Living independently for longer

Living at home for as long as possible with help from the municipality

Municipalities are responsible for ensuring that people are able to live independently and participate in society for as long as possible. The municipality looks at what people living with disabilities can still do for themselves, and how family, friends or neighbours can help.

If required, the municipality can offer assistance at home under the 2015 Social Support Act (Wet maatchappelijke ondersteuning 2015), like a programme of daily activities, home help or support for informal carers. It can also offer general information and advice.

Enabling the elderly to live independently

A person is able to live independently if they are able to perform basic day-to-day activities and run their household adequately. Basic day-to-day activities that are important for living independently are:

• getting in and out of bed;
• getting dressed and undressed;
• moving around;
• walking;
• sitting down and getting up again;
• personal hygiene and grooming;
• using the toilet;
• eating and drinking;
• taking medication;
• relaxing;
• engaging in social contact.

If someone can’t perform these activities because of their physical and/or mental limitations, they will require assistance. If they need so much assistance that it would be irresponsible for them to be without supervision and help, they may not be able to continue living at home.

Older people and social participation

Social participation means that older people, despite physical and/or mental limitations, can:

• meet other people (to a limited extent);
• maintain contact with other people;
• do the shopping;
• take part in social activities.

In order to participate in society people must be mobile. The municipality can provide support with these activities and help older people live independently for longer.

Living at home for as long as possible with help from district nurses

Under the Healthcare Insurance Act (Zorgverzekeringswet), healthcare insurers are responsible for home care right up to and immediately after hospital admission. This gives care providers and insurers greater scope for setting up integrated care, for example when discharging or admitting a patient.

Under the Healthcare Insurance Act, people can receive medical care (and nursing) at home. Personal care, such as help with washing, is also covered under the Act. District nurses are responsible for arranging such care. They assess the care needed and draw up a care plan together with the client. Home care and personal care are covered by the standard care package. The mandatory excess does not apply to these services.

Qualifying for district nursing for the elderly

District nursing can help older people with health problems live at home for longer. Those who currently require medical care or are very likely to do so in future are entitled to see a district nurse. This means that all personal nursing and regular nursing care is now the task of district nurses. The classification system used in the Exceptional Medical Expenses Act (Algemene Wet Bijzondere Ziektekosten) no longer applies.

The phrase ‘very likely to [require medical care]’ gives scope for the provision of personal care alone, for example help with getting in and out of bed and washing. This will enable older people who have no medical issues, but are at risk of developing them, to stay living at home for as long as possible.

District nursing is community-based

The main task of district nurses is to provide care. This includes liaising with the municipality and coordinating the client’s care needs. District nurses offer locally-based support in the form of medical care and help with welfare and housing issues. They offer people in the community:

• easy access to assistance;
• a single point of contact;
• better coordinated care;
• direct referral to other care providers.

Assessment under the Chronic Care Act: residential facility or care at home

People who require 24-hour care or supervision are entitled to a place in a residential facility, which offers high-level care for the vulnerable elderly or people with disabilities. They are assessed and awarded a place on medical grounds under the Chronic Care Act (Wet langdurige zorg).

People with a care needs assessment for residential care can continue to live at home, as long as proper care can be provided and the costs for care at home do not exceed the costs of residential care.

Independent for longer, thanks to ICT

An increasing number of ICT applications are being developed that improve people’s comfort and quality of life. For example, there are tools for opening and closing curtains automatically. These applications are known as home automation and they can help older people live independently for longer.