Gert-Jan sleeps in his wheelchair for a few nights every week, because no one from home care is there to put him in bed. Only twice a week help comes to put it in and that is really incomprehensible to many people who hear that. How can such a thing happen? And what can home care itself do about this?
The story of Gert-Jan (67) has two sides. He himself feels shortchanged in the home care he now receives. Ruud Dijkers, board member of Thuiszorg West-Brabant, knows his situation but can say little about it with a view to privacy.
Showering every day is not medically necessary.
This does not alter the fact that some people in need receive much less home care than they would like and are therefore mainly dependent on help from their environment. Health care has been cut back, the number of home care workers is decreasing, while the number of people in need is only growing. So home care organizations need to assess more critically when someone needs their help.
This is mainly due to the difference between what the organization calls ‘medically justified’ or ‘medically necessary’. “Let me give an example”, Dijkers starts by explaining. “Suppose you want to be showered every day as a client. Then that is medically responsible, but not medically necessary.” Due to the cutbacks and staff shortages, this care task will be placed with the environment or informal carers, not with the home care organization.
However, Gert-Jan is not about showering every day, but about climbing in and out of bed. That weighs heavier than showering, but how heavy exactly depends on many different factors. “If someone is actually otherwise healthy, it is not medically necessary. But in the case of bedsores, it is. The choice depends on what is possible, what is responsible and what is insured.”
“We now have to focus on the medical part.”
In addition to this practical help, clients often need contact and guidance when they are at home. “That was still part of our concern a few years ago,” says the board member. Home care would then, for example, visit a patient after an operation, also to combat a bit of loneliness. “But due to the changes in healthcare, that is no longer possible. We now have to focus on the medical part, while clients, their children and informal carers would prefer to see it differently.”
This change places greater demands on the environment. Nowadays, clients are also discharged from the hospital earlier and the need for care at home is being assessed. “That is because there have been cutbacks, but our biggest bottleneck is the labor market,” says Dijkers. “We just don’t have enough people.”
“People sometimes expect more than what our job is.”
On the other hand, the number of elderly people is increasing. “Health care has to change because there are not enough people who want to work in health care,” says Dijkers. “But we don’t determine that, that’s up to the government and the health insurers. Until then, the demand for informal carers is simply greater and that’s difficult if you don’t have many people around you to absorb that.”
If the home situation is irresponsible or unsafe, the home care organization will always talk to the client, Dijkers emphasizes. “Only people sometimes expect more than what our job is.”
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2023-08-01 18:30:31
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