Although the case management programmes in this
study have developed separately and in different regions
of the country, this study on case management for people
with dementia shows that the motives, aims and
main characteristics of case management are comparable.
All the programmes offer services that focus on increasing
the continuity and integration of primary, specialty,
mental and long-term health care. The programmes are
crossing these boundaries for people living in the community
and are being client and caregiver focused.
The ‘intensive case management model’ as described
by Challis et al. (2001) and Banks (2004) corresponds
most closely to the programmes investigated here. The
shared core tasks model covers ‘usual care’ in The
Netherlands and appears insufficient as usual care often
lacks continuity and long-term support. Three programmes
also correspond with the joint agency model,
in which case management is embedded in a MDT.
However, in our study, the case managers’ tasks do not
rotate among team members, but are delegated to one
responsible case manager, usually a specialist nurse or
social worker. When comparing the case management
programmes with care arrangements in other countries,
like the UK and Canada, it shows that the diversity of
programmes in those two countries is large. However,
the case managers in this study confirm that case management
suits complex groups such as people with
dementia. Challis et al. (2006) suggest that the presence
of case management programmes can be seen as an indicator
of the fragmentation of healthcare systems.