goes due to the dynamic nature of the needs and circumstances.
Service Planning
The service planning process is an important component of geriatric case management as it determines the success or failure of the client. In this stage, the case manager formulates specific goals and the required actions for realizing the objectives. This process results to a plan that will include the outputs and outcomes that are used to gauge the success of clients ( Powell & Tahan, 2018) . Case plans act as the blueprints to the whole process and thus have to be measurable and achievable.
Monitoring and Evaluation
The final component is monitoring and evaluation of the management process. In this stage, the metric of outcomes and outputs that were defined in the preceding steps are applied to continuously monitor and evaluate the client’s success ( Powell & Tahan, 2018) . This final stage ensures that the data and evaluation is qualified and quantified instead of simply being anecdotal.
Application to Long-Term Care
All the components discussed above are needed in long-term care, as older adults are more susceptible to chronic diseases. The initial intake or screening ensures that the client in the long-term care requires specialized interventions. The case management assesses the eligibility of need for the institutional placement, and arranges the activities that are required to meet the goals ( Bayliss et al., 2014) . Case management involves the connection between the chronically ill clients and the service they need but are not aware exists.
The four components reduce the unnecessary primary care admission that may increase the cost of care. The patients report improved quality as case management seeks to address the non-medical issues and interventions. The clients can be coached on how to manage their conditions without being admitted to the hospital, which can save the costs of Medicare ( Holland et al., 2015) . When the number of admissions reduces, the hospital will be better spaced for the more necessary visits like emergencies. Overall, there is a reduced wastage of resources.
The ethical principles affecting the practice are autonomy, nonmaleficence, and beneficence ( Hamilton et al., 2016 ). Autonomy refers to the independence to making personal decisions. A case manager ought to respect the client’s behaviors and choices. Nonmaleficence is the principle of refraining from hurting others. Case management involves making referrals to the necessary services for the client and thus it is imperative to comply with the codes to avoid intentional or unintentional harm ( Hamilton et al., 2016 ). Beneficence requires the manager to promote and benefit the client’s welfare, their support system, and others.
One ethical challenge involves the honoring of autonomy. The manager may be in a tough position to offer assistance where the client’s cognitive ability is poor. They may not accept and heed the advice that the case manager offers and continue making dangerous choices.
References
Bayliss, E. A., Bonds, D. E., Boyd, C. M., Davis, M. M., Finke, B., Fox, M. H., ... & Lind, C. (2014). Understanding the context of health for persons with multiple chronic conditions: moving from what is the matter to what matters: The Annals of Family Medicine , 12 (3), 260-269.
Hamilton, P. M., Roe, M. M., & Gootherts, E. (2016). Ethics for Case Managers.
Holland, D. E., Vanderboom, C. E., Lohse, C. M., Mandrekar, J., Targonski, P. V., Madigan, E., & Powell, S. K. (2015). Exploring indicators of use of costly health services in community-dwelling adults with multiple chronic conditions Professional case management , 20 (1), 3-11.
Powell, S. K., & Tahan, H. M. (2018). Case management: A practical guide for education and practice : Lippincott Williams & Wilkins.
