Running Head: Client Centered Approach – Assignment 1 – Case Assignment Client Centered Approach – Assignment 1 – Case Assignment Nancy E. Webb Case Management Program 560-501 McMaster University Emily Jones attended the CCAC in person and requested assistance in finding Long Term Placement Services for her 94 year old father. A case manager sat with Emily and was informed that the client resides in a rural area of Renfrew County in a large turn of the century farmhouse. The primary source of heat is an external wood stove which requires manual feeding of three foot logs once a day.
The electricity is only available in three rooms in the farmhouse; the bathroom, bedroom and kitchen. The client has some small livestock on the farm that are free range feeding. The client has been widowed for two years from the wife that he has had for 74 years. The family’s main concerns are that Mr Jones is not coping well alone in the country, the family members fear for his safety , and feel that he would be better off in a Long Term Care Facility. Mr Jones attended the CCAC with his family in attendance and met with the Case Manager.
He expressed that apart from being slower in his elder years and having to watch his diet from Type II diabetes he feels is managing fine. Mr Jones reported that he bathes once a month whether he has to or not. He does sink bathe daily as he has for the last 70 years. He has neighbours that visit daily and attend the grocery store on his behalf, purchasing frozen T. V. dinners, fresh fruit, milk and bread. He goes to bed every night at the same time and gets up with the sun. He loves to walk the land around his farm and feed his livestock daily and uses machinery to assist him to put the wood in the woodstove.
This routine he exclaims, gives him reason to get out of bed every day and keep mobile with a purpose. He further stated that he would never move into a Nursing Home and that he wanted to die on the farm as his wife had. Although the family members were primarily concerned for their father’s safety, they were able to hear first hand how Mr Jones was coping with the solitude and the love of the life he was living. Family members vocalized their need to ensure his physical and mental health and could not understand why he would not move away from the farm.
CCAC services were implemented for Occupational Therapy to provide a home safety and equipment assessment to reassure the family and client that the house was suitable to ensure both client safety and a lifeline for emergency awareness and responsiveness. The client was able to remain in his home safely and contently with a support network that merged neighbours, family members and professional service support into a cohesive and effective team. Mr Jones resided on his farm for six more months with minimal professional services.
When he passed away in his own bed, Mr Jones had lived his life right to the end on his own terms. Mr Jones is a testimonial to an effective client-centred approach. The importance of his cultural values and the self driven passion of farm living, the need for Mr Jones to have an active role in his future plans, and the ability to have openness and honesty within the relationship of the Case Manager and his family is reflected and described in Client Centered Practice: What does it mean and does it make a difference? Law et al, 1995). Mr Jones’ autonomy and recognizing he was the expert on his own life, coupled with having family and the case manager provide the client with understandable information, supported the decision to allow him to remain in his home. The Partnership and Responsibility (Law et al. 1995) allowed Mr Jones to accept Occupational Therapist assistance, as well as inform the family members of his relationship with his neighbours.
The communication between Mr Jones and his family promoted the family to express that they felt he was at risk with this decision, while gaining a deeper understanding of the personal motivation Mr Jones felt for staying on the family farm. Mr Jones listening and acknowledging albeit choosing to remain in his present situation, also enabled himself, and the family to value the choices that he has made. The Case Manager and the client were flexible in the approach of the care plan to identify his personal strengths and empower his life goals while maintaining culpability for ensuring his values were upheld.
Following the Client Centered Approach (Law et al, 1995) the concepts and fundamental issues of individual autonomy/ choice, partnership, client, family and Case Manager responsibility, enablement, and respect for diversity were met. (Law et al. 1995) I found this experience as a Case Manager exhilarating. Enabling patient centered communication with the family and a supportive practitioner of Client Centered Practise resulted in positive perceptions of the client, the family and CCAC. There was a cohesive plan that increased the efficiency of care, while enabling the client the satisfaction to control and influence his care and lifestyle.
The client perceived his health as normal and valued each of his seemingly routine accomplishments as a source of motivation to continue daily. In retrospect Mr Jones had personified his strengths in overcoming adversity and redefining the viewpoint of a successful and meaningful life. The importance of this one case that impacts my approach to case management and the assessment process, underscores the importance of understanding the clients values, and achieving a balance of care that harmonizes with their personal goals.
The need to avoid imposing personal belief systems and culture is paramount in the successful application of a client centered approach. This further influences my approach to conducting interviews that I am truly listening to what the client is saying and what the client believes he needs.
References: Law, M. , Baptiste, S. And Mills, J. (1995). Client Centred Practice: What does it mean and does it make a difference? Canadian Journal of Occupational Therapy, 62(5) 225-227. 235