C A S E M A N AG E M E N T
The importance of working with clients and their families While the role of the case manager is to support their c l i e n t , t h e i nvo l ve m e n t a n d needs of their partner and family can be fundamental to the situation being a success.
and frequent contact with the case manager and other health professionals? This is what our clients have to go through when they instruct a solicitor to pursue a claim for personal injury. On one visit, many years ago, I was told that the couple only faced up to the reality of what had happened when I visited. They otherwise tried to mask the enormity of the change in their lives and lived tandem lifestyles which left the client feeling isolated by his wife and not supported.
From high-flyer to carer
Here, Virginia Bowley, case manager with ILS Case Management, discusses how this can be difficult to achieve – but the end result can be hugely beneficial for all parties Being a case manager, I have often wondered how I would react to having health professionals coming into my life and talking about many aspects of my personal and private life, with the details then being reported to others. What would it be like to give up any control over what I did because someone else thought it might benefit me? How would my partner react to time-consuming meetings
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I worked with a client who sustained a spinal injury and whose wife had a very well-paid senior role. She was used to being in charge of matters and delegating tasks to others. She enjoyed her job and had worked hard to achieve her position. When her husband was injured, she wanted to be as involved as possible in his care and support which jeopardised her work prospects. As a result, she reluctantly decided to leave her job. She made this decision with real sadness, and it was a source of deep frustration for her. I quickly needed to ‘tune in’ to what the client’s wife needed from me as the case manager. She was highly organised, time focussed and, frankly, quite intimidating! I decided to have a meeting with her to talk about what aspects she wanted me to do, and which she wanted to be in control of. I realised, to make this work and to avoid duplication of tasks, that excellent communication between us was of key importance. The client was struggling to come to terms with his catastrophic injury and sadly became very depressed, as a result it was difficult for him to engage with anything proposed. His wife was very keen to find something that might capture his attention and help him in his recovery. The difference in their personalities was stark. Given that I was my client’s advocate, and that I was not working for the client’s wife, I needed to reflect on what approach I needed take to effectively move things forward. We decided to work on hobbies that the client previously
enjoyed, and with the help of an Occupational Therapist, agreed goals were drawn up to help him overcome the barriers he was now facing in doing what he used to enjoy. Thankfully, we were able to establish a working relationship where the client’s wife felt supported by me as case manager for the benefit of her husband’s rehabilitation.
Anger needing to be managed On another case, my client was a father of four children. He was living with extreme pain following a road traffic accident in which he was injured. Despite being safe to be left on his own for short periods, he demanded that his wife stayed with him rather than go to work. His children were not allowed to have friends in the house, for fear of him becoming angry with them, and he had a low tolerance to auditory stimuli meaning that the TV and any other form of noise had to be kept to a minimum at all times. The controlling behaviour had a devastating impact on his wife, who eventually stated that unless he accepted paid care support, she would leave him. The anguish my client’s wife was feeling was clear to see, as she had aspirations to progress her career in the educational field. However, the anger and determination in my client was also evident as he seemingly wanted to keep his wife from having any freedom. I had to carefully navigate my way through their seemingly unsurmountable differences in order to get the best result for my client and his family. It took time to resolve, but the wife’s ultimatum stirred my client into action and he did begin to realise that not only would he have lost the life he used to have, but he stood to lose his family as well. He reached a point where he was able to accept the importance for his wife to be able to return to work part-time, and he agreed that we could arrange for external paid carers to support him whilst she was at work.