Negotiation Training for Case Managers to Improve Older Adult Acceptance of Services

Abstract

Purpose of Study: Older adults frequently choose not to accept recommended social support services (e.g., caregiver and home therapy). Social workers/case managers (SWs/CMs) are often caught in the conflict encouraging patients to accept services, but facing resistance. As a result, older adults may experience unsafe home scenarios and hospital discharges. This research sought to examine whether business school negotiation and dispute resolution (NDR) training could ease these conflicts and potentially improve outcomes for both older adults and SWs/CMs. Practice Settings: Urban health care system (pilot), national case management conference (implementation). Methodology and Sample: Researchers tailored the NDR training, offered at graduate business schools, for SWs/CMs. Researchers then pilot tested the NDR training at an urban hospital and implemented it with a national cohort of SWs/CMs at a national case management conference. Participants completed a survey that ascertained conflicts, utility of the NDR program, real-world applicability, and future directions. Results: Eighty-five SW/CM participants, from 22 states, completed the NDR training and survey. Participants reported experiencing conflicts frequently in their workday. Post-NDR training, respondents were very positive about the knowledge gained from the course, specifically noting themes of learning the negotiation basics, tactics (e.g., framing), and integrative strategies (e.g., win-win/expanding to multi-issue discussions). All participants planned to use the NDR skills in the future. Implications for Case Management Practice: The NDR training program can provide SWs/CMs with formal strategies to facilitate older adults' acceptance of social services while balancing patient autonomy. Learning negotiating techniques can be “win-win” for both older adults' home safety and case manager well-being.

Emotional Universe of Nurse Case Managers Regarding Care for Elderly at Risk in Spain: A Hermeneutical Study

“…The NCM feel resignation and attrition when the EAR refuses care, such as home caregivers or a place in a residence. Campbell et al reported [ 74 ] how older adults often choose not to accept recommended social support services.…”

“…However, as they refer in their speeches, the NCM are resigned to these refusals, basically, because of the recognition of the principle of autonomy. These experiences are reflected in the study of Campbell et al [ 74 ] who state that case managers have the task of organizing support services for older adults, balancing their right to self-determination/autonomy with the maintenance of their security and that of the community.…”

“…Reinhoudt-den Boer et al reflected [ 75 ] the emotional experience of these professionals when they find how their negotiation attempts do not led to the expected results. Recent studies [ 74 , 76 ] describe interventions related to the humanization of care and negotiation that are capable of overcoming these conflicts.…”

Characterizing Caregiver Roles and Conflict in Health Management Support to Older People With Multiple Chronic Conditions

“…One strategy clinicians utilized to respond to conflict was to assume a collaborative approach involving validation of both older adults' and caregivers' experience, while facilitating shared decisionmaking. In addition, recent studies have used negotiation training to help clinicians navigate conflict with older adults when encountering resistance (Campbell et al, 2020(Campbell et al, , 2021; similar approaches could be used with caregivers. Ultimately, managing MCCs is a collaboration between older adults, clinicians, and caregivers that often requires compromise.…”

Concierge Nurse Case Manager

“…Many have financial resources to meet monthly bills, mortgage, and so on, in addition to hiring of a full-time or part-time caregiver or attendant, but do not know where to begin the process. One small study done in 2021 by Campbell et al 6 looked at the importance of case manager negotiation skills when providing services or placement to skeptical seniors. These researchers identified 4 challenges for case managers: (1) skilled placement that patients are against, (2) differing goals between seniors and their families, (3) challenges when the family and the medical team are not on the same page, (4) an ideological conflict based on “patient wishes are taught to be paramount” (despite unsafe), and (5) when goals of treatment are in conflict.…”