Does the organisational model of dementia case management make a difference in satisfaction with case management and caregiver burden? An evaluation study.

José M Peeters,Anne Margriet Pot,Anneke L Francke,Peter M Spreeuwenberg,Jacomine De Lange

doi:10.1186/s12877-016-0237-y

Abstract

BackgroundIn the Netherlands, various organisational models of dementia case management exist. In this study the following four models are distinguished, based on differences in the availability of the service and in the case management function: Model 1: the case management service is available from first dementia symptoms + is always a separate specialist function; Model 2: the case management service is only available after a formal dementia diagnosis + is always a separate specialist function; Model 3: the case management service is available from first dementia symptoms + is often a combined function; Model 4: the case management service is only available after a formal dementia diagnosis + is often a combined function. The objectives of this study are to give insight into whether satisfaction with dementia case management and the development of caregiver burden depend on the organisational model.MethodsA survey was carried out in regional dementia care networks in the Netherlands among 554 informal carers for people with dementia at the start of case management (response of 85 %), and one year later. Descriptive statistics and multilevel models were used to analyse the data.ResultsThe satisfaction with the case manager was high in general (an average of 8.0 within a possible range of 1 to 10), although the caregiver burden did not decrease in the first year after starting with case management. No differences were found between the four organisational models regarding the development of caregiver burden. However, statistically significant differences (p < 0.05) were found regarding satisfaction: informal carers in the organisational model where case management is only available after formal diagnosis of dementia and is often a combined function had on average the lowest satisfaction scores. Nevertheless, the satisfaction of informal carers within all organisational models was high (ranging from 7.51 to 8.40 within a range of 1 to 10).ConclusionsOrganisational features of case management seem to make little or no difference to the development in caregiver burden and the satisfaction of informal carers. Future research is needed to explore whether the individual characteristics of the case managers themselves are associated with case management outcomes.

Highlights

In the Netherlands, various organisational models of dementia case management exist
Driven by the ongoing discussions in practice and policy about which organisational models for case management are most appropriate in dementia care, the main objective of this paper is to give insight into whether satisfaction with case management and the development of caregiver burden depend on the organisational model of case management
Four of the 13 dementia care networks that participated in this study delivered case management according to organisational model 1, three networks according to model 2, three networks according to model 3, and three networks according to organisational model 4

Summary

Introduction

In the Netherlands, various organisational models of dementia case management exist. The objectives of this study are to give insight into whether satisfaction with dementia case management and the development of caregiver burden depend on the organisational model. Mood, behavioural and personality changes in the person with dementia are often very challenging and many informal carers experience a high caregiver burden [5, 6]. This may, for instance, be manifested in feelings of having too many responsibilities, having difficulty combining a job and care tasks, and psychological problems [7]

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