Diffusion of low-tech equipment as a component of case managers' role
                         Fritz, Charlotte K.; PhD
                         UNIVERSITY OF MASSACHUSETTS BOSTON, 2001

                         GERONTOLOGY (0351)

                         The goal of this research was to determine if case managers can become effective in assessing for and
                         promoting the use of low-tech assistive equipment on the part of their home care clients. Elder-service
                         case managers from two Massachusetts Aging Service Access Points (ASAPs) were interviewed to
                         understand how case managers received this new job component. These case managers were
                         participants in a Robert Wood Johnson (RWJ)-sponsored demonstration and research project to provide
                         for low-tech equipment assessment and distribution. Analysis of the interviews was conducted using the
                         QSR NUD*IST qualitative software program. The Diffusion of Innovation framework (Rogers, 1995) was
                         applied to interpret the potential for adoption. Prior to the RWJ participation these case managers had
                         only been assessing and referring clients for limited types of assistive equipment (typically items used for
                         bathing and toileting). The greatest barrier to adoption proved to be that case managers were attempting
                         to recommend equipment without the benefit of ever having seen or tried the items themselves. While
                         the case managers believed that low-tech equipment would be beneficial to their clients, they were
                         generally not able to make arrangements for thorough assessments, follow-up, or minor assembly, or to
                         assist their clients with simple instruction when the equipment was delivered. Case managers also had
                         initial concerns regarding liability in case a client were injured on any equipment a case manager had
                         suggested. Some re-invention of the intended protocol occurred, as a number of case managers
                         recommended only one or two items (most typically, can openers and jar openers) to each client,
                         requiring no in-home assessment or instruction. Higher levels of adoption can likely be achieved with
                         stronger support from the state-level agency and by better framing the introduction of a new job
                         component within the existing elder-home care culture. Insights from the application of the Diffusion of
                         Innovation framework can aid other home care agencies in initiating or expanding equipment distribution
                         services, or in seeking to achieve maximum adoption of new roles or job responsibilities presented to
                         their case managers.


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