COVID-19 policy responses affecting nursing homes in the Netherlands

FLorien Kruse, Toine Remers, Patrick Jeurissen (Radboud University Medical Center)

This posts summarises key challenges in the long-term care policy responses to COVID-19 in the Netherlands, which are explained in more detail in the latest report on the Netherlands in this site.

The number of cases and deaths in Dutch nursing homes has grown rapidly. This contrasts with the downward trend in the overall number of cases in the Netherlands. Despite the high social cost, the ban on visitors to nursing homes remain in force. Some restrictions have been lifted for care-dependent individuals who live at home. The allocation mechanism for PPE was amended in order to improve the distribution of PPE to LTC facilities. Testing capacity has somewhat increased and this has allowed the government to widen the eligibility criteria for tests. LTC personnel are now also eligible for testing when they show symptoms, and informal care-givers will be allowed to access testing in the coming month.

A few lessons can be learned from the developments related to COVID-19 and its impact on the LTC sector. The LTC sector has been overshadowed by the acute care sector during the early stages of the COVID-19 outbreak. Therefore, one of the lessons is that it is important to include the LTC sector in the distribution of PPE as soon as possible. Additionally, clear guidelines are needed to outline the measures that nursing homes must take to prevent a COVID-19 outbreak.

Another lesson is that little attention has been given to support the mental health of LTC workers important. They are especially exposed to high-stress environments during health crises such as the COVID-19 pandemic and this could cause serious mental health issues. Pro-active measures should be considered to address these mental health concerns.

The vital question that remains is when, and how, to lift the ban on visits to nursing homes and the restrictions on visiting the elderly at home. The government is planning to initiate several pilots to assess what the impact is when the visitor ban is loosened in nursing homes (14). Nevertheless, there will always be a trade-off between the physical health and the mental health of elderly and care-dependent individuals. The government may look to innovative ways to provide relief to those seeking social warmth in times of social distancing.

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