Principles of intervention
The style of
intervention is psychosocial: the service aims to provide prompt, adequate
and coherent responses to patients' needs, practical as well as psychological
and social, while trying to alleviate and control their symptoms. Special
emphasis is given to integrating different interventions, such as
medication, family support, and social work. Case management, patient
advocacy, and welfare provision are key aspects of these interventions.
Another aim is to ensure continuity of care, as reported above. One way of pursuing this aim is to promote trusting and stable personal relationships between staff and patients.
Special attention is paid to the most disabled and difficult to manage, as well as to chronic patients: apart from the case manager, two or three other staff members are assigned to each patient, so that one is available at any given time, in spite of turnover, shifts and leave. These patients are regularly assessed and treatment plans are revised accordingly.
Recurrent family complaints about being overburdened and in need of respite from caring for the patient are not very common, probably because of the strong social role of the family in Italy. When they occur they are taken seriously and worked through.
The evaluation of users' needs is routine in South-Verona, and the commitment to meeting them well established. Over the years, the Service has acquired considerable resources and facilities to meet such needs. New types of worker have come on to the scene: the educatore professionale (counsellor), the operatore di assistenza (support care provider), the assistente domiciliare (housekeeper). In addition, a comprehensive range of treatment and welfare opportunities are available to users, and there is a growing call to co-ordinate interventions and rationalise resources as a natural consequence of the increasing complexity of the system. Thus, a frequent problem of contemporary case management, besides the issue of finding more resources or establishing new services, is about how to use existing resources in a directed and co-ordinated way, making optimum use of costly staff time.