The Case Manager’s Creed in Practice
Helping a client make big life changes
By Gill Dunn, Case Manager, Cheltenham
I am always asked ‘What does a case manager do?’ I have to stop and think, ‘what do I do?’ as every day is different, but I suppose the short answer is ‘whatever it takes’!
I recently gave a presentation and this same question came up. In response, I quoted the ‘Case Manager’s Creed’. If you are thinking of becoming a case manager you should read it – it says it all. Before writing this article I read the creed again and realised I could tick every box, especially in the last 7 months…
Towards the end of last year, I saw one of my clients ‘going downhill’ and becoming increasingly frail, but refusing help. This is not unusual, especially when someone has been so independent in their own home, and as a case manager my role was to be caring, supportive and understanding of my client’s wishes, feelings and frustration, as it became evident he was no longer able to live on his own. I could see he was not looking after himself, but as any case manager knows, mental capacity is one of the first things to be determined, before diplomatically trying to ‘persuade’ the client to reconsider their living situation. My client did have capacity in this area and wished to remain at home without help. Unfortunately, an incident shortly before Christmas resulted in him being hospitalised and unable to return home.
This is when I had to become assertive, or ‘bossy’, as my friends would say. I came straight to the point, explaining to him why he should not (or, to be honest, could not) go home and, to my surprise, he agreed. He didn’t want to go back home and understood that he needed support. At this point I had to put my thinking cap on… Where do we go from here? What would I do if this was a family member?
My immediate priority was to find a safe and caring respite placement, where he could have his privacy and enjoy a nice Christmas, while at the same time thinking about his future. Prior to his hospitalisation, my client’s deputy and I had both (very diplomatically) suggested downsizing and moving to a retirement flat, where he would still have his independence, but with support. He wasn’t interested.
I put the idea to him again when he moved into his respite placement. This time he agreed to the idea, so I got ‘on the case’! After looking at several flats in the retirement complex, we finally agreed on one, all the time keeping my client up to date, involving him as much as possible and keeping his family in the loop, as they were happy for me to manage it all.
It was then that the true “whatever it takes” nature of the case management role came into full effect. I became a buyer and seller, interior designer, personal shopper, house clearer, liaison officer, carer, transporter, finder of painters, electricians, a handyman, equipment, therapists… the list goes on and on and I am sure I have forgotten a lot of what I did and continue to do.
I was determined to have the flat all set up, so that when he walked in the door for the first time it would feel like home. For a month I ran around like a headless chicken, buying furniture, buying the equipment the OT had recommended, having the rooms painted in the colours he chose, introducing a physiotherapist to help with his mobility, arranging for an automatic front door and automatic lights to be fitted and getting aids and adaptations in place, so my client could be as independent as possible.
Lastly, but crucially, I introduced the support team. The team already worked at the retirement complex and had supported individuals with brain injury, so they understood my client’s needs, which did make life a bit easier.
By the time my client moved into his flat in the spring, everything was in place and ready for him, and I’m delighted to say that we have now reached a stage where he is settled, happy and healthy.
Finally, even though we don’t do this job for praise or glory, it’s nice to know people appreciate what you have done. My client’s family thanked the ‘team’ involved which made me smile as the team was ‘me’, but my client’s deputy made me smile even more when he said –
As you recognise, all this has been achieved through Gill’s tireless work and dedication.