A case manager, who was relatively new to the practice, approached a more experienced colleague for advice on how to help a client. "Mary" was a woman in her 80s with Alzheimer's disease, whose condition had deteriorated to the point that her husband was struggling to care for her at home. As Mary's family made suggestions for next steps-from hiring in-home caregivers, which they could not afford, to finding a facility that specialized in care for patients with Alzheimer's disease-her husband seemed increasingly confused and unable to make a decision.
"He seems frozen in place," the new case manager told her colleague. "He told me he is afraid of making a mistake. What should I tell him? It's obvious that Mary's care has become too much for him."
Rather than coming up with a plan and simply telling the younger colleague what to do, the experienced colleague suggested that the root of the problem was a lack of information. Mary's husband needed more information about Alzheimer's disease as a progressive, terminal disease. The family needed to understand what options were realistic, given their finances and what Medicare would authorize and pay for. But that is not all; the new case manager also needed more information and support on how to advocate for individuals with complex needs.
"To make an informed decision, the family needs more information," the experienced case manager explained.
The family might be well served by sitting down with a hospice or palliative care organization. Perhaps you can help them identify two or three of these organizations for them to reach out to so they can find out more and make the right decision for them, given their goals and circumstances.
In taking the time to talk through the situation with the younger colleague, the experienced case manager emphasized the importance of being guided by ethical principles such as autonomy, which supports informed decision-making (Commission for Case Manager Certification [CCMC], 2015). The experienced case manager explained that, when faced with a serious illness affecting themselves or a loved one, people can feel paralyzed, afraid of making things worse instead of better. But when they receive more information, decision making becomes empowering.
Interestingly, the client-case manager dynamic being discussed also paralleled what was happening between the two colleagues. Through this conversation, the younger case manager received more information and felt supported in carrying out her responsibilities, which, in turn, enabled her to better advocate for Mary and her family.
This exchange between the two case management colleagues, based on actual events, is an example of the goal of developing others, one of three interconnected objectives for case managers identified by the CCMC. The first two are self-evident as professional goals: to get certified and stay certified. Getting certified is recognized as a "proxy for workforce readiness," which has become increasingly important in providing patient-centric, coordinated care (CCMC, 2022a, p.1). Staying certified acknowledges that the benefits of pursuing certification accrue over a case manager's career, with continuing education for renewal to stay relevant and support lifelong learning (CCMC, 2022b). Developing others speaks to being part of the overall case management community, in building one's own knowledge base while also supporting others who are joining the case management profession or are interested in doing so (CCMC, 2022c).
In recent conversations with case managers, I have noticed some are confused about what developing others entails. Some have the view that developing others should be the purview of those who are educators or trainers. Others believe that they are not able to help develop others because they are not in supervisory roles. What these case managers do not fully appreciate is that every professional case manager, whether they are newly certified or earned their credential many years ago, can play an important part in developing others. It starts by taking the time to answer questions and talk through scenarios.
Importantly, developing others is not about having all the answers. In fact, it can be very beneficial to all involved to seek out the information together and draw on evidence-based practice. At the same time, developing others can only happen when colleagues feel free to ask for information or clarification. Over the years, I have encountered colleagues who were reticent to ask a question because they were worried about "looking stupid" or being criticized for not knowing something. Sometimes this fear was exacerbated if they perceived a tone of condescension from a colleague who seemed too busy to be interrupted. I can recall being a young case manager and knowing who to avoid when I needed to ask a question.
No doubt such experiences and perceptions are familiar to many of us. As we recall how we felt at the time, we allow those former experiences to shape us as colleagues, mentors, and instructors. Now, we strive to be the go-to people when a colleague has a question because we know that sharing evidence-based information is good for case management practice and for our clients for whom we advocate. Here are a few things to consider in developing others in day-to-day practice:
* Establish the freedom to ask. Whenever I conduct a workshop or seminar, I tell attendees not to be afraid to ask anything. "The only stupid question is the one that isn't asked," I tell them. Similarly, I will often start a mentoring relationship by telling the mentee, "I do not know everything, and I'm not afraid to admit that. If I don't have the answer, I will find someone I can reach out to."
* Break down broad questions. At times, someone will ask a question that is too broad. To find out what someone wants to know, it is helpful to ask probative questions such as: What challenges are you facing? How are you being confronted with this issue? What does this situation look like? Such questions provide clarity and promote engagement. You discern gaps in knowledge or a misperception, which builds empathy for the person with the question. You develop others by helping build their knowledge.
* Provide options to consider. Make it a habit not to tell people what to do. People need options so they can make their own decisions, whether that is a client or a case management colleague. Among colleagues, resist the temptation to take over the case; collaborate and communicate with others instead. For both clients and colleagues, priorities are helping them understand their circumstances, providing realistic options, and supporting good decision-making.
Developing others can and, ideally, should happen in the course of our daily practice and interactions with colleagues. We discuss, explore, and investigate in free-flowing collegial conversation. When that exchange occurs between an experienced case manager and a younger colleague, it is never about just giving an answer; rather, it is engaging in the discussion. This brings to mind the old adage that advises us not to simply give someone a fish for a day but to teach them to fish for a lifetime.
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