Photographer:Fotograaf: Joey Roberts
The media have been full of negative messages about nursing homes for a while, sighs Jos Schols, professor of Nursing Home Medicine. He refers to the recent pamphlet in the AD newspaper by football journalist Hugo Borst, who appeals for less bureaucracy and more care for his mother who is suffering from dementia. Or the commotion surrounding the nursing home Careyn in Hellevoetsluis at the beginning of November; the home had drawn up a toilet contract for its residents, allowing them a maximum of three toilet visits a day. And then the other stories: senior citizens were being left in their pyjamas for a large part of the day, having to eat what they are given, not being allowed to bring much of their personal belongings to the home, having no privacy and last but not least, a nursing home supposedly being the waiting room for death.
“Obviously there are incidences,” says Schols, “and they need to be dealt with.” But that toilet contract story, for example, has been blown completely out of proportion. The facts are that the restricted toilet visiting times apply to a few residents (out of a total of sixty) who are suffering from dementia – who keep forgetting that they have just been to the toilet – and everything has been recorded in a so-called care/living plan. In consultation with the family. Such plans also include what the persons involved like to eat, how often they would like to shower each week, which activities they would like to undertake every week, et cetera.
Whether the news messages are true or not, they confirm the negative image of nursing homes. Schols feels that this is totally unjustified. “This bad image is completely at odds with all the changes that we have set in motion since the beginning of the nineteen-nineties. We should be proud of this sector.”
He sums up the innovations: large-scale homes, such as Klevarie in Maastricht, where for years “four hundred senior citizens were put away,” will be (or have already been) demolished and replaced by several small-scale health care institutes spread across the regions. “In many cases, people can continue to live in their own village. The living communities are more homely, cosier and – very important – a great deal more attention is being paid to the residents and their family. Where in the past the elderly had to adapt to the rhythm of the care providers, it is now the other way around. If someone wants to go outside regularly or continue to be a member of an association, we try to organise that. If family members want to stay for dinner, they can do so. We have learned lessons from the hospitality approach in the hotel sector. And as far as privacy is concerned, the days when you used to share a room with a few other people without your own personal stuff, are definitely over. We don’t just want to add more days to a person’s life, we want to add life to a person’s days.”
So why is there so much criticism about nursing homes? Schols: “In the past four or five years, many nursing homes have closed down by order of the government. The current policy is that people should stay at home as long as possible. When it is no longer possible and the mother or father eventually has to go into a nursing home, the family - who have in many cases being providing voluntary care - is at the end of its tether. They are happy that the nursing home has taken over the care, but at the same time suffer from feelings of guilt. Being admitted to a nursing home is never nice. What the family will do is scrutinise the home. If something goes wrong or if the care does not meet with their expectations, they are tremendously disappointed, feelings of guilt are playing up and they become angry: surely they shouldn’t have been allowed to do this to their mother or father. And of course things do go wrong sometimes, but if the parents had still lived at home, accidents would have happened there too, that is part of life.” The solution? “Nursing homes should take the time to prepare new residents and their families. What are their expectations? What is realistic? And make it clear that the family will continue to play a role. Not as care provider, but to go for a walk, visit friends or a day out.” And don’t misunderstand Schols: there are certainly matters that can and should be improved. “But join forces. Grumbling at each other doesn’t work.”
One last remark: “We have always had many nursing and care homes in Northern Europe. In Southern and Eastern Europe, but also in countries such as China, children always looked after their parents at home. That is changing now. They want information about how we look after the elderly and are impressed when they visit Dutch nursing homes. They are learning from us.”
This is a series in which academics shoot down popular myths