Reviving Traditional Retirement Homes: A Proposal by MPs Agema and Pouw

Elderly care was once well organised, say MPs Fleur Agema (PVV) and Nicki Pouw-Verweij (BBB) ​​in Agema’s office in the Chamber building. Long before someone became seriously in need of care, they registered for an assisted living home. Independent living, but in the adjacent retirement home for bingo, card evenings and the restaurant.

By the time independent living became more difficult, he or she moved to the retirement home itself. “In the morning, the elderly were washed, dressed, had their hair combed and then sat neatly with their teeth in place, waiting for visitors.” And if that was no longer possible, there was a place in the nursing home.

For the elderly it was “a beautiful and gradual transition,” the two MPs write in their private bill, in which they argue for a return to the traditional retirement home (or care home). The duo will present the proposal this Monday. They believe that the cutting of a large part of the approximately 1,200 care homes by the second Rutte cabinet (VVD/PvdA) was a big mistake.

The idea that there is ‘something missing between home and nursing home’ is widely supported

Pouw is still a practicing doctor in nursing home care and has been working on the subject since her arrival in national politics in 2021 – then before JA21. The politician, who recently switched to BBB, says: “I don’t get as many emails about anything as I do about the nursing home. Like: I’m 86 years old, I really want to go to a care home…” Agema talks about “emails from people over sixty. They are not talking about now, but about later. They think: wait a minute, what will happen in 2040? That’s slowly starting to dawn.”

From 2028 – there is still a lot of construction to be done – if it is up to Agema and Pouw, the elderly can return to the retirement home. Their private member’s bill regulates an adjustment of the indication for the elderly, so that they are eligible for the nursing home, which will need to add many hundreds.

Large-scale closure

Until the 1960s, there were hardly any facilities for the elderly. Elderly people were dependent on the support of their own children. With the Retirement Homes Act In 1963 the government took over care for the elderly, and retirement homes sprang up like mushrooms. In 2013, the Rutte II cabinet decided on a large-scale closure to halt growing healthcare costs. Elderly people had to live at home longer and sit at the kitchen table with a community nurse to determine what care was needed.

Two types of elderly care remained: at home (supplemented by community nursing and/or home care) and the nursing home. Many people fell through the cracks: too good for a nursing home, too bad to live at home. Agema and Pouw come up with one example after another. People with dementia who wander around the streets – sometimes naked. Neglected, hypothermic elderly people brought to the emergency department. Elderly people who fall victim to chatter tricks at the front door.

The idea that there is ‘something missing between home and nursing home’ is widely supported, say both MPs. The House recently adopted a motion by Pouw’s former party colleague, JA21 leader Joost Eerdmans, who argued for a ‘reintroduction of an intermediate provision’.

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‘Knarrenhofjes’

But opinions differ about how to fill the gap between home and nursing home. The outgoing cabinet focused on living independently for as long as possible, for example in ‘clustered living arrangements’ as service flats and ‘knarrenhofjes’ with communal areas and care at home. Outgoing minister Conny Helder (Long-term care, VVD) wrote to the House that today’s elderly people “have a different approach to life” than the elderly of the past. “People want to be independent for as long as possible, have control over their own lives and live in a place where they feel at home.”

But that is too much to ask for a large and ever-growing group of elderly people, says Agema. These are people “who have lost their way a bit” and increasingly older people who are in the early stages of dementia. “They shuffle across the gallery to do an errand, and the wallet is then simply placed in the basket at the front of the walker.” The demand for care is increasing rapidly, especially among people aged 75 and over. There are currently 1.6 million people over 75, but by 2070 there will be 3.1 million, according to figures from Statistics Netherlands.

Member of Parliament (BBB) ​​Nicki Pouw-Verweij It does not have to be with flower curtains and geraniums, as in the eighties. It could be more modern

Director Anneke Sipkens of the ANBO senior citizen’s association drew up this statement at the beginning of this year NPO Radio 1 that nursing homes are not a solution: “I don’t think we want to go back to the old-fashioned retirement homes, with long corridors and everything arranged.”

But, says Agema, that is not the intention. “It’s not about three hundred people in a long corridor.” Pouw: “It doesn’t have to be with flower curtains and geraniums, like grandma’s in the eighties. It could be a bit more modern.” Small-scale, for example sixteen rooms, but with a shared front door, living room and kitchen. Where someone keeps an eye on things day and night.

Costs: 600 million euros

The PVV and BBB plan will structurally cost around 600 million euros from 2028, an amount that both MPs derive from a calculation by the Central Planning Bureau (Care choices in Map) from 2020. The gross costs are much higher (2.6 billion), but this is offset by almost 2 billion in revenue effects (additional expenditure is partly recouped through additional tax revenue) on home care and community nursing, according to the CPB. In addition, Agema and Verweij expect savings of hundreds of millions on unnecessary hospital admissions of the elderly.

And what about the staff shortage that healthcare is already struggling with? That is “one of the smallest problems,” says Agema. “If all 1.4 million healthcare workers had to do less administration and work a few more hours, then there would no longer be a shortage.” In addition, a retirement home is much more efficient, because home care no longer has to “cycle from house to house,” says Pouw. “Ten, twelve addresses in one day!” Agema shouts. “Soon they will just go to work in a nursing home.”

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2023-11-12 20:31:01
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