Case management is not a lifetime service. With the lack of funds available for all the clients in need of service often times termination of service is the only option. In this paper we will examine the process a case manager goes through when termination of services occurs. We will also discuss how independent care will help in continued client growth. Termination of services provided by case management can occur for a large variety of reasons. The main goal of a case manager is to provide the client with all the resources available to meet the client’s needs. By the end of the action plan the client should be prepared and skilled enough to continue without the case manager. The termination of this relationship between case manager and client is the last step in the case management process. Since a successful case manager builds a strong lasting relationship with his or her client there may be some emotions that come out during the termination. In order to do this correctly a case manager must be aware of their personal responses to loss so these emotions do not influence their decision to terminate services (Pucher, 2015).
In addition the case manager must be aware of the client’s emotional state when discussions of termination begin. It is common for a client to feel a sense of loss, abandonment, or rejection which could hinder the client’s progress. During the initial discussion about termination of service the case manager must observe and assess their client to determine their next course of action. Depending on the client’s reaction the case manager may have to deal with negative emotions and actions from the client. With the large variety of reasons for termination the case manger’s reactions and game plan will differ. In the perfect scenario termination occurs because a client has met the outcome they desired and both case manager and client feel that service is no longer needed. According to Rothman, this type of termination is often viewed as a graduation of sorts by the client. Other less desirable outcomes can include termination due to client noncompliance.
Once the client’s needs have been established and the resources have been located the case manager must constantly review the progress of the client and determine if continuing case management service is needed. Terminating the relationship is never an easy process; the case manager must carefully create a termination process depending on the client’s level of dependence in him or her. If a client is heavily dependent on the support of the case manager, the need for a gradual decrease in the amount of contact with the client may need to occur before termination. When planning a termination strategy the case manager determine if the client will lose access to the services and resources once the relationship is terminated. While this may not always be the case often times case management services provided through community based waiver programs will be terminated.
So when planning this type of termination the case manager can look for other resources to help the client or decide not to terminate the relationship because the client is still in need of those services. Since the case manager’s main goal is to help the client often times “Case Conferences”, a meeting between client, caregiver, service provider, and legal counsel, may be needed so the client will not be terminated before he or she receives the needed services (Case Management Society of America, 2010). If a case conference is not successful often times the client will be referred to protective service organizations when service is still needed (Case Management Society of America, 2010).
As discussed above case management and client relationships will come to an end. Once the client has reached his or her goal and has obtained the skills to live successfully the case manager must begin to separate the relationship. By slowly weaning the client off the support of the case manger the client is given the opportunity to use the skills they learned to make better life decisions. The more a client makes positive decisions for him or herself the more confident and self-reliant they become. The relationship between a case manager and client cannot last forever. It is up to the case manager to create a successful termination strategy that benefits the client. If done correctly the client will not fell abandoned and will have the skills to make independent decisions to improve their life.
Case Management Society of America. (2010). Standards of Practice for Case Management. Retrieved from http://www.cmsa.org/portals/0/pdf/memberonly/StandardsOfPractice.pdf Pucher, A. (2015). Case Management: A Consolidated View of Customer Care. Retrieved from http://www.isis-papyrus.com/Download/factsheets/BAFactSheet_Case-Management_E.pdf Rothman, J., & Sager, J. (1998). Case Management: Integrating Individual and Community Practice (2nd ed.). Boston, MA: Allyn and Bacon.
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