Termination Case Management

In this paper I will describe the criteria and strategies for termination of case management. I will also discuss how independent care will help in continued client growth. The process focuses on discontinuing case management when the client transitions to the highest level of function, the best possible outcome has been attained, or the needs/desires of the client change.

Criteria for termination of case management The termination of case management may include but is not limited to the following:

• The injured worker achieves maximal medical improvement as determined by the authorized treating physician.

• The case is determined by the payor to no longer meet the criteria for case management.

• The case management assignment has been for

It is common for both the case manager and the client to respond emotionally to termination of the case management relationship. How each responds to the termination is influenced by experiences of the past, the intensity of the client/case management relationship, and the circumstances which precipitate termination. Case managers need to examine their personal responses to separation and loss so that they can be aware of how those feelings may impact decisions to terminate case management services (Annemarie,

The ideal condition for discharge occurs when the client has met his or her desired outcomes and the case manager and client mutually agree that there is no longer a need for case management services. In this instance, discharge may be viewed as the client’s “graduation” to a more independent way of life (Rothman, 1998). At other times, circumstances that result in termination of case management services may be less than ideal. For example, the client may lose eligibility for the service before reaching desired outcomes or the case manager may be unable to continue the relationship due to client non-compliance, lack of progress towards established goals, or health and safety concerns.

Other strategy may begin a relationship with a client knowing that some degree of intervention will be required on a long-term, open-ended basis. Intervention may be needed due to the physical, mental, or emotional condition of the client or may be related to the client’s circumstances such as poverty, abusive relationships, or capacity. An example would be case management services offered to a person who is diagnosed with AIDS. The client may function quite independently except at various crisis points during which the case manager may need to provide fairly intensive