The Netherlands, as it happens, ranks among the top in long-term care provision among developed countries. However, Covid-19 has had and continues to have an impact on the shortage of healthcare professionals in the Netherlands. Due to a shortage of personnel in the Dutch health care system more nurses are in demand each year. This means that there are plenty of opportunities for nurses to find their standing. Unlike other countries, the Netherlands has a culture where elderly care institutions and homes are common. These healthcare facilities are part of the formal care culture. Over 18% of the population is above 65 years old. They are in the high-risk group and therefore require more care than ever. In this blog we will explain why people-centered health care such as home care and senior housing are so popular in the Netherlands.
What exactly are home care and homes for the elderly?
Because of high living standards and relative welfare in the Netherlands, state-of-the art home care programs and elderly homes are, mainly, financed by municipality or the state. Also, a part is covered by the patient’s contribution. Annually, 600,000 (approximately) people make use of Dutch home care services. The most common problems faced by elderly people, as a result of old age and chronic conditions, are loneliness and functional problems (think mobility and self-care problems). This makes it difficult for the elderly to live independently at home. Due to the increasing aging of the Dutch population (the percentage in the demographic of 65+ is projected to grow from 18 percent right now to 26 percent in 2040). The number of people with age-related diseases will increase in the coming decades. Among these diseases are dementia, diabetes, vision, and hearing disorders. Therefore, it is important for the healthcare sector to gain enough qualified healthcare professionals in the years to come.
The Dutch system is financed by the Dutch social security system and health insurance companies. Everyone in The Netherlands is obligated to have a health insurance, however people below a certain income limit are entitled to health care benefits. Anyone who needs constant supervision has the right to be placed in residential care. These are facilities for people with high-level care needs, like vulnerable elderly people or people with severe mental or physical disabilities. Clients are assessed and awarded a place on medical grounds under the Chronic Care Act (Wet langdurige zorg). The high-level care system is set out in the Chronic Care Act (WLZ). Hence the demand for health professionals specialized in elderly care is high.
Home care: The role of a nurse working in homecare
On our Instagram page you can watch a video on what it is like to work in homecare. Helana takes us through a day in the life of a homecare nurse.
The word may explain the meaning. Home care depicts a set of measures that are taken to care for a patient in their home. If a client does not need to be hospitalized but still requires long-term or temporary medical care, they are able to receive home care which is called Thuiszorg.
For instance, when a baby is born, it is possible for the parents to opt for a nurse to help with the care at home (“kraamzorg”). Depending on the situation, 24-80 hours of kraamzorg are administered. As often is the case with home care, it is financed by the health insurer.
Furthermore, the elderly and mentally or physically disabled are eligible for long-term assistance at home. For example, if you cannot go to a hairdresser due to a particular handicap, home care will arrange one to come to your home.
Homes for the elderly (verzorgingshuizen or bejaardentehuizen)
The Dutch government wants its citizens to live as long as possible at home: this is also the wish of the elderly themselves. Temporary elderly care can be considered as a form of home care. Senior citizens who need 24/7 care are entitled to a place in homes for the elderly.
Dutch senior citizen homes are designed to fit the needs and wishes of elderly citizens. Not only is health care arranged for effectively and personalized in such homes, but the rooms are also furnished with the wishes of the residents in mind.
Formal vs informal care
Care in the Netherlands is divided between formal (e.g. publicly- or privately-paid homecare professionals) and informal caregivers (e.g. spouses, children, friends). Formal care is a very important form of care. Research reveals that a vast majority of nurses in the Netherlands feel attracted to this type of integrated care (Maurits et al., 2018). Dutch rate the quality of the health care system and their personal health as good (Kroneman et al., 2016).
Home‐care nurses with a bachelor’s degree have the legal authority to perform the formal needs assessment, where they determine what nursing‐care and personal‐care services are needed. Within home care, they collaborate closely with nurses with an associate degree and certified nursing assistants. In the care for individual patients, home‐care nurses are required to promote self‐management by the patient and co‐operate with informal carers.
Home care and homes for the elderly are high-quality features of an overall well-functioning Dutch health care system. Yet, there are problems and challenges concerning the individualizing Dutch society which promotes formal care and often neglects the role of family caregiving. The increasing ageing populations request innovative policies and initiatives, dedicated professionals, participating elderly, and evidence-based procedures. So, whilst taxes in the Netherlands are higher than other countries the direct out-of-pocket costs of care are lower. This means that the elderly is well taken care off by the system. For healthcare professionals it may be interesting to note that during times of crisis like the current pandemic, the government has implemented tax-free bonuses (Dutchnews.nl).
Dutchnews.nl (2020). Healthcare workers to get €1,000 tax-free bonus, unions call for structural pay rise. https://www.dutchnews.nl/news/2020/06/healthcare-workers-to-get-e1000-tax-free-bonus-unions-call-for-structural-pay-rise/
Kroneman, M., Boerma, W., van den Berg, M., Groenewegen, P., de Jong, J., & van Ginneken, E. (2016). Netherlands: health system review.
Maurits, E. E., de Veer, A. J., Groenewegen, P. P., & Francke, A. L. (2018). Attractiveness of people‐centered and integrated Dutch Home Care: A nationwide survey among nurses. Health & social care in the community, 26(4), e523-e531.
WHO. (2015). WHO global strategy on people-centered and integrated health services: Interim report. Geneva: World Health Organization.