PubMed1998
Three strategies are followed in handling the key issue within the field of action of care an services for the elderly: securing the material needs of those requiring care, creating appropriate care structures, and providing an effective counselling back-up to alleviate interface problems. Those latter, process-oriented aids, have been the subject of discussion and further development under the key term of case management for a good decade. The aim in this context is to prevent the elderly from being unnecessarily moved into residential care, to stop the revolving door syndrome, to ensure that older people can stay in their homes, to support family members acting as care providers, to enhance the quality of services and those to ease the strain on fund providers. In the context of case management, these diverse tasks are performed by three basic substantive functions: the gatekeeper, broker, and advocacy functions. Each of these three functions characterizes the main variants of case management with a different weighting (care management, community care, managed care and case management as a counselling approach with a particular focus on individual help). Although these variants may improve the handling of the key issue in the field of action of care, they nevertheless remain too limited in scope. The integration of a fourth basic function, the support function, leads to a modification and extension of case management and characterises the concept of support management which is better able to fulfill the tasks and standards in the field of action of the elderly population in need of care: interruption of the dynamics leading to residential care, grater transparency through the maze of service provision, the right of self-determination of those requiring assistance in the planning and implementation of care, and quality assurance of care arrangements; it also serves as a contribution to an improvement of care structures.