What is Case Management?
What is case management…if we are honest with ourselves, the answer changes depending on the day. Case management is advocacy, empowerment, facilitating autonomy, and assisting people in attaining their goals whether medically or personally. Case management can be a whirlwind of excitement, frustration, fulfillment, and reward all in the same day. A colleague of mine frequently describes case management as the junk drawer of the care team because “everything gets dumped on the case manager.” When I think of a junk drawer, I think of the half pack of birthday candles, the random assortment of batteries that never seem to be the type I need, the pen that doesn’t work, and the random thumbtack I don’t need. I think of a drawer of useless possessions that don’t have a place anywhere else. I don’t think of case management as the junk drawer; I prefer to think of case management as the toolbox.
A toolbox is often stuffed full of random items, much like a junk drawer, but in the case of the toolbox, each item has a specific purpose. A well-organized toolbox is essential for resolving issues. Having the tool you need improves efficiency, increases productivity, and lowers frustration. A toolbox is put together with intention, each tool playing a part in fixing a problem. Sure, sometimes after a complicated job, the tools get thrown back in and don’t look as pretty, but everything still has a useful purpose. As case managers, as the toolbox, we are prepared for anything because on any given day, anything can happen. From suicidal individuals to sudden homelessness, we must adapt our tools to meet diverse needs.
Have you ever seen someone that fixes things for a living? Have you been in their workshop? Every tool has a home, every machine is well kept, and they can make seamless movements from one tool to another based on the need. An effective case manager has a strong organizational system and has all of their resources at their fingertips. We are responsible not only for managing whatever administrative requirements are placed on us given the field in which we work, but we are also responsible for lives. Lives that are at risk due to barriers to health, barriers to work, and often barriers to safety.
A case manager may often feel that they are being “dumped on,” but in actuality, they are being recognized as the essential person for the task at hand. Some days are harder than others. Some days our toolbox feels empty and filled with inadequate tools, but the beauty of case management is that those days are balanced with days where our tools are able to help fix barriers and make progress. Case management requires flexibility, resilience, patience, tenacity, and sometimes a nice margarita.
Case management looks different depending on the field or position in which the case manager works. Years ago, I was a case manager for adults with developmental disabilities. In that position, advocacy was 99% of my job. I advocated for their human rights. I advocated for their wants and needs. And in one instance, I advocated for appropriate legal counsel. In that situation, I had a 22-year-old young man with the cognitive capabilities of an 8-year-old who stood accused of a crime he did not even know about. He was arrested, questioned without a lawyer, and as a product of the foster system, had no family support to assist him. With no law degree, I had to open my toolbox and reflect on what I could do in order to assist this young man. With the support of my supervisor, we created a fundraiser to raise money for him to hire a new lawyer that could advocate for him in a way that I could not. It would be easy to think of the added responsibility as “one more thing added to the junk drawer,” but I chose to see it as a chance to learn another facet of advocacy. One more tool in my toolbox with the added bonus of helping someone in need. Sometimes case management is knowing that we are not the appropriate ones to meet their needs at that moment and facilitating the appropriate transition. This experience taught me that effective case management is balanced.
Case Management is a field where balance is key. When a case manager is able to effectively attain a work/life balance they are better able to think clearly and develop creative plans to help others. On a regular basis, I have individuals tell me “you are my angel” or “you saved my life.” Those are the moments when I know I am not a junk drawer; those moments remind me that case management is essential. These moments help provide balance to the moments when my toolbox is empty and I have used all of my tools with no success. Case managers must understand that we can’t fix everything.
In case management, the only constant is change. Change in expectations, change in work level, change in resources, just CHANGE. Case management is flexible. In every case management position, I have worked across different fields, being flexible wasn’t just a good idea, it was necessary. On any given day we may be asked to change the assessment we are using, the process we use, or the way we document something. COVID-19 has required more flexibility than ever before. But we are flexible with a purpose; as a case manager, we understand that our flexibility allows us to continue to provide the individuals the assistance they need no matter what changes we are being asked to make.
To me, thinking of case management as the junk drawer just doesn’t fit. The junk drawer has such a negative connotation. We are not junk. Sure, we are pulled in a lot of directions, and some days it may feel like things are just thrown on us continually. But if case management was the junk drawer we wouldn’t be given the opportunity to step up and meet the need. As case managers, we are optimistic and enthusiastic. We are the toolbox, the essential backbone of the care team. We use our tools of being organized, resourceful, flexible, creative, resilient, patient, tenacious, and balanced. We take on the tasks that no one else wants because we know they are essential and life-changing. The next time you start feeling like the junk drawer, remember—nothing about you is junk. Case management is definitely the toolbox.
Guest post from Jennifer Zentner, submitted as part of our “Case Management Is… Contest” and selected as an Honorable Mention!
Jennifer Zentner lives in Central Illinois and has 10 years of experience in the field. Jennifer has worked in a variety of agencies gaining experience with developmental disabilities, dual diagnosis, and at risk populations. Jennifer currently works in the managed care field and works primarily with at risk and aging populations.