Case Management from Home is developed with the aim to empower families in effective management of their child or family member and to integrate optimally with their health and education team to promote benefits for communication of information, time management and hopefully to reduce the burden that these families feel in living lives with individuals with high needs.
This information has been provided to attempt to alleviate challenges that I have seen from working as a Speech Pathologist with individuals with complex support needs over the past 20 years.Some individuals can have a large number of health care professionals, educational providers and support individuals that provide input and support in all aspects of their daily life activities.
There can often be limited communication between busy professionals and support workers making long term attainment of goals challenging for families and individuals living with disabilities.
There is no doubt that some individuals have high support needs. The burden of this can be felt from not only family members and carers, but also their professional and educational providers who work to support their high needs, making their work overwhelming on a long term basis. I felt this personally in private practice as there is a different service delivery model in the nature of private practice compared to the government health and educational models of service delivery. Private practice tended to have a much more clinical contact session frame to its model due to the need to balance business costs for small enterprise, whereas support systems in the government were based on service delivery models where time was allocated in the workplace to attend meetings, plan services and liaise with other professionals.
With this in mind, this led to ideas to attempt to solve some of the ongoing challenges I was noticing since the changes in health services in recent years. With the introduction of support for individuals through programs such as Betterstart for Early Intervention and the FaHCsia Autism Package, individuals with disabilities were then able to access Private Medical/Allied Health Practitioners for treatment from this financial support. As the private practice model did not account for the additional time required for these complex client’s needs, there became an increased burden on professionals in maintaining the same integrity of service, given the depth and extent of support that some clients were in need of to achieve reasonable goals. The restructuring of medical and educational funds has been a positive step forward for families, however, with these changes came a greater burden in then coordinating a smooth service model between multiple professionals in the community who had a role to work with one individual. The introduction of a “consortium” for professionals was a start in this direction of binding groups of professionals together, however I am not certain that this has achieved the goals it set out to achieve.
Sometimes, the time to prepare this for each individual would require a significant amount of out of work hours to work at the standard expected to provide an effective service. It would take a significant toll on personal time to manage my own family and health on a long term basis. I understood that this was not just a problem for myself, but also for many colleagues across the profession who were serious about providing a high level of care for their clients, but also needed to strive to find a suitable work-life balance to raise a family.Case Management from Home was birthed from a need to integrate services and professionals, and to share assessment and clinical knowledge. It was also important to be able to readily access information from other professionals in a smooth and timely manner to increase the efficiency of working with families and individuals. In my profession, I also saw a need to be able to communicate information, goals and even therapy techniques to other professionals and support workers to facilitate support and improvement in their programs across both medical and educational platforms. This enables transference of the skills learned in therapy sessions to home and school.
I understood I was one team member being like a spoke on a wheel of many other “spokes” (being a team of support workers), revolving around an individual who lives life with disability. Even if I had the skills for case management, I was unable to provide this due to my placement in the design and structure on this “team wheel”. Yes, I had responsibilities for treatment and education of speech pathology goals and issues but I did not have the full perspective of the disabled individual like the family member/ parent did. The person who constantly supports the individuals through the progression of years are the parents. They are the ones who hold the key information that is then passed from one person to the next. This is especially important when that individual cannot communicate effectively or advocate for themselves. So from here, I understood that it was up to supporting the family members/parents to undertake this role as best that they could, by supporting them in learning skills to case manage from home.
This did not mean that they take control over the big decisions for medical management or that they needed to have the knowledge level that professionals held in various fields of medicine, allied health and education. That is unreasonable and professionals are extensively trained, qualified and often highly experienced in their particular field and should be valued for this role that they play on the team. Their consultancy with the family in regards to the child is undeniably irreplaceable and necessary. What case management from home proposes, is skill training for families to be effective in their integration and coordination of these teams of people to improve the smoothness and ease of working through support systems, therapy programs and educational plans that could last for a long time for some individuals. Since some clients and families are “here” for the long run, why not make it a pleasant, stress free and enjoyable process for the clients, families and the professionals involved.
Some family members are “naturals” and come into therapy with folders organised and Individual Education Plans sketched out to be discussed in sessions, however, for some individuals, this was an overwhelming task to grasp in their already burdened life, when remembering even the basic items to support their family members with disabilities was an achievement on some very taxing days. This is especially noticeable when behavioural challenges and emotional outbursts can derail the best laid plans. It is not uncommon to miss crucial opportunities in therapy sessions and feel the frustration of more time, human and financial resources being lost due to managing other needs of these individuals.
Some of the goals of Case Management from Home as a concept and education-skill building system are:
- To organise and stream line case management to free up more time for the family members/parents
- To support family members/parents in not having to repeat and reteach each new individual….not keep reinventing the wheel
- To enable communication between team members on a progressive basis
- To have a method of capturing specific information relevant to the disabled individual for specific needs and functions (eg. therapy goals, Individual Education Plans, professional correspondence, updated medication list)
- To safe-guard, protect and store information in a conclusive and ordered manner
- To facilitate education and teaching to family members/parents in effective methods of working within a multidisciplinary team to enable the highest level of care for their disabled family member
Case Management From Home as a teaching program brought right to your “door”, plans to throw in bonus suggestions from the perspective of a Speech Pathologist and Rehabilitation Provider that may enhance your life living with a loved one with specific and multiple needs. This is invaluable, given the scarcity of Speech Pathology services available in the community and the lengthy waiting lists experienced in the government sector for the Health Department, Community Health Service and the Education Department.
Case Management from Home is as simple or as diverse as the family member wants to develop. It can grow with the individual training and experience of the home and family. Case Management from Home is based on using online computer services to hold and store this information. It will require family members/parents to develop some computer skills which can also be taught along the way through the lessons.
The program will need to be sculpted around the specific needs of the disabled individual, however, suggested ideas, documents and templates will be provided as tools along the way.
This will be explained further as you progress through various stages and lessons in the design. I hope this makes a difference and gives you more time in your busy week to spend sharing positive moments … which is really what it is always about.
I look forward to providing further support for you and your family soon.