Case and Care Management for the Elderly

Abstract

Background: Whilst care service capacities and investments in health for the elderly increase, several social groups are threatened to be excluded from adequate access and quality of care in East-Styria and Western Hungary, with about 1,5 Mio. habitants. Those vulnerable are the more disabled, who suffer from disease or illness earlier in life, have accumulated health problems and neither the health literacy nor the economic resources to attain proper care arrangements at home, compared the average. In both countries, the existing public services have significant problems to deliver integrated long term care. Informal carers cover more than 80% of the care spent, often without professional help and social security, and they are at health risk themselves. In Hungary, care structures are not covering the health care needs of the elderly quantitatively. From Hungary, there is also a significant lack of professional care givers, who tended to work outside public health services, and often abroad – in Austria. Case and Care Management Model: Chance B, offering 27 different services to enable persons to live an independent and self-determined life who´s services manly focus on services for people with disabilities in Styria Austria all through a lifetime, has prepared a well-designed Interreg-project in Austria and Hungary, named „Age-friendly Region“. In both countries, despite of having completely different health systems and ongoing health reforms, a bilateral case management model for the elderly has been systematically developed. The model is based on a comprehensive and inclusive notion of health with strong emphasis on social resources of clients. It is based on the bio-psycho-social model, as well as the system theoretical approach. It provides tools like interdisciplinary case-conferences, multidisciplinary health assessments, concerted and participative networking with service providers including primary health care and strategical communication with local and regional authorities. Intervention: The intervention consists of offering 6 case managers in the project regions and developing a case and care management model with regional and local stakeholders. The project „Age-friendly Region“ offers elderly and caregivers a fully cost-free case management service, delivered through home visits and counselling. Project activities for care management aim at strengthening organisational integration of care by defining processes at the interfaces of services in the health, social and care sector. Of utmost importance, activities aim to actively promote professional integration of care from nurses, social workers and several medical professions. Furthermore the project is guided by a selective media and TV-campaign. First results: In Austria, the implementation not only has to deal with a complex political environment, it also has been creating a communication platform in the first year of the implementation, that is reliable and brought policies into action. At the same time the case management services are highly frequented. In Hungary, the service providers and municipalities of three regions are implementing the Case management model, with a high probability of sustainable organisational development within the provider organisations. Assessment instruments were introduced and play a key role in the development of the bilateral model for case and care management.