Welcome to the information page of Aedes-Actiz Kenniscentrum Wonen-Zorg, the knowledge centre for housing and care. Here you will find information on various developments in the Netherlands with respect to combined housing, care and welfare, as well as the government policy and different housing concepts offered for combined housing and care. Links to English versions of selected Dutch websites are given where available.
You will find the following subjects on this webpage:
- Demographic trends
- The housing requirement
- The Dutch approach
- Concepts combining housing and care
- About Kenniscentrum and it's partners
- For further information
Between now and 2035, the population of the Netherlands will continue to increase from 16.3 million (2005) to an estimated 17.1 million, after which the numbers will gradually decrease to 16.8 million in 2050, although figures may vary by region.
The percentage of residents of aged 65 and over will peak at 25% around the year 2040, followed by a gradual decrease to 23.6 % in 2050.
|Year||Dutch population||Number of residents 55 and over||% of total population||Number of residents 65 and over||% of total pouplation|
Table 1: Population forecast for the Netherlands. Source: CBS Statline 2006
|Year||Native Dutch||Non-western ethnic minorities||% of non-western ethnic minority residents 65 and over|
Table 2: Forecasted number of ethnic minority senior citizens. Source: CBS Statline 2006
The housing requirement
Compared to 20 years ago, it is relatively uncommon for Dutch seniors to live in a nursing home. These days, senior citizens generally live in single-family dwellings and want to stay there. Over 96% of Dutch residents 55 and over and 93% of those 65 and over live independently.
If seniors are to continue living independently, their homes must be adapted to their needs. For instance, an additional toilet can be installed on the same floor as the bedroom or home automation can be installed. One-third (100,000) of all severely disabled persons aged 65 and over live in regular homes that have interior staircases and that have not been adapted to their needs. In 2004, one-fifth of all seniors (about 750,000 people) lived in some 500,000 adapted homes.
In 2006, there were 1.48 million homes in the Netherlands whose outdoor entrance and main rooms were accessible without the use of stairs. The government aims to build more of these homes in the future.
Society cannot permit seniors to live independently for longer unless care and welfare facilities are also made available in the community, in addition to a sufficient supply of adapted homes. Popular housing solutions include projects with integrated neighbourhood services and sheltered housing projects (i.e. full-service lifetime housing estates).
Information relating to combined housing, care and welfare also applies in addition to seniors to the mentally disabled, mentally ill or recovered mentally ill, persons with acquired brain damage and those who rely on shelters in the community. Nowadays, an effort is made to realise as much housing as possible in regular residential areas, instead of in secluded areas, which was once common practice. Homes are often part of small-scale housing projects, where the occupants can actively participate in society through social activities and work. This trend is also referred to as 'community care'.
The Dutch Approach
As of the present time (2007), the Dutch government is delegating more and more of its duties and responsibilities to the local authorities. Housing, care and welfare are no exception. At the same time, promoting a free market is also a key issue. The local authorities are increasingly assuming the role of director within the local sphere of influence.
The governments housing policy takes several approaches to addressing the growing demand for accommodation for residents/senior citizens. One of the policys cornerstones is to enable senior citizens to continue living independently for as long as possible.
- Increasing supply
The government has called on local authorities to commission the construction of as many homes as possible for senior citizens. There are also programmes for adapting existing homes to the needs of this group.
- Promoting affordability
It is easier for people aged 65 and over to qualify for a rent subsidy than for those under 65.
- Improving quality
Under Dutch building legislation, all newly built homes must be 'modifiable', so that they can be more easily adapted should the occupant become disabled or develop mobility problems.
- Encouraging combined housing and care
As the Dutch population ages, a growing number of people will need accommodation that combines housing and care. It is the local authorities responsibility to meet this need.
Care & welfare
Reform of the system of long-term care and social support
In January 2007, a new system was introduced in the Netherlands for long-term care and social support. Under the new Social Support Act (Wmo), the local authorities are in charge of organising the less intensive forms of assistance and support. The new system is designed to allow people to remain independent for as long as possible. 'Social support' refers to activities that help people participate in society. Therefore, the social aim of the Wmo is to encourage participation by everyone in all aspects of society, with or without the assistance of friends, family members, acquaintances or the local authorities. The various care and support facilities should be coordinated and be readily available in the immediate living environment.
Housing & care
Separation of housing and care
In the future, housing and care services will be funded separately. Regardless of whether residents rent or own their homes, they will have to purchase care services separately.
For more information about the Dutch governments policy in the area of housing, care and welfare, please refer to the following websites:
- The Ministry of the Interior and Kingdom Relations (BZK):
- BZK on housing
- Housing for the Elderly in the Netherlands
- Ministry of Health, Welfare and Sport (VWS)
The government is not alone in making it possible for people to live independently for a longer period of time. Housing and care and welfare service providers are also responding to this trend. Market forces will play a greater role in this. The providers' supply-driven policies are gradually making way for 'demand-oriented' and 'demand-driven' policies. Providers have had greater success in finding the right partners to offer a collective and cohesive range of services tailored to the customer's needs. However, competition in the sector is also becoming tougher.
In the care sector, changing demands are accelerating the move towards outpatient care. Clients are increasingly dissatisfied with the quality of housing and of everyday life in residential care facilities. In addition to shifting towards outpatient services, care providers are also under constant pressure to serve more clients with fewer staff and to work more efficiently. It should come as no surprise then that the institutions are reorganising and relying more and more on technology to aid them in their work. Care providers are working with partners from other sectors to professionalise their services, cut costs and form transsectoral care chains. By contrast, arrangements for intensive home care and small group homes for dementia patients are on the rise, resulting in more care service sites. Care providers are developing 24-hour outpatient care services based on a minimum number of clients requiring care within a housing cluster.
Care institutions are also showing greater differentiation with regard to land and property, as they decide to adapt their locations and property portfolios to the new care demands. Some will choose to operate solely on an outpatient basis and only offer extramural services; others will maintain certain infrastructure, facilities and remaining accommodation on their own or transfer them to a specialised property company.
Of the housing stock in the Netherlands, 56% is private property (subsidised and non-subsidised owner-occupied homes), and 35% subsidised rentals, which is largely controlled by the housing corporations. The housing stock also includes non-subsidised rentals. The housing corporations are required by law to focus on the less fortunate members of society, such as low-income people, senior citizens, the disabled and those in need of care. In 2002, the subsidised housing sector included 315,122 homes that catered especially to the needs of seniors and the disabled and 12,000 homes for specific target groups.
The market segment known as 'housing combined with care and welfare services' is becoming increasingly important for the housing corporations. In addition to sheltered housing, they are also developing clustered housing solutions for those in need of intensive care. They have the task of building adaptable and modular homes, which provide an optimum solution for an array of target groups who require combined 'housing and care', as well as for the regular housing market. Housing corporations are also developing more medium-category sheltered housing projects, sometimes in cooperation with private lenders. Finally, there is still a demand for the construction or acquisition of inpatient care facilities for use by care institutions, which usually involves entering into a multi-year lease. Housing projects can be developed on the previous locations of the main branches of institutions, effectively diluting a given areas need for care.
- Building for the region, by Daniëlle Harkes: Article about new developments on building for a rapidly ageing population
Concepts combining housing and care
Care organisations, housing providers and welfare organisations are collaborating more and more. They are developing new concepts and implementing formulas that have proven themselves useful in experimental projects. The housing stock is becoming increasingly diverse and the changing demands of consumers have given rise to a greater variety of housing solutions, thus offering more options.
A home is defined as a 'life-cycle' home (levensloopgeschikte woning) if it can be lived in during each stage of a persons life without major physical exertion or a high risk of injury. New homes meet the requirements of the WoonKeur certificate, existing homes those of the Opplussen certificate. The exact number of life-cycle homes in the Netherlands is unknown.
Integrated neighbourhood services
Occupying a district or village either in part or in whole, areas with integrated neighbourhood services (woonzorgzones) offer optimum conditions for housing combined with a whole spectrum of care and welfare services including 24-hour care that cannot be scheduled and are generally organised around a community service centre or regional care centre. 'Integrated neighbourhood services' is also used as a general term referring to all initiatives relating to adapting regular districts so that care and welfare services can be provided to those in need of them.
At present, almost 70 areas with integrated neighbourhood services are registered in the Kenniscentrum Wonen-Zorg databank. In all likelihood, there are many more such areas now under development. An estimated ten of these areas have actually been completed.
- Example of integrated neighbourhood services: Skewiel Trynwâlden
- Article: Large Dutch study shows positive effects of Integrated Service Areas for the elderly (May 2013)
Sheltered housing (woonzorgcomplexen) consists of independent housing complexes, which are designed with safety and shelter in mind. Each complex is subject to an agreement for the provision of care and services, although the provision of housing, care and services are clearly separated contractually. The homes meet the requirements for adaptable housing.
Such a complex can function as a service centre in an area with integrated neighbourhood facilities for the surrounding community. There are presently (August 2008) 1,242 sheltered housing complexes registered in the Kenniscentrum Wonen-Zorg databank. Most are intended for senior citizens, but there are others that house both the mentally and physically disabled. Recent projects have included a growing number of homes, the construction of which was privately financed. The trend is moving towards increasingly larger sheltered housing complexes that offer more services and leisure activities. In other words, they are trying to move from a care-based image to one based more on services and leisure. The Humanitas complexes in Rotterdam are a good example of this.
Small group homes for dementia patients
This housing solution involves a situation in which a small group of people in need of intensive care and assistance live in a group home, enabling them to live as normal a life as possible. In 2005, there were some 193,000 dementia patients and the capacity of the 349 locations in the Netherlands offering small group homes for dementia patients was 4,442. In 2010, the capacity of small group homes for dementia patients will increase to 10,834.
Community service centre/ multi-functional centre
Community service centres (wijkservicecentra) provide facilities for housing, care and welfare in the district and often also offer additional amenities such as healthcare centre, childcare centres and a grand café.
Offering temporary accommodation and 24-hour care and services, care hotels (zorghotels) combine aspects of hotels with care facilities. The Kenniscentrum Wonen-Zorgs preliminary screening in 2006 identified 45 care hotels. Care hotels have now been included in the Kenniscentrum Wonen-Zorg databank.
Multiple generation homes
Multiple generation homes (kangoeroewoningen) are self-contained homes or housing units adjoined with built-in connections and house senior citizens or the disabled and their families. There have been dozens of initiatives for multiple generation homes by private construction companies and at least 60 by housing corporations.
Immigrant senior cohousing
The dilemma of living alone when needing more support and supervision, especially in an environment where the language, beliefs, and religion are not one's own, led tot the idea of cohousing projects designed specially form aging immigrants.
- Article Community and health: Immigrant senior cohousing in the Netherlands (pdf, 2,6 mb). Copyright 2009, Dorit Fromm, Els de Jong, and Communities magazine. First appeared in Communities: Life in Cooperative Culture, Issue #145, Winter 2009.
About Aedes-Actiz Kenniscentrum Wonen-Zorg & its partners
Part of the Aedes association of housing corporations and the ActiZ organisation of care providers, the Aedes-Actiz Kenniscentrum Wonen-Zorg is the expertise centre for those wishing to know more about housing, care and welfare. Affiliated knowledge partners include Vereniging RIBW Alliantie and Vereniging Gehandicaptenzorg Nederland (VGN). See below for information on these partners.
Kenniscentrum Wonen-Zorg supports care organisations and housing corporations in the development of new concepts combining housing and care through its website, newsletter, theme meetings, networking, research, excursions and member services.
The combination of housing and welfare and care services is relevant to various target groups including senior citizens, the disabled, Dutch Mental Healthcare Association (GGZ) clients and the homeless. Other trade organisations for providers in the field can affiliate themselves with Aedes-Actiz Kenniscentrum Wonen-Zorg with regard to technical aspects. At this time, the knowledge partners include Vereniging RIBW Alliantie and VGN.
ActiZ care providers
ActiZ is a trade organisation with over 600 members, which are providers in the care, housing, welfare, prevention and other related services sectors. Every year, these care providers offer a broad-based and diverse range of care services to about two million clients of all ages. These packages include care home, nursing home, home care, maternity care and youth healthcare (early childhood healthcare centres) services.
ActiZ supports its members and plays a facilitating role in their work by developing policy and providing information and a platform for knowledge exchange. Additionally, in its role as an employers' organisation, ActiZ sees to it that the industry has a good collective labour agreement. It is a member of Royal Association MKB Nederland.
ActiZ was established on 1 July 2006 as a result of the merger of Arcares and Z-org.
Aedes housing corporations
Aedes is the national organisation promoting the interests of practically every social housing organisation in the Netherlands, on all possible fronts. Together, Aedes members manage 2.4 million dwellings, constituting 40 percent of the total housing stock. As a network organisation, knowledge centre and think tank, Aedes provides a platform for its 700 members (modern real estate businesses and service providers) to meet, exchange ideas and develop visions. Aedes works together with its members on living/care arrangements for the elderly and groups with special needs, such as mentally or physically disabled and asylum seekers. Aedes also supports the housing organisations in city development plans by entering into collaborative relationships with other organisations.
Vereniging RIBW Alliantie
The 24 regional institutions belonging to Vereniging RIBW Alliantie offer professional guidance and support to people with serious and long-term mental and/or psychosocial problems. They provide customised care within the context of sheltered housing solutions or via ambulatory support. Together with their clients, the various RIBW branches focus on creating the right conditions for participation in society. To achieve this goal, the clients must develop skills, maintain relationships and be respected by others as individuals in their own right. By working together on strategy, the RIBW branches are able to continue improving and standardising the quality of their services.
Vereniging Gehandicaptenzorg Nederland (VGN) is the trade organisation for the providers of care and other related services to the disabled. VGN's mission is the proactive representation of the collective interests of its 173 members. The disabled care sector employs 127,000 people who provide services to about 100,000 clients. VGN is dedicated to achieving favourable terms and actively promoting interests in the area of funding, legislation and regulations, employers' issues and the substance of the care services.
For further information
- The Dutch system of long-term care
- Factsheet: The government's health and wellfare policy - VWS
- Senior citizens - VWS
- AARP International - AARP
- AARP Global report on aging, special edition om livable communities
- Comparing care. The care of the elderly in ten EU-countries - SCP