Case Management Assesment 2.docx - 1 It could be argued that a measure of who we are as a society is reflective of how we care for and respect our Older

Case Management Assesment 2.docx - 1 It could be argued...

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1 It could be argued that a measure of who we are as a society is reflective of how we care for and respect our Older People (OP). Many have offered views shrouded in concepts of distain for ‘toxic’ OP, focusing on deficits and problems of the OP, and this is no more evidenced than in their assault, so often reported on by media and resulting in a Royal Commission. This essay will offer a critical analysis and in-depth discussion of the key historical and contemporary issues faced by OP and further, attempt to shed light on and understand the shifts in the paradigm of the Case Management (CM) practice landscape surrounding them. Traditionally, models discussed by Fine & Glendinning (2005) for the care of OP tended to implement a ‘carer-dependent paradigm’, which implies that the OP being cared for is ‘grateful’ and ‘submissive’ for the care being distributed by the case manager, of which has greater power and control. Further similar views as reflected in Ham, Sloane, Warshaw, Potter & Flaherty (2007) & Davenport (1999) on the care of OP reflect a domineering tendency to exercise excessive control and authority towards them. In recent years, a new approach moving away from evidence-based practice emerged in which concepts of elder care shift to a more person-centred approach, incorporating independence and enabling and encouraging the OP themselves to set their goals. OP are “expected to become an active rather than passive agent in the care relationship” (Fine & Yeatman, 2009, p.170). With this perspective in mind, Fine & Pross (2009) suggest that when a client- determined goal is successfully achieved, a successful outcome is accomplished. As well as being reflected on by the Australian Government (2019), Gursansky, Harvey & Kennedy (2003) suggests that OP should be able to have choice in the selection of the desired services they require as well as the way in which those services are supplied. This would facilitate the
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2 OP’s autonomy; however, Austin & McClelland (2000) raise questions about the degree to which this actually transpires in practice and furthermore, Pickard (2009) highlights that the process of CM with OP may not actually decrease dependence on professionals but actually tends to increase it. Furthermore, although indulgent of the out-dated ideas, Clark (1998) could be seen to successfully argue that although facilitating a OP’s independence should always be a guiding and fundamental standard of CM practice, in reality is it sometimes necessary to implement a ‘professional paternalism’ when attempting to support an OP to accomplish their valued goals. If CM with OP aims to be person-centred, personalised rather than impersonal, and organizes services to the particular needs of individual OP as is prescribed by Gursansky et al., 2003; Fisher & Fine, 2002 & Fine & Pross, 2009, delivery should be synergistic with ‘enablement’ with restorative approaches foundational to its approach. For this to happen, Fine & Yeatman, (2009, p.170) argue that the key to the CM relationship with OP is the “fostering of the service user’s capabilities and autonomy”. If an OP’s wellbeing is to be
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