Home care in the Netherlands

If you are in need of medical care but don’t have to stay in hospital, you can apply for a wide range of home care services. More than half a million people in the Netherlands live in nursing homes, or use home care (thuiszorg) or maternity care (kraamzorg). However, at the moment there are severe staff shortages in the care sector, so that it may be impossible to get help, or for fewer hours than would be ideal.

The government’s policy in recent years has been to help as many elderly people as possible to live in their own homes, as this is cheaper than living in nursing or care homes. If you live at home and are elderly or disabled, you get assistance from home care organisations. In order to arrange this, the fi rst step is to visit your GP (huisarts) to discuss your needs.

Next, an assessment is made of the needs you have, as well as how family, friends and neighbours can assist. As a result, most home care consists of a mixed program of care by professional providers and help around the house from informal carers, called mantelzorg. Professional carers will be able to help with simple medical tasks, such as changing wound dressings, handing out medication and taking blood pressure readings. They can also provide assistance with a wide variety of day-to-day activities, such as getting in and out of bed, dressing and undressing, going outside, eating and drinking, using the toilet and personal hygiene. Those depending on home care can also receive shopping assistance and dietary advice. If necessary, other care providers will visit you at home, such as physiotherapists, mental health professionals et cetera. As the main providers of care, district nurses (wijkzorg) are the fi rst point of contact and liaison with the municipality – who may pay for this care – to coordinate a client’s needs. They also stay in touch with family and friends and other informal caregivers. To fi nd a home care worker, ask your doctor or check zorgkaartnederland.nl/thuiszorg (in Dutch). It is also possible to receive home care for a short period of time, for example if you’ve just been discharged from hospital and are not yet able to fully take care of yourself. This is usually arranged by the hospital before you are discharged. By law (the Zorgverzekeringswet) healthcare insurers are responsible for care at home. Home care may therefore be covered by your insurance and/or supplemented by your municipality. You may also have to pay some expenses out of pocket, but these may be reimbursed if they are covered by your additional insurance (aanvullende verzekering). If you can no longer live at home, you may be admitted to a nursing or care home. These often have waiting lists, so it’s worthwhile to check the options before the situation at home becomes untenable. Your GP can help you fi nd the best option and get on a waiting list.

When you are pregnant, you will be asked if you want to deliver your baby in a hospital or at home. The Netherlands boasts a high number of home deliveries : giving birth is considered a natural process, that should be done with as little outside intervention (including medication) as possible. However, the number of home births is dropping and stands now at 13% of all births.

After giving birth, the mother will receive professional help at home (kraamzorg) for a maximum of 49 hours spread over 8 days. A nurse looks after the mother and infant, helps around the house, gives guidance on breastfeeding and looks after other children. Note that you have to arrange kraamzorg with a specifi c organization early in your pregnancy. It is covered by your health insurance, apart from a small contribution that you will have to pay yourself.

When registering with your GP, you will also be required to register with a pharmacy. Prescriptions issued by your GP will be sent directly to your pharmacy, which will check for possible problems (e.g. medications that cannot be taken together). Depending on your insurance package, the bill may be sent automatically to your insurer; otherwise, you will have to pay fi rst and then make a claim with your insurance. Many pharmacies offer drop-off services delivering medication to your home free of charge. Another possibility is to pick up medication after pharmacy hours from a secure pick-up box.

Our modern building at the front of HMC Westeinde provides services to pregnant women, those seeking to become pregnant, parents or carers and children up to the age of 18. Here in the heart of The Hague, our care providers deliver the best possible care tailored to each person’s individual situation.

Mother and child Worry-free pregnancies, happy babies and healthy children. That is what we are committed to at the HMC Sara de Bronovo Mother and Child Centre. But we are also here to provide support and excellent care to those struggling to conceive. Or when pregnancies do not go smoothly, or a child needs treatment.

Suites and facilities Our private suites at the Mother and Child Centre are adapted to each person’s circumstances and needs. Luxury suites are designed with a homely atmosphere, with plenty of daylight. Parent and child can remain together day and night. The suites also o er su icient space and facilities for all medical care, so there is no need to leave the room to shower or to feed or wash the baby. Central areas o er 24/7 facilities to get something to eat or heat up food. And those staying at the Mother and Child Centre can choose when we come to clean the room.

Family Integrated Care The Mother and Child Centre marks another step towards Family Integrated Care. This means that care is not just focused on the child and the parents, but also actively involves them. This way, the family stays together as much as possible and the parents remain in control wherever possible. This also helps smooth the transition to home. ‘Who do you want to have present at the birth?’ ‘What are your wishes in terms of your pregnancy and giving birth at our hospital?’ And in the case of older children: ‘What does the child need?’ We provide objective information on the options and treatments, enabling our patients to make informed decisions. This includes pain relief during childbirth, or the options for the safest way to give birth.

Care At the Mother and Child Centre we o er: + Delivery rooms + Obstetrics triage room + Family suites + Children’s ward + Children’s day care treatment

Patients are admitted to these departments, including in the case of emergencies. For a scheduled check-up, such as a pregnancy check-up or a consultation with a paediatrician, pregnant women and patients can contact the gynaecology outpatient clinic (at the HMC Westeinde and HMC Bronovo locations) and the paediatrics outpatient clinic (HMC Westeinde, Bronovo or Wassenaar peripheral outpatient clinic).

Specialists A specialist team is available at the Mother and Child Centre 24 hours a day.

Giving birth Giving birth at the Mother and Child Centre means: + Several luxury birthing pools available + A wide range of pain relief options, with epidurals available 24/7 + The right medical care providers available 24/7 + Homely private suites fully equipped for parent(s) and baby + A partner is always able to stay to eat and sleep

Child Advisory Board At the Mother and Child Centre we feel it is important to learn from the experiences of children in our department. We have a Child Advisory Board (kinderadviesraad) to help us view the care and processes in the department from the child’s perspective. The Child Advisory Board is made up of six children of di erent ages who are happy to advise us. The Child Advisory Board has provided us with input on issues such as the wall art in our new Mother and Child Centre and the toys and entertainment that are essential to a stay in the children’s ward. Parking Patients and visitors can park in the car park at the back of HMC Westeinde. If labour is progressing very rapidly or in an emergency, you can park your car temporarily in the specially reserved emergency parking spaces at the front entrance (Lijnbaan).

Confidence When the patient and/or family is ready to be discharged from the Mother and Child Centre, we will arrange a taxi if necessary and walk them to the exit. Everyone returning home from the HMC Sara de Bronovo Mother and Child Centre can do so with full confidence!

More information? www.haaglandenmc.nl/giving-birth

Would you like to know more about information meetings for expats? Contact Nanda Jagusiak-Monteiro, Expat Coordinator E n.jagusiakmonteiro@haaglandenmc.nl

Foreign Business Financial issues can be discussed with the employees of the Centrale Kas. E Foreign-business@haaglandenmc.nl Telephone hours of business: Tuesday and Thursday 10.00 - 12.00 am T +31 (0)88 979 29 00 T +31 (0)88 97 97 900

Nanda Jagusiak-Monteiro

www.haaglandenmc.nl info@haaglandenmc.nl

Care for pregnant women, those seeking to become pregnant, parents and carers, and children aged up to 18 is integrated as much as possible at the HMC Sara de Bronovo Mother and Child Centre.

Gynaecologist Kim Boers has been involved in female and child healthcare at HMC for many years and has worked at HMC for almost two decades.

Kim says: “What has been the biggest change in mother and child care in the last few years? It has to be that we have centralised clinical obstetric care in one place: at HMC Westeinde. Instead of two teams of nurses and doctors in two locations, Bronovo and Westeinde, we now have one large specialist team. We have joined forces, which means we can do even more for mothers and prospective mothers in The Hague and surrounding areas. This is especially important these days, where there is a lack of capacity in many fields. The Mother and Child Centre brings all our ambitions together!”

The Mother and Child Centre marks another step towards Family Integrated Care, explains Kim. “This means that care is not just focused on the child and the parents, but also actively involves them. We want to ensure that the family stays together as much as possible and the parents remain in control wherever possible. This also helps to smoothen the transition to home. Previously, as professionals, we issued advice based on our areas of expertise. Now we involve the patient and family in the process from the outset. ‘Who do you want to have present at the birth?’ ‘What are your wishes in terms of your pregnancy and giving birth at our hospital?’ And in the case of older children: ‘What does the child need?’ In the children advisory board, children participated in choices we had to make for the Mother and Child Centre. We provide objective information on the options and treatments, enabling our patients to make informed decisions. This includes pain relief during childbirth, or options for the safest way to give birth.”

One aspect that is strongly supported at the Mother and Child Centre is the option to give birth in a pool. Interest in pool births has risen sharply in recent years. The HMC Sara de Bronovo Mother and Child Centre will offer no fewer than six luxury, adjustable birthing pools, so that all pregnant women wanting to deliver their baby in a pool can do so.

“We are also further expanding the possibilities for home monitoring”, says Kim. “Pregnant women with a medical indication who would usually be admitted to hospital can stay at home longer. They can record the baby’s heartbeat in the womb themselves at home. They speak on the phone every day to the HMC midwives, who monitor and assess the situation remotely in consultation with the doctor. It’s a lot less stressful than being admitted to hospital. We adopted this innovation many years ago, but it fits extremely well in these modern times of transition in health care. Who doesn’t want to be in her own surrounding when extra monitoring is necessary?”

Regarding plans for the future, Kim explains: “For 2023 we will focus more closely on Value Based Health Care, where patient-reported outcomes and experiences are incorporated in our care pathways. And of course try to constantly evaluate and improve care for mother and child.”