The Case for Integrating Behavior Change, Client-Centered Practice and Other Evidence-Based Models into Geriatric Care Management

• Published in: Social work in health care 2004-01, Vol.38 (3), p.1-19
• Main Authors: Hackstaff, Lynn, Davis, Carol, Katz, Lynne
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Aged; autonomy; behavior change theory; Behavior Modification; Behavior Therapy; Behaviour modification; Care management; Case Management; Client centred practice; client-centered; Data Collection; Elderly; Elderly people; engagement; Evidence based; Evidence-Based Medicine; Female; frailty; Geriatrics; Health Maintenance Organizations; Health Services for the Aged - organization & administration; Humans; Integration; Intervention; Los Angeles, California; Male; Models, Organizational; Nonprofit making organizations; Patient-Centered Care; Philadelphia
• ISSN: 0098-1389; 1541-034X
• DOI: 10.1300/J010v38n03_01

This paper describes the complexities of engaging a frail, elderly population in the process of behavior change to improve daily functioning. Implementation of a brief Purchase of Services (POS) benefit supplementing usual geriatric care management in an integrated, not-for-profit HMO environment is used to illustrate these complexities. Findings from the first two years of the four-year study of the intervention showed that one-third of the group of 541 study participants who were randomized as eligible to participate refused these free, enhanced services. The reasons for these refusals are examined, and a case is made for incorporating behavior change theory into traditional geriatric care management practice for cognitively intact clients in order to facilitate acceptance of needed services and increased patient autonomy.