During their internship, students notice how hard it is to work in elderly care: ‘I’m dying’

Jantine Duijnmaijer (40) works in a nursing home. In addition to caring for the elderly, she also arranges food and drink for the residents. Not cooking, that is no longer allowed: ready-made meals are cheaper than “an extra man in the kitchen”. But she still has to pay close attention to how much she buys. “I can’t pour too much coffee or order too much bread. But in the meantime, the residents are fighting over the last potatoes because there are not enough.” Order more than that? “I will then hear that from my manager.”

She tells the story at a meeting of the ROC Midden Nederland in Utrecht, where Minister of Long-Term Care Conny Helder (VVD) is visiting students this Monday in June to talk about care for the elderly. Duijnmaijer is doing the nursing course himself. About fifteen students have come to meet Helder. Duijnmaijer is not the only one who wants to share her story.

Working in healthcare is tough, these students already notice during their internship. One of them tells Helder during a roundtable discussion that as an intern in a hospice, she often has to take care of eleven clients with only one other colleague. “That saves you moderately. Especially since many of them are in a wheelchair and therefore need a lot of physical support.” Another has to shower “bigger residents” in “too cramped bathrooms” and has to perform tasks outside her authority, such as checking and preparing medication.

Helder defends the fact that too much food should not be bought in nursing homes: the elderly usually eat less, and some institutions really throw away too much. But Duijnmaijer’s anecdote goes “too far” and the rates that healthcare institutions receive should be “more than sufficient” for decent meals. “It is important that you have a say in your work, that you can discuss such matters with your manager,” she encourages the students. In other words: these kinds of matters are the responsibility of the institutions themselves, not of the ministry.

‘Future Care Lab’

The meeting is in the so-called Future Care Lab of the ROC, a lab where just about everything talks – from a planter that reminds you of the day of the week to a dancing robot – and where continuous beeps sound from all equipment that can be used in elderly care. It is therefore not surprising that the students unanimously say ‘yes’ to one of the teachers’ question whether care for the elderly will look ‘completely different’ in thirty years’ time. “More robots for the home”, it sounds, “fewer nursing homes” and “a lot of technology”.

This means that the picture of the students corresponds with Helder’s intentions: she does not want the number of nursing homes – there are currently 2,350, with around 130,000 places – to grow any further. “Since World War II, we have taken more care of our elderly thanks to nursing homes,” she tells the students, “but we have also taken something away from people. Your identity disappears when you end up in a nursing home, without your own belongings.” That is why the minister wants to focus more on home care, “so that the elderly can keep their own lives” – to which the class nods angrily.

Your identity disappears when you end up in a nursing home

What would the students themselves change if they were ministers? An internship allowance, first of all, because not all of them get that. But higher wages in general are also mentioned. Helder calls this a “troublesome point”, because the government already contributes to salary increases in the healthcare sector every year. “It happens automatically every year. That money comes from the government and is therefore tax money: your money. If we want to spend more on this, it must also be paid from taxpayers’ money, so we must first get it from you. That is why we are careful with it.” The students seem to be content with that explanation.

Prevention

When the word ‘prevention’ comes up during the roundtable discussion, the fingers shoot up. The students believe that the elderly should continue to exercise a lot so that they remain mobile for longer. And healthcare providers should make that fun. Luca de Hoop (18), who is studying to become a care assistant and is doing an internship in a nursing home: “I often try to encourage residents to walk a bit. Make it a nice round, with a chat right away, and occasionally sit along the way. That helps.” And seventeen-year-old Jesse Dekker, sports student: “Give a compliment if you succeed. Research shows that people need an incentive to exercise, and the same applies to the elderly.”

Helder: “I have to, as an older person [de minister is 64]compulsory sports?”

Dekker: “It is your own choice, but it would keep you mobile.”

Nursing student Amine Amahzoune (22): “As long as you are aware of the consequences if you don’t.”

Eline van Minnen (17), social work student: “In the hospice I see how fast people deteriorate when they stop moving. Half an hour a day already helps.”

Amahzoune: “A quarter of an hour even!”

Student Dekker himself has ideas for getting the elderly to exercise, he says afterwards. If he were a minister, he would set up special sports clubs for the elderly. “With sport we focus on the youth, while the elderly also desperately need it. You can create specific training courses for that.” Later he would like to work for such an association, he says. “But now I am still very young and fit, so I prefer to work at a high level in sports first.”

Nursing student Najoua Aassafro (33) is considering immediately entering elderly care, although she is now doing an internship in a hospital and is still unsure whether she wants to continue working there. She previously did an internship at an institution for the elderly with mental problems. “I thought that was a very special job. You see that you make a difference to people when you offer a chat or play a game. I have built up a good relationship with the residents: I still go for a walk now and then.”

Aassafro believes that it should be easier to train as a nurse, especially given the shortage of staff. “When I applied I was told that it would be too difficult for me, because Dutch is not my first language. I really had to convince them, that was demotivating.”

The students often say that they have been ‘curious’ about the minister, and that is why they are present at the meeting, which is not obligatory for them. Student De Hoop: “I wanted to know how she views our work. I now understand that it is difficult for her to make choices. But something really needs to be done about the staff shortage, because I’m doing my internship [in het verpleeghuis] completely broken.”