GERONTOLOGY (0351)
The goal of this research was to determine if case managers can become effective
in assessing for and
promoting the use of low-tech assistive equipment on the part of their home
care clients. Elder-service
case managers from two Massachusetts Aging Service Access Points (ASAPs) were
interviewed to
understand how case managers received this new job component. These case managers
were
participants in a Robert Wood Johnson (RWJ)-sponsored demonstration and research
project to provide
for low-tech equipment assessment and distribution. Analysis of the interviews
was conducted using the
QSR NUD*IST qualitative software program. The Diffusion of Innovation framework
(Rogers, 1995) was
applied to interpret the potential for adoption. Prior to the RWJ participation
these case managers had
only been assessing and referring clients for limited types of assistive equipment
(typically items used for
bathing and toileting). The greatest barrier to adoption proved to be that case
managers were attempting
to recommend equipment without the benefit of ever having seen or tried the
items themselves. While
the case managers believed that low-tech equipment would be beneficial to their
clients, they were
generally not able to make arrangements for thorough assessments, follow-up,
or minor assembly, or to
assist their clients with simple instruction when the equipment was delivered.
Case managers also had
initial concerns regarding liability in case a client were injured on any equipment
a case manager had
suggested. Some re-invention of the intended protocol occurred, as a number
of case managers
recommended only one or two items (most typically, can openers and jar openers)
to each client,
requiring no in-home assessment or instruction. Higher levels of adoption can
likely be achieved with
stronger support from the state-level agency and by better framing the introduction
of a new job
component within the existing elder-home care culture. Insights from the application
of the Diffusion of
Innovation framework can aid other home care agencies in initiating or expanding
equipment distribution
services, or in seeking to achieve maximum adoption of new roles or job responsibilities
presented to
their case managers.
Social
Systems Simulation Group
P.O. Box 6904 San Diego, CA 92166-0904 Roland Werner, Principal Phone/FAX (619) 660-1603 |