✅ Reviewed for accuracy and relevance by Deanna Cooper Gillingham, RN, CCM, FCM on July 22, 2025.
Health Literacy for Case Managers
Health literacy is the ability to obtain, communicate, process and understand basic health information. Patients can have difficulty following instructions after a doctors visit or hospitalization, or may take mediations wrong due to lack of understanding. This can lead to serious health problems.
Knowing if the patient has low health literacy enables the Case Manager to adjust instructions to the ability of the patient. Signs that a patient may have low health literacy include stating that another family member handles their medications or deferring questions about their health history to a family member.
The Case Manager can also assess health literacy by asking questions such as:
- Does someone usually help you read hospital materials?
- Are you confident filling out medical forms by yourself?
- How often do you have problems learning about your medical conditions
There are also formal Health literacy tests including TOFHLA (Test of Functional Health Literacy Assessment) and The Newest Vital Sign, a quick screening test for general literacy, numeracy and comprehension skills related to health information.
Effective case management requires an awareness of each client’s education needs. Even highly educated individuals may not grasp medical terminology, understand treatment plans, or recognize early signs of complications. Identifying and addressing these knowledge gaps helps clients make informed decisions and follow through on recommended care.
Language barriers can further complicate communication. Clients may not speak English as their first language, or they may have vision or hearing impairments, resulting in misunderstandings that go undetected when clients nod in agreement. Providing an interpreter, translated materials, or resources for sensory impairments can help ensure information is understood.
Address language barriers – Clarify the client’s preferred language early. Arrange for professional interpreters or translated materials when needed. Watch for clues of low understanding, such as referring all questions to a family member.
Consider special populations – When working with older adults, be mindful of vision, hearing, or cognitive changes that complicate health literacy. Assess for cultural factors that may influence learning styles, decision-making, or willingness to ask questions.
This article shares a portion of the information covered on this topic in CCM Certification Made Easy, 4th Edition by Deanna Cooper Gillingham, RN, CCM, FCM (2025). For more details on this topic and related concepts, purchase your copy at CCMCertificationMadeEasy.com
