Challenges for Aged Care in The Netherlands

Healthcare for in the Netherlands is stalled. Rising care demands and the shortage of tens of thousands of employees, create an untenable situation. The elderly must become more self-reliant, live at home longer and make greater use of technological innovation. Minister for Long-Term Care and Sport, Conny Helder (VVD), has presented her plans for a “transformation” of the sector before 2040. 

Various stakeholders in elderly care believe that the branch is due for restructuring. Today’s elderly are more vital and live longer, even with chronic diseases. Consequently, they want (and are able) to live independently for longer than the elderly of a generation ago. They want more control over their lives and if they need care, they don’t want this care to determine their lives, but to support them to continue living their regular lives.

The minister presented a new program: Housing, Support and Care for the Elderly (WOZO). This consists of various measures, initiatives and projects to ensure that elderly care continues to fit the elderly’s future needs and wishes. Through the WOZO program, the various parties in the elderly care sector are setting a new standard: do it yourself if possible, stay home if possible and deliver care digitally if possible. Stakeholders in elderly care are working towards a form of care and support in which the elderly are self-reliant as much as possible by (re)learning skills if necessary, staying fit, using aids and help from their environment. This model has proven itself successful in Denmark, for example.

Within the new program, technology and digitalisation are playing a leading role in the delivery of care. This involves a range of innovations like video calls with the district nurse, a robot that reminds you by voice to take medication or a sensor that alerts the nurse if you have fallen; innovation can increase the quality of care and relieve caregivers.

The principle that the elderly live at home until it is no longer possible requires the availability of suitable housing for the elderly and the provision of good, appropriate care at home. The goal of the WOZO program is to initiate a change in the coming years, turning the new norm into a reality throughout the Netherlands. This makes it a very ambitious program partly given our country’s scarcity of affordable housing. To support this transformation, the government is allocating over €770 million.

The urgency is great, it is expected that due to the ageing population, more and more people will rely on elder care in the coming years. At the same time, the number of people working in care and the number of informal caregivers will not increase at the same rate. The current shortage of care workers is partly due to the ageing population, but there is also the fact that healthcare institutions are not attractive employers for many (young) people. Minister Helder of Long-term Care (VVD) is therefore investing €500 million in the future-proof elderly care program in order to stimulate more job satisfaction and thus retention of employees. The success of the program depends greatly on employee participation. Engaged employees make the industry more attractive and simultaneously increase patient safety and the quality of care.

So in addition to plans to make the elderly more self-reliant, live longer at home and learn to make more use of technological innovation, the minister is also putting a lot of money into plans to make care more attractive to employees.

The plans of the minister will certainly help a group of elderly people well. However, strengthening the social networks of elderly people should be taken into greater consideration. It is one of the most important factors for the success of this model, as for many older people in particular, a lot of social contacts have been lost and not added.  The emergence of several distinctive private care facilities offers a pleasant alternative for those that can afford it and don’t need intensive care. The emphasis of these facilities is on fine living and the success of these houses is mainly due to the engaged employees who place emphasis on personal attention and are often more experienced than employees in public facilities.

 

The question remains: What if you need more intensive care? For this category of people, the “regular” nursing home often remains the only option, thus there must be enough places and staff to accommodate them.  In order to deliver high-quality care, Dutch nursing homes need to change course. Besides good care, more attention must be given to “looking at things differently.” Even if you need a lot of care, you are more than your illness. This is commonly known, but we don’t organise care around this principle. Giving hospitality and well-being plenty of room, that too will relieve the burden on care workers.

 

The future of elder care thus has several degrees:

  • At home, with digitisation and care when the clinical picture is primarily somati
  • In a private institution, with dementia or somatic syndromes when there is no complex multidisciplinary care needIn a (specialized) nursing home when complex care is needed