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Balancing Formal and Informal Care for Older Persons: How Case Managers Respond

Published online by Cambridge University Press:  29 April 2014

Allie Peckham Open the ORCID record for Allie Peckham [Opens in a new window] ,
A. Paul Williams  and
Sheila Neysmith
Allie Peckham*
Affiliation:
Institute of Health Policy, Management and Evaluation, University of Toronto
A. Paul Williams
Affiliation:
Institute of Health Policy, Management and Evaluation, University of Toronto
Sheila Neysmith
Affiliation:
Factor-Inwentash Faculty of Social Work, University of Toronto
*
*Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: / Allie Peckham, MSW, Ph.D. Candidate Institute of Health Policy, Management and Evaluation University of Toronto 155 College Street, Suite 425 Toronto, ON M5T 3M6 ([email protected])
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Abstract

This study examined how front-line home and community-care (H&CC) case managers view the role of informal caregivers, and the factors that contribute to H&CC managers’ resource allocation decisions. The study research used two methods of data collection: (a) secondary analysis of the results from balance of care (BoC) simulations conducted in nine regions of Ontario, and (b) in-depth follow-up interviews with participating BoC case managers. Results suggest that case managers unanimously agree that the unit of care in the H&CC sector is not confined to the individual, as in acute care, but encompasses both the individual and the caregiver. We found, however, considerable variation in the mix and volume of H&CC services recommended by case managers. We conclude that variability in decision making may reflect the lack of regulations, best practices, and accountability guidelines in the H&CC sector.

Résumé

Cette étude a examiné la façon dont les gestionnaires de cas de soins à domicile et en milieu communautaire dans la première ligne de la profession voir le rôle des aidants naturels et les facteurs qui contribuent aux décisions de ces gestionnaires en ce qui concerne l’allocation des ressources. La recherche pour l’étude a utilisé deux méthodes de collecte de données: (a) l’analyse secondaire des résultats de simulations de la balance de soins, réalisées dans neuf régions de l’Ontario, et (b) des entretiens en profondeur de suivi avec les différents gestionnaires de la B de S. Les résultats indiquent que les gestionnaires de cas sont d’accord à l’unanimité que l’unité des soins dans le secteur SDMC ne se limite pas à l’individu, tel qu’en soins aigus, mais englobe à la fois l’individu et le soignant. Nous avons constaté, cependant, des variations considérables dans l’assortiment et le volume des services SDMC recommandés par les gestionnaires de cas. Nous concluons que la variabilité de la prise de décision peut refléter la manque de réglementation, de meilleures pratiques, et de lignes directrices pour la responsabilité dans le secteur SDMC.

Keywords

aging at homebalance of carecase managershome and community careinformal caregiverstreet-level bureaucracyvieillissement chez soibalance de soinsgestionnaires de casaidant naturelsoins de santé à domicile et communautairela bureaucratie de rue (?)
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 33 , Issue 2 , June 2014 , pp. 123 - 136
Copyright
Copyright © Canadian Association on Gerontology 2014 

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