1. MISSION STATEMENT of CoornhertCentrum
CoornhertCentrum is a socially involved and a market oriented service-organisation that provides a coherent offer of living, care and welfare products to consumers who are living (in)dependently.
The question of the consumer is the focal point.
One works from a humanistic vision: 'think personally, live together'
Essential values are:
respect
independence
responsibility
self-determination care
participation
CoornhertCentrum is a partner in 'Adagia, humanistic alliance for living, care and welfare The Hague and its environs'.
2. FACTS & FIGURES - CoornhertCentrum in 2002
The humanistic centre for living, care and welfare CoornhertCentrum is located at the Erasmusplein, centrally situated in the district Moerwijk in the south west area of The Hague.
CoornhertCentrum is one of the larger care-providers of The Hague and accommodates 171 elderly people. The building consists of 13 floors with 153 spacious single apartments and 9 double apartments. There are shop facilities and green areas in the vicinity of CoornhertCentrum and it is easy accessible by public transport.
Every day more than a hundred older people that are living independently make use of the restaurant, day care, short term care, district infirmary, so called Bridge Care and the ‘Zeker Thuis®’-care by subscription among other things. Separate brochures of CoornhertCentrum-products are or will be available.
The staff exists out of 150 people (95 full time equivalent)
CoornhertCentrum: living, care and welfare
CoornhertCentrum has a large range of products with reference to living, care and welfare:
Living
Spacious apartments, a menu of choice, the Coornhert-shop, laundry service, dry cleaner's, communal garden, hotel rooms, hairdresser's, tailor, restaurant, CoornhertCash (banking-system).
Care
A coordinating care provider, nursing, group care, personal care, care plan, domestic maintenance of the apartments, alarm system, appliances, physiotherapy, General Practitioner consulting hours, laboratory services, hearing aid facilities, pedicurist, thrombosis service.
Welfare
Program of activities and entertainment, humanistic mental care, excursions, outings, dedication of volunteers, billiards, library, CoornhertInfoTelevision, Internet corner.
A day care centre is available for local children.
CoornhertCentrum: community care
The local elderly can make use of the facilities and services of CoornhertCentrum:
day care, for support and as a get-together
Zeker Thuis®care by subscription
residential restaurant
Bridge Care for future residents
short term admission
district infirmary
Quality
The CoornhertCentrum has developed itself into an authoritative dynamic living and care
company.
In December of 1999 CoornhertCentrum has been given the Living Care Quality Label. This label is based on the model of the Corporation of Harmonisation of the Quality Promotion in the care sector in The Netherlands. The quality of care and welfare and its implementation by CoornhertCentrum was given a very good evaluation.
In april 2002 the ‘Zeker Thuis®’-care by subscription was awarded with ZorgMerk: it accords to a national standard of not-for-profit care by subscription.
3. FUTURE POLICY - CoornhertCentrum in 2010
In 2010 CoornhertCentrum is a socially involved and a market oriented service organisation that provides a coherent offer of living, care and welfare products to consumers who are living (in)dependently. These products are offered in (administrative) coherence with other providers, in order to guarantee a total package.
CoornhertCentrum no longer offers institutional capacity. There are spaces created in the building for some communities of clients with i.e. psycho-geriatric or psychiatric problems.
The building consists of an attractive accommodation on the ground floor with for instance a restaurant, a super market, a pharmacy, a General Practice, physiotherapy, a day care centre, a crèche and a customer service place for living, care and welfare. The ground floor has a natural 'single counter' function. Some of the floors have short stay accommodations, office and work spaces and general (rental) spaces.
The other floors consist of apartments of high quality in the (30 % social) rental sector and in the purchase sector aimed at the over fifty. There is room for communal living, groups with a distinctive life style and other groups.
If living independently is no longer possible temporarily, a large amount of short stay facilities is available (i.e. day care, short term care, district infirmary, hospice care, interval admissions, rehabilitation and a care hotel).
Only in the exceptional cases in which living independently is no longer possible (heavy nursing home care or long-term specialist medical treatment) institutional admission will be arranged.
The range of products varies from giving information (the support of the Living care zone), alarm system, activities, social contacts, planned and unplanned care, domestic care, physical care up to case management, optimally supported by the newest technologies.
Employees are the biggest capital of the service-organisation. They have a broadeducation and work with optimal independence in area oriented teams and get a maximum of opportunities to unfold their talents.
The consumer acquires through indication ('AWBZ' financing) or on his own initiative (in accordance with the market) products of the service-organisation or of other providers on the free market.
4. CARE PRODUCTS IN THE NETHERLANDS
The officially description for care-products related to residential care and the ground for financing is as follows:
Old age home admission
Product: 701 Short-term old age home admission
A coordinated offer of integrated care services, accommodation and supervision, 24 hrs availability during a short period of time, in aid of the clients who are living independently. The essence of the integrated offer is the direction take-over when necessary.
Product: 702 Old age home admission
A coordinated offer of integrated care services, accommodation and supervision, 24 hrs availability in aid of the permanent residents of an old age home. The essence of the integrated offer is the direction take-over when necessary.
Product: 703 Supplementary nursing home care
The offer of supplementary care to permanent residents of an old age home (with slight to moderate psycho geriatric problems), in order to prevent or delay admission to a nursing home.
Semi-mural facilities
Product: 601 Day care
An offer of organised activities and the possibility to make use of various facilities of the old age home.
Product: 603 Night care
A coordinated offer of integrated care services and supervision during one night or several nights a week, to clients in order for them to be able to function independently in the home situation.
Product: 606 Night nursing
A coordinated offer of integrated treatment, nursing, care and supervision in an intramural setting during the night to clients who are living independently and are in need of complex care, in order for them to be able to function in the home situation.
Product: 610 Day nursing
A coordinated offer of integrated care services and supervision during one night or several nights a week to (slightly psycho geriatric) older people, in order for them to be able to function in the home situation.
Day nursing is a kind of nursing that among other things is supplied within the framework of the abolishment or the prevention of social isolation, support of the home situation, reactivation respectively resocialisation of the older people, or the bridging of a period until definite intramural admission.
Day nursing tries to encourage the physical, mental and social well-being of the clients.
5. DEVELOPMENTS IN SUPPLY AND DEMAND
Question trends
Demographic developments
The Netherlands will age rapidly the coming years. More and more people are getting old. In the next 10 years the number of 75 year olds will increase with almost 15 %, i.e. 140.000 people. At this moment more than 12 % of this age group is living in an old age home and almost 5 % in a nursing home. If the policy doesn't change this means that the demand for admission to an old age home or a nursing home will increase the coming 10 years with approximately 20.000 persons. If we take into account certain syndromes, that form an important ground for admission to an old age or a nursing home, this number could even become higher.
The expectation is that the coming 10 years the increase of the number of people who become senile will increase with more than 10 % and that this number will even double in the coming 30 years. One can also expect that - due to demographic developments – heart and vascular diseases, CVA, different kinds of cancer, diabetes, sensory disorders, cara and motion apparatus disorders,will increase a lot ('Room for care – Research of the Future, November 2000). Depression also is a syndrome that will occur progressively.
From a nursing state to a consumer's society.
The demand for admission to an old age or an nursing home will not increase consistently with demographic changes. In general it is considered that the construction of more intra-mural facilities should not be the only answer to the increase in demand of care. This has to do with other life styles and the preferences of clients and their recognition. It is expected that the older people of the future, even more than at this present time, will strive for a life style aimed at independence and a complete sense of well-being, at more outdoor activities and more recreation and sports. The mobility, the participation in voluntary work and the politico-social involvement will increase as well. This development will be the strongest with the over-fifties. (SCP, 1998 / 'Room for care – Research of the future')
Clients will become more critical and more emancipated also as a result of a higher level of education and bigger financial possibilities. This is supported by the client legislation that has strengthened the position of clients since the eighties and also the changing forms of demand-oriented ways of finance. Together with a better availability of information this has led to a more equivalent social status of social workers and clients.
Although the trends mentioned above are definitely visible, it is necessary to make a marginal note. It is uncertain how these trends will translate themselves when people really become in need of care and be dependent on others. Practice has shown that the course of a disease can be so radical that many older people lose their direction skills. Realism is very important. Especially in relation to the increasing number of 'old elderly' (75+) given the demographic developments: an increase of 33 % in 2015, with an even bigger growth after that.
This however applies to the bigger financial possibilities as well. The group of elderly people with minimum wages does not decrease and there is a large group that has no or insufficient pension build up!
Supply trends
As an answer to the question trends mentioned above several supply trends are recognizable. These trends start by reformulating the visions of care. In addition a new intermediary function seems to derive from it; this function is crucial to achieve a continuous fine tuningbetween supply and demand on the individual level to avoid a new 'facility based organisation'. Finally new organisation schemes and forms of cooperation will originate that will enable a complete, client based supply.
Changing visions of care
Care providers make use of these developments and reformulate their vision of care. Two of the main aspects are: the demand for care is individually determined and the demand for care has an integral nature.
The demand of the client is defined individually by the developments mentioned above and therefore has a more diverse character. In the visions of care there is more eye for the individual and his of her unique preference and life style. The attention for privacy derives from this as well. Terms like ' course of life, autonomy and meaning of life' will occur more often in the vision of care.
Additionally care providers are setting the (care) problems in their vision of care in a wider context of the well-being of the client. People in need of care want sociability, contact with family and friends, want to make a trip once in a while, read a good book or see a movie etc. The individual demand is thereby defined more broadly; the human as a whole is the centre, the demand for care is part of a much larger demand. Opposite this undivided demand care providers are placing a complete offer of care, welfare and living services.
This integral approach has also led to the awareness that parts of the supply might work as communicating vessels. Several parts of the supply are put in in such a way that the scales are balanced for the client (towards financial strength and burden). This will make room for a more preventive approach, in which welfare plays an important role. For instance the participation in numerous activities by older people who are living independently prevents solitude, depression and therefore a lot of distress, and can prevent a demand for care.
An adjusted house, with or without advanced technology, complementary care and welfare services can accomplish that an older person in need of care can lead an independent and satisfactory life for many years. When this is no longer possible a switch to a more concen-trated form of living can be more appropriate. This will provide for more possibilities to give these groups, who run the risk of becoming less mobile and lonelier through sickness or handicaps, a good climate of well-being.
This integral approach also has a better eye for the social environment and the cover care of the client. If the continuation of living independently means that contact with family and friends / acquaintances stays intact, it is a benefit for the client. Therefore care can also be aiming at the support of cover care. This informal way of care – although very pressurised – is of high importance, especially with the current shortage of personnel.
The tuning of supply and demand
To shape the tuning of the supply to the demand on the individual client level in a correct way, a specific (intermediary) function is being created more and more. This applies to a large diversity of functions in several denominators. This can be primarily responsible care-takers / nurses), the elderly advisor, case managers or course supervisors.
The necessity of these functions reveals that the persons in demand of care can not always be the director; professional insight in the processes of illnessis required to shape the supply in the appropriate way.
Seen from the perspective of care these 'agents' fulfil several essential functions:
the monitoring of the demand for care and the processes of illness, the active anticipation
tothe future demand for care, as well as the supervision of the client (monitoring, super-
vision & prevention)
the arrangement of (and the application of coherence to) the supply of care (coordinate
function)
advising the client at formulating the demand for care (advisory function)
These functions are essential to prevent facility orientation (supply orientation).
Through continuous dialogue and tuning one can avoid that a client must make abrupt transfers to another facility due to crisis situations.
6. HOUSING APPLICATION OF THE FUTURE SENIOR
The senior in ten years time is expected to manifest himself as less and less old. The senior will be more vital than the old person of not so long ago, and will try to get more out of life in the spiritual sense. This is shown already by the increase of internet use among seniors.
In future the senior will use the technology in other areas as well, like communication, safety and comfort.
Life styles will be elementary for the wishes and demands that seniors make of their house and its environment. Important differences will be found in image, the need of contacts ànd in the need of care. The group of 'young' seniors (from 55 to 64) certainly will not yet profile itself with care. Housing concepts in which living and care services are not connectedare more suitable to this group. Thinking about types of living adjacent to care servicesor situated in one complex becomes more important at the age of 65 and up. In formulating the senior concepts a distinction has been drawn between care at a distance (extramural care) and nearby care (intramural care).
One can formulate a number of requirements that a house for seniors should conform to:
a living room, a bedroom and a bathroom on the ground floor. When there is a staircase
present, it must be possible to install a chairlift
at least 2 or 3 bedrooms
a spacious living room of at least 25-40 square metre
a bathroom with rugged tiles and a shower with ample space for a seat
a private outside space like a garden, balcony or terrace
sufficient security of the accommodation (burglar-proof fastenings, videophone, door secu-
rity etc.). It must be possible to see who is waiting outside
the resident should be able to see the outside world from a sitting position