Kelley M L, MacLean M J
Department of Social Work, Lakehead University, Thunder Bay, Ontario, Canada.
J Case Manag. 1997 Winter;6(4):174-82.
The research on long-term care for seniors clearly demonstrates that efforts to integrate urban case management services with elderly people living in rural settings have not been successful. Presenting findings of the Rural Seniors Assisted Living Study conducted in northwestern Ontario, Canada, this article demonstrates the complexity of providing health and social services for seniors living in small rural communities, services that are often vastly different from those provided in urban communities. The article proposes a specialized Rural Case Management approach with rural elderly clients and identifies four intervention roles: providing direct service, consulting extensively with specialists of other disciplines, constructing and supporting natural helping networks, and resource management. The approach also requires that the rural case manager assume a leadership role at the community level in the development of services for seniors. Having a locally based case manager rather that a case manager who travels out to rural areas from an urban center is essential to the success of this rural case management approach. Finally, the article contends that rural case management differs from urban case management by requiring specialized knowledge, skills and educational programs.
对老年人长期护理的研究清楚地表明，将城市个案管理服务与农村地区老年人相结合的努力并不成功。本文展示了在加拿大安大略省西北部进行的农村老年人辅助生活研究的结果，表明为生活在农村小社区的老年人提供健康和社会服务的复杂性，这些服务往往与城市社区提供的服务有很大不同。本文提出了一种针对农村老年客户的专门化农村个案管理方法，并确定了四个干预角色：提供直接服务、与其他学科的专家广泛咨询、构建和支持自然帮助网络以及资源管理。该方法还要求农村个案经理在为老年人开发服务方面在社区层面发挥领导作用。拥有一名本地个案经理而非从城市中心前往农村地区的个案经理对于这种农村个案管理方法的成功至关重要。最后，本文认为农村个案管理与城市个案管理不同，需要专门的知识、技能和教育项目。
