Home care or care home: the elderly decide

Care for the elderly is going to change but it won’t be an Armageddon for the old, says Barend van Lieshout

The separation between care and living arrangements means the all-in care for the elderly is on its way out. The elderly are supposed to stay in their homes for longer and any care they need will take place there. The media meanwhile have been showing pictures of boarded-up care homes, worried elderly people, administrators clamouring for money and angry opposition members.

Care for the elderly is going to change, that much is certain, but to suggest we are on the verge of an elderly Armageddon is taking it too far: the care home of today is not going anywhere, it will just have a different name on the door.

Until recently, elderly people who could no longer live independently were entitled to go into a home which came with an all-in package of care, food and housing. For the lightest cases among them this is no longer the case. From now on, these elderly will be cared for in their own homes.


For those who catered for this group, things are going to change drastically. Big care locations are no longer assured of the guaranteed custom of the elderly in search of a diminishing care supply. Home care can be procured anywhere. Does advice bureau Berenschot have a point then and will care providers go bankrupt in their hundreds because of the depreciation of empty buildings? Will the housing corporations need billions to build replacement homes for all those elderly who will be chucked out?

Of course not. The only thing the panic mongering media have achieved is to highlight that our view of the care sector has been skewed by years of rules and regulations. These rules and regulations have been in place so long we no longer know what the elderly really need.

The elderly already had the opportunity to remain at home with more home care or to move to a home without thresholds as early as last year. The elderly who chose to go into a care home evidently preferred the package it offered (or decided it was the best alternative in their worsening circumstances).


This is not surprising because although the move to a care home is often very difficult emotionally, it has many advantages. There are no staircases or thresholds to negotiate and the apartments have been adapted for disabled residents. Appropriate care is close by and personal. Meals, washing and cleaning are all provided. There are other, like-minded people.

Why would the need for this sort of environment suddenly disappear? Of course, the whole exercise is meant to save money so costs will have to come down. The elderly will have to pay for many of the services and will therefore be more selective. Care providers will have to adapt their business model accordingly and cater to a smaller market with critical customers.

If they do, it is unlikely that hundreds of buildings will stand empty: the property has already been invested in. Some providers will go under perhaps, but they will be the ones who have not been able to provide a sufficiently attractive package to the customer.

The last thing we need is a subsidy from the state. The sector will then look to The Hague once again. We must not deprive ourselves of a chance to put in place the type of care for the elderly which really takes their needs into account.

Barend van Lieshout is a health advisor at Rebel


Thank you for donating to DutchNews.nl.

We could not provide the Dutch News service, and keep it free of charge, without the generous support of our readers. Your donations allow us to report on issues you tell us matter, and provide you with a summary of the most important Dutch news each day.

Make a donation