Abstract
BackgroundCase management interventions have been widely used in the care of frail older people. Such interventions often contain components that may act both independently of each other and interdependently, which makes them complex and challenging to evaluate. Qualitative research is needed for complex interventions to explore barriers and facilitators, and to understand the intervention’s components. The objective of this study was to explore frail older people's and case managers’ experiences of a complex case management intervention.MethodsThe study had a qualitative explorative design and interviews with participants (age 75-95 years), who had received the case management intervention and six case managers who had performed the intervention were conducted. The data were subjected to content analysis.ResultsThe analysis gave two content areas: providing/receiving case management as a model and working as, or interacting with, a case manager as a professional. The results constituted four categories: (1 and 2) case management as entering a new professional role and the case manager as a coaching guard, as seen from the provider’s perspective; and (3 and 4) case management as a possible additional resource and the case manager as a helping hand, as seen from the receiver’s perspective.ConclusionsThe new professional role could be experienced as both challenging and as a barrier. Continuous professional support is seemingly needed for implementation. Mutual confidence and the participants experiencing trust, continuity and security were important elements and an important prerequisite for the case manager to perform the intervention. It was obvious that some older persons had unfulfilled needs that the ordinary health system was unable to meet. The case manager was seemingly able to fulfil some of these needs and was experienced as a valuable complement to the existing health system.
Highlights
Case management interventions have been widely used in the care of frail older people
Case management is a complex intervention that has been used in different health care settings such as psychiatry and geriatric care [2,3]
The experience of the intervention was interpreted from two perspectives: that of the case managers (CM) that
Summary
Case management interventions have been widely used in the care of frail older people Such interventions often contain components that may act both independently of each other and interdependently, which makes them complex and challenging to evaluate. Qualitative research is needed for complex interventions to explore barriers and facilitators, and to understand the intervention’s components. The objective of this study was to explore frail older people's and case managers’ experiences of a complex case management intervention. Case management is a complex intervention that has been used in different health care settings such as psychiatry and geriatric care [2,3] It has no single definition but it has been suggested that basic case management may include identification and outreach, comprehensive individual-based assessment, care planning, care coordination, service provision, monitoring, evaluation and meeting individual needs [4,5]. Several studies have investigated the effects of case management for older people.
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