Nursing Case Management Case Management Thesis

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For example, the individual may not feel he is truly 'sick' because he does not feel bad, may not wish to suffer the side effects of the drugs, and not fully how to understand to take them properly. Psychological counseling, the assistance of a nurse, even a meal provision service for the sick and the disabled all might be necessary to ensure that the man was compliant. The goal of comprehensive case management is to provide interventionist services over the long-term, and AIDS is a long-term, chronic illness, even (or especially) when treated with antiretroviral drugs. In the case of a comprehensive case management intervention, the individual's immediate needs are first met (for example, the cost of the drugs or problems with coordinating medical treatment with employment). But then provisions are made to integrate social support services into the individual's life, such as home visits by a nurse, free home-delivered meals, or financial assistance.

For example, the patient might be contacted by a nursing facility to arrange for home visits to check on the individual's medical status. or, he could receive psychological as well as physical healthcare services on a regular basis. If the depression or mental issues are the obstacle regarding taking his medications, he may be connected with counseling services or a support group specifically designed to help AIDS patients cope with their illness. Long-standing social support is more likely to act as an additional motivator to be treatment-compliant than a few, brief sessions.

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If finances are an issue and cannot be resolved in the short-term with the patient's insurance company, "services may be supported by grant funds or Medicaid reimbursement" (Case management definitions, 2009, Department of Health).

Comprehensive and supportive case management are not mutually exclusive. For example, supportive case management may be appropriate for clients who have completed comprehensive case management but still require a maintenance level of periodic support from a case manager or case management team. Also, the person's need for supportive services may change with his health status. For example, if the patient's health is currently not strong, comprehensive care with continual meetings with a nurse and financial and nutritional support may be required. This can be followed by a supportive period that only addresses certain specific health or lifestyle issues, like fine-tuning the timing of the drugs, or providing transportation to work. Then, comprehensive care may be needed in the far future, if his health status changes once again. However, the fact that the patient was treatment-resistant is a 'red flag' for future problems. Even if it is determined that this first sign of a crisis is a short-term problem appropriate for supportive therapy, such as frustration with certain side effects of one of his new medications, the client should be aware that comprehensive case management options exist, should he need to avail himself of them in the future.

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