The Dutch babyboomers are now ‘wrinklies’ and ready to retire. The percentage of old people is growing rapidly and care for the elderly is under pressure. Although the Netherlands is a rich country, sick and frail old people are not getting the care they need from nursing homes.

“I’m not sending my father to a home” writes Job van Amerongen, himself a nurse, in an emotional article in national daily de Volkskrant. For now, his mother is looking after her husband, who suffers from dementia.

Carers and managers
He says the problems in geriatric care touch him deeply: “As a nurse I was trained to believe you should aspire to provide the same kind of care you would give a loved one. But that’s no longer really feasible.”
Old people in care homes just about get food and drink and a shower occasionally, he says, but that’s all.

Van Amerongen, who is a political scientist as well as a nurse, believes the fundamental problem is that most people working in old people’s homes have not been trained as nurses. These carers, nearly all women, are doing work that is physically and psychologically too much for them. They are badly paid, have no opportunities for additional training and hardly ever get any sign of appreciation. The offices of the care institutions they work for, on the other hand, are full of well-paid managers with little understanding of the daily work.

He is calling for better wages for care workers, the pruning of unnecessary managers and more investment in education and training.

Inspiration
Care sector expert Anneke Francke of VU University Amsterdam says not all institutions are that bad. She acknowledges a great deal of Van Amerongen’s criticism, but argues that the situation is not that black and white. Small-scale homes do provide good care, particularly where there is little bureaucracy and there are good staffing levels.

The quality of management makes a big difference, she adds. Inspired and inspiring team leaders and bosses can really set good examples in an institution. Francke has noticed, however, that the quality of care somehow improves as patients near the end of their lives. Suddenly, a lot more can be done for them.

Freedom
How can care for the elderly be so bad in a rich country like the Netherlands? Van Amerongen:
“Apparently this is all it’s worth to us. I don’t think it’s good either, that the government has withdrawn from care in recent years and institutions have been given much more freedom about how they spend their money.”
From his point of view, some of those choices have turned out quite disastrous.

Job van Amerongen is prepared to take over from his mother if she is no longer able to look after her husband. He knows how tough that can be, but he won’t be putting his father in a home.

(imm)