Case manager attitudes toward client-directed care.

Advocates for individuals with severe and long-term physical disabilities have lobbied aggressively in the U.S. and Canada for the implementation of Independent Provider Care (IPC). In this model of home support service delivery, the client assumes sole responsibility for the management and scheduling of his or her personal care and home support. This article reports on the findings of a Canadian survey that assessed case managers' beliefs regarding the efficacy, benefits, and risks to clients of an IPC program. Survey results indicated that case managers generally believed that IPC would not significantly improve their clients' well-being and quality of care, would pose risks of abuse to both the client and support attendant, and would result in greater job demands for case managers. Possible sources of their apprehension are identified, and measures that may help to alleviate their concerns are discussed.