What is the role of a case manager in community aged care? A qualitative study in Australia

Abstract

This study aimed to explore the perceptions of case managers about their roles in providing community aged care in Australia. Purposeful sampling was used and 33 qualitative semi-structured interviews with 47 participants were conducted. Participants were drawn from a list of all case managers working in aged care organisations that provided publicly funded case-managed community aged care programmes in the State of Victoria, Australia. Participant selection criteria included age, gender, job titles, professional backgrounds, practice locations, organisational attributes and organisational size. Data collection was implemented between September 2012 and March 2013. Thematic analysis was performed. Participants believed that case managers performed diverse roles based on clients' needs. They also articulated 16 important roles of case managers, including advisors, advocates, carers, communicators, co-ordinators, educators, empowering clients, engaging clients and families, liaising with people, managing budgets, navigators, negotiators, networking with people, facilitators, problem solvers and supporters. However, they were concerned about brokers, mediators and counsellors in terms of the terminology or case managers' willingness to perform these roles. Moreover, they perceived that neither gatekeepers nor direct service provision was case managers' role. The findings of this study suggest that case managers working in community aged care sectors may be more effective if they practised the 16 roles aforementioned. With the value of helping rather than obstructing clients to access services, they may not act as gatekeepers. In addition, they may not provide services directly as opposed to their peers working in medical care settings. The findings will also assist organisations to design job descriptions specifying case managers' roles and associated job responsibilities. Clear job descriptions will further benefit the organisations in staff recruitment, orientation and ongoing development, as well as facilitate case managers to set professional boundaries in the delivery of case management interventions to their clients.

An early investigation of individual budget expenditures in the era of consumer‐directed care

“…Hours of formal care support 6 (4) 5 (4,9) Time on CDC (mo) 9 (5) 7 (5,14) Data collection period (mo) 10 (4) 9 (8,12) proportions in contributing to overall HCP expenditures at an individual level. The results indicate that over 60% of expenditure was allocated to direct services (care services and brokered services) and it was evident that, regardless of the HCP level, administration and case co-ordination/care management fees accounted for a significant proportion of total expenditure: nearly 40% for the total sample, 41% for HCP level 1/2 and 38% for level 3/4.…”

“…To offer a HCP under a CDC model, aged care service providers assign a care co‐ordinator/case officer to co‐ordinate clients’ care. The responsibilities of the care co‐ordinator/case officer include explaining to the client how the CDC model works and designing a care plan and individualised budget equivalent to the client's package fund and organising the care services in consultation with the client . In principle, according to the CDC model, clients are aware of the budget available for their care and have control over the management and co‐ordination of their care.…”

“…The responsibilities of the care coordinator/case officer include explaining to the client how the CDC model works and designing a care plan and individualised budget equivalent to the client's package fund and organising the care services in consultation with the client. 11,13,14 In principle, according to the CDC model, clients are aware of the budget available for their care and have control over the management and co-ordination of their care. However, it is a legislative requirement that service providers retain responsibility for financial control and accountability to the government.…”

How would case managers’ practice change in a consumer-directed care environment in Australia?

“…Case management practice encompasses a full spectrum of roles, functions and activities that case managers are educated, competent and authorised to perform (You et al . ). It has been implemented in various care settings, such as community aged care and primary healthcare.…”

The Role of Home Nursing Visits in Supporting People Living with Dementia in Japan and Australia: Cross-National Learnings and Future System Reform

“…29 Though there is some evidence for the efficacy of case management in regard to improving client outcomes and reducing health care utilization, criticism remains in regard to coordination of care, because case managers do not always have autonomy over supply or availability of services. 30 Consequently, there has been a promotion of integrated care to improve connectivity, alignment, and collaboration between and within funding and administrative sectors and health services. 29 More recently, consumers have also advocated for the introduction of consumer-directed care-the ability to make choices regarding the care they and their caregivers receive.…”