Diffusion of low -tech equipment as a component of case managers' role

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.