By STEPHANIE WATKINS on June 20, 2023
I once had a client who called me each week to update me about his life. I knew when his cable and WIFI were down over the weekend. Distraught, he would call me on Monday to fill me in. If you were to quiz me about his off-and-on relationship with his adult children, I would ace the test. I could even provide more info for extra credit! I knew so much about his aches and pains and feelings and thoughts that I could recite his complaints almost as well as he could.
And you know what? That’s part of the gig.
Case management can be an intense business. Depending on the caseload, it’s sometimes hard to keep the standard 9 to 5 hours when you’re fielding calls from MCOs, social workers, community service agencies, and other case managers. Progress notes and care plans are the easy part. Establishing boundaries with clients—who often have trust issues due to trauma, mental health issues, and/or substance use disorder—is, in my opinion, one of the most difficult parts of the job. So how does one build a bond with clients while maintaining clear boundaries?
– Draw a line
Frequent calls or unannounced visits that are more about socializing than the client’s care can be uncomfortable. And in some cases, dangerous. These scenarios call for a firm hand. When a client’s calls become persistent or their unplanned visits escalate, advise them that you will reach out to discuss any changes or updates in the status of their case. While you appreciate hearing from them, your work prohibits contact that has nothing to do with your client’s care and wellbeing.
– Suggest an alternative
As a case manager, you are familiar with personal aspects of your clients’ lives. For instance, you may know who their emergency contact is, or the name of the senior center your client likes to attend. When a client begins to fixate on you, don’t be afraid to ask about their familiar relationships or about the best friend they talked about when you first took on their case. Try to discover the reason behind their laser focus on you. If you can do that, you may be able to steer them toward a more appropriate alternative, such as various social or recreational activities.
– Start a brainstorming session
Ask the client questions to get to the bottom of the incessant calls or inappropriate visits. How are they feeling? Are they lonely? Bored? If anxious or depressed, perhaps you could refer them for mental health counseling. If they’re simply the impatient type, explain that obtaining community resources or entitlements takes time. Paperwork, even in this modern era, must go through various hands to be checked and rechecked before applications pass muster. Patience is key. Remind them that you will reach out as soon as you receive an update.
Bonding with clients while marking your boundaries is a necessary part of case management. Drawing clear lines, suggesting alternatives to inappropriate behavior, and brainstorming methods to help get clients’ what they’re seeking may help maintain the relationship, while enforcing limits.
| Stephanie Watkins is the owner and editor of BillableNotes.com, which focuses on case management, Medicaid coordination, and the health and human services industry. She lives in Brooklyn, New York. |
