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<p>Abstract</p> <p>Neoliberalism and the new managerialism have become entrenched in Canadian social policy. This paper is an examination of how neoliberal philosophy and the new managerialism are embodied in case managers’ tools. The setting for this research is Veterans Affairs Canada. Presently, Veterans Affairs Canada is in the process of transforming policy and practice. Veterans Affairs Canada has implemented a managerial business model as the foundation of its transformation initiative.</p> <p>This research examines how the ruling relations of the macro level have infiltrated the local practice of case managers. Institutional ethnography is utilized to examine the texts used by case managers. It is important to research the relationship between case managers’ tools and managerialism in order to understand impacts on the role, practice and discretion of case managers. Only by having a full understanding of the relationship between the underlying power structures of neoliberalism and managerialism can social workers fully appreciate the negative impacts to client service. Through this understanding, social workers can more effectively advocate for their clients and find ways to implement change.</p> / Master of Social Work (MSW)

Homeless research has focused on the service-directed approach, but few qualitative studies have focused on the critical and sensitive nature of the intake process. Staff in rural and remote communities struggle to refer services and mainstream resources to homeless veterans. The purpose of this case study was to explore case managers' perspectives on intake procedures in rural Pennsylvania communities. Lewin's force field analysis was used as a theoretical basis to examine the rationale for behaviors and forces that impact an individual's state. Six case managers and 1 supervisor were selected for face-to-face interviews based on their experience, job duties, and length of time involved in homeless services. The themes that emerged from coding analysis included coordinated entry, paperwork length and redundancy, geographical barriers including transportation and employment services, identification and outreach, and case management staff. Findings may be used to improve assessment techniques and critical time intervention strategies to reduce the length of homelessness for rural veterans.

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<p>With government pressure to cut healthcare costs, the hospital sector in Ontario has directed increased attention to moving patients out of the hospital as soon as they are deemed not to require acute care. Discharge planning has become a highly measured and managed process facilitated by social workers and Community Care Case Managers. The purpose of this thesis is to look at the experiences of hospital social workers and CCAC case managers and the common (and distinct) ways they experience their discharge planning roles and responsibilities. Information was obtained from two focus groups: one with hospital social workers and the other, with hospital CCAC case managers. Themes from the focus group of social workers emerged that illustrated the ‘heat’ in discharge planning and the implications this pressure had on patients and families, and the role of social work. Two dominant sources of pressure on discharge planning were the provincial focus on reducing wait times and organizational performance markers related to patients’ length of stay. Social workers voiced their concerns about government rhetoric and the inadequacies in community resources for ‘aging at home’, constrained choices and coerced caregiving that had implications for patients and families. CCAC case managers experienced similar pressures to discharge patients quickly while wanting more time to spend with them so that they could arrange the most appropriate services and care plans. CCAC case managers described the unique experience of working in an organization that is not their employer and having to facilitate ‘their’ discharge planning policies. This study looked at the inter-professional relations between social workers and CCAC case managers and how professional identity impacts the role of discharge planning. Social workers associated a certain “character” as needed to stand up against a system that is not always working in the best interests of patients and families.</p> / Master of Social Work (MSW)

Yes / Community-based case managers in health have been compared to glue which holds the dynamic needs of clients to a disjointed range of health and social services. However, case manager roles are difficult to understand due to poorly defined roles, confusing terminology, and low visibility in New Zealand. This review aims to map the landscape of case management work to advance workforce planning by clarifying the jobs, roles, and relationships of case managers in Aotearoa New Zealand (NZ). Methods: Our scoping and mapping review includes peer-reviewed articles, grey literature sources, and interview data from 15 case managers. Data was charted iteratively until convergent patterns emerged and distinctive roles identified. Results: A rich and diverse body of literature describing and evaluating case management work in NZ (n = 148) is uncovered with at least 38 different job titles recorded. 18 distinctive roles are further analyzed with sufficient data to explore the research question. Social ecology maps highlight diverse interprofessional and intersectoral relationships. Conclusions: Significant innovation and adaptations are evident in this field, particularly in the last five years. Case managers also known as health navigators, play a pivotal but often undervalued role in NZ health care, through their interprofessional and intersectoral relationships. Their work is often unrecognised which impedes workforce development and the promotion of person-centered and integrated health care. / This research was funded by the AUT University, Faculty of Health & Environmental Sciences Summer Student Grant 2021/2022 and the School of Public Health and Interdisciplinary Studies PBRF Funding 2021. The APC charge is covered by the School of Public Health and Interdisciplinary Studies PBRF 2022.

The study aims to describe and analyse how case managers reflect and act in the regards to self-determination when caring for residents with dementia diagnosis. Our main questions dealt with how the case managers handle the right to self-determination in relation to the residents’ relatives’ opinions when a person has dementia. To find answers to our questions, we interviewed seven care takers within elderly care in four different municipalitys in the Southern Sweden. We used qualitative interviews based on a semi-structured interview guide and two vignettes. The vignettes were based on two fictive narratives which both included persons with dementia but with different relatives and opinions. The purpose of the vignettes were to investigate whether there was different perceptions among the case managers in terms of consideration the residents’ self-determination in relation to their relatives. The results of the study were analyzed using Hasenfeld’s theory on Human service organizations, Lipsky’s street-level bureaucracy and Strauss’ negotiation-perspective. We displayed similarities to previous research showing that the case managers work with the residents’ best interest in mind even though relatives can be very obstinate. Our main conclusions are that the interpretation of self-determination is fluidity according to the case managers is fluidity and the case managers at some occasions try to persuade the person with dementia to apply for care and welfare. Furthermore can the relatives of the person with dementia be both beneficial and disadvantageous depending of the relation between them.

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