Title:	Older Case Management Clients and Younger Family Members in Need of Care
Investigator:	Elizabeth Essex, Principal Investigator
Funding Source:	John A. Hartford Foundation/Gerontological Society of America
Start/End Dates:	September 2002-August 2004
Description:	Case management is used by many states to assess eligibility and develop care plans for publicly-funded, community-based services for frail older adults at risk for institutionalization.  Their focus is on the older adult and their assessments center around the older adult’s service needs.  In some cases, however, the client co-resides with a family member under age 60 who is also in need of care because of a disability or chronic health problem.  Other times, the client co-resides with minor children, such as great grandchildren.  When multiple dependencies exist, optimal case management must ext3ent the focus beyond the older adult.  Younger family members and their caregivers may have unmet needs for support, or there may be a need for coordination between service systems, such as the aging services and child welfare systems.  Currently, little is known about this vulnerable population of case management adults and their families, their prevalence, and how to serve them.  The aim o f this cross-sectional study is to build a preliminary knowledge base about urban older case management clients who live with younger family members in need of care and about their needs.    The sample will be recruited from the caseload of a publicly-funded case management unit in Chicago.  Up to 80 subjects will be interviewed over an 18 month period, with two sub-samples representing two caregiving configurations: 1) cases where the client is the primary caregiver for the co-resident minor child(ren) or younger adult(s) in need of care; and 2) cases where a family member or close friend is primary caregiver for the client and the younger dependent invidivual(s).  The theoretical framework for the study reflects stress process theory, research on reciprocity between caregivers and c are receivers, and literature regarding problems in social service delivery to older adults and their family members.
Title:	Using Client Satisfaction to Improve Case Management Services for the Elderly
Investigator:	Chang-ming Hsieh
Funding Source:	John A. Hartford Foundation/Gerontological Society of America
Start/End Dates:	September 2003-August 2005
Description:	Client satisfaction has long been an important part of program evaluation.  Although the quality of a program can not be represented by client satisfaction alone, client satisfaction is often accepted as an important indicator of program or service quality.  There have been, however, a number of limitations regarding client satisfaction studies, including 1) the use of measures that are not contextually specific, 2) the predominantly positive responses which are not very helpful for service providers to make sense of the data without comparing the results with other agencies or conducting surveys longitudinally, 3) the multidimensional nature of client satisfaction, and 4) the problematic assumption of equal weight among all survey items.  To surmount these limitations, this research will use a client-centered approach to measure client satisfaction.  Client satisfaction data will be collected that can provide concrete feedback to service providers, enabling them to improve their case management services to the elderly.  Management setting this research project will overcome these limitations.