Independent Care

Independent Care

Ronda Cranfill

Deanna B

February 20, 2017

     A client’s program can be terminated for different reasons in different ways but it can still be hard on a client and a case manager.  Case manager and clients build a relationship during services.  When a client makes progress through working towards their goals to becoming independent and meeting other objectives.  A termination of services happens and clients may not be happy about their services ending.

Strategies for Termination of Case Management

     Termination of the client’s relationship with the case manager is the last stage of the job of case management.   Each program or agency where the case manager works will handle his or her own policies and procedures for termination or discharge of services.  A person who takes action to stop a client’s services without the wishes of the client, does not give the client consideration in a proper way of termination of services, and leaves the client’s needs unmet, the client’s services being terminated could be abandonment.  Policies and procedures are put in place to support the client’s rights and to protect the case managers from liability due to wrongful termination of services.  When case management services are terminated in an appropriate occasion and could occur for several reasons.  Procedures are put into place to insure that a client has due process rights, the case manager will use different skills to show the client how to successfully separate from the client and case manager relationship.  It is not uncommon  for case manager and client to react emotionally to the termination of the services.  People respond to things in different ways due to their past, the vulnerable of the client’s and case manager’s relationship, the circumstances surrounding the termation.  Managers look at the way they respond to the separation and stop of a client so that they are aware of how their feelings can influence the termination of case management.  When stopping of services is discussed between the client and the case manager, the client can feel a sense of being left, being given up on, or lied to, or loss.  A client who is afraid of termination of services the case manager may start to notice that the client’s progress is going downhill towards goals and objectives that are established.  They could also start to see where the client is starting to avoid working on the goals.  Other times clients will not respond because they have insulated themselves from emotions so they avoid being hurt due to hurtful relationships in the past.  Manager’s will have to be able to look at each person to determine his or her reaction to the services being terminated and make an effort to deal with the negative emotions and reactions of the client.  The biggest termination of services would be when a client has met the goals and services and the client and case manager agree that there is no longer a need for services.  When a client and a case manager have agreed that services are no longer needed a client can see this as a “graduation” to having an independent way of life.  Other ways a termination can happen is if a client loses their eligibility for services before their desired goals and objectives are met, lack of making head way towards set goals, or due to well-being or safety.  Programs that have a time limit on the case management services it might be best to start out with talking to client about the amount of time they will have to work together.  During this time they will need to talk about the parameter of the program, discuss what they would like to do to help, how they will help the client, and how long the service will be provided.  Residential case management would be a type of service that would have a time limit for the client to reach their goals.  Some programs begin a relation with a client knowing that to some degree of intervention will be need on a long term and open ended basis.  A client may need an intervention if there is some sort of physical, mental, or emotional condition of the client or is related to the client’s life such as abusive relationships, capacity, and poverty.  Some people who have on going health problems may require on going case management at different times throughout their life.  When the decision to close someone from his or her program it needs to be carefully considered depending on the client’s level of dependence on the case manager.  The manager may have to slowly end the time spent with the person over time so they are more independent.  If a case manager leaves the place of employment, termination will happen but a case manager will help the client find another case manager.