A Case Management Model for Community-Dwelling Older Adults at Moderate Risk for Institutionalization

Many gerontologists base their philosophical framework on a philosophy that encapsulates designing and implementing social interventions that enhance opportunities for older adults to build self-esteem, personal control, individual and social involvement, and social action. The older adult population is expected to grow exponentially over the next 50 years, yet the United States does not have the financial resources to sustain this large group with the same services they have for the current cohort. In order to save money and elongate physical health in longevity, preventive measures must become commonplace. New research is indicating a reduction in morbidity, mortality, and long-term institutionalization when seniors at a moderate risk for institutionalization are supported with community resources and case management services while living in the community. Traditionally, older adults could only receive government-sponsored case management when they were high risk and the long-term benefits were fewer. I was asked by a local nonprofit senior service entity to develop a case management program for their use. The nonprofit agency had learned that a subset of the older adult population did not qualify for any services; consequently, the staff were trying to fill the gap. I recommended a program design to LifeCare and other similar nonprofit organizations to meet the needs of older adults living in the community at moderate risk for institutionalization. This program design is fashioned after the Modified Community-based Long-term Care Model and considers key design elements such as funding resources, staffing requirements, and ethical concerns. This program could reshape the lives of seniors, empower them more, and promote healthier and longer-lasting community living with potentially significant cost savings to the United States.