No, she cannot actually call the gentleman whom Linda Vermeer is visiting now a client. To Linda he is ‘Uncle Lex’ and his wife is ‘Aunt Magda’. Linda (55) has known them since primary school here in Rozenburg, a village near Rotterdam. She was friends with their youngest daughter. Family with Indian roots. Lex was an electrician and super handy, he built the spiral staircase to the attic and the wall between the kitchen and living room himself. Now he is ninety and sits on the edge of the bed silently waiting for Linda’s care.
Together with a colleague, she will put him on a mobile chair and wheel him to the bathroom for a shower. Then they help him to the stair lift and once downstairs they guide him via his walker to his triple chair. With that he shuffles to the dining table. His medications – blood thinner, anti-sweat pill, stomach protector – are ready next to his sandwich with chocolate sprinkles, pre-sliced by Magda. She summarizes Lex’s medical history: first a heart rhythm disorder, then two TIAs and then he needed a walker. In 2024 he suffered a cerebral infarction. Since then, he has hardly been able to walk, nor can he speak: understanding him requires a trained ear.
90-year-old Lex is helped during a meal by his wife Magda (left) and home care worker Linda Vermeer (right).
Linda Vermeer with 85-year-old Magda.
Photo Hedayatullah Amid
Lex starts eating his bread. “Shall we have your drink right away?” says Magda. She hands him a mini measuring cup. It contains a transparent liquid. No alcohol. Lactulose. Laxative.
It is increasingly difficult for the elderly to qualify for a nursing home. You have to be, to put it bluntly, ‘bad enough’. If not, then living at home is the credo because nursing home care is expensive and there are few staff. Lex is, if desired, eligible for a nursing home. But he doesn’t want to. Magda doesn’t want to think about it either. “I want him home,” she says. “We have been together for 64 years and then I should give him up?”
With the exception of Lex, the route only passes women. The youngest is 79 and the oldest has lost count
Linda Vermeer – profession: caregiver – visits day after day only people who still live at home, although most of them, like Lex, would easily qualify for a nursing home. Together with colleagues, she provides the help at home that these people would also receive within the nursing home walls. NRC walked along one morning. What kind of help is provided and what is the condition of the elderly?
With the exception of Lex, the route only passes women. The youngest is 79 and the oldest has lost count. Most women are widows and live alone, all in Rozenburg. The names of the clients and their partners are known to the editors. Mentions their surnames NRC not in connection with their safety: it could increase the chance of success of any fake agents and other chatterboxes in this village of 12,500 inhabitants.
Cut back
“First let’s have a smoke,” says Linda with a Rotterdam-like accent and she walks into the alley behind the office of her employer, the Careyn healthcare institution. The office is located in the health center of Rozenburg, where the general practitioner is also located, the physiotherapist, the pharmacy and the village hall that offers the elderly day care and a hot meal at lunch. In a previous life, this building served as a care home for the elderly, but like everywhere else in the Netherlands, these types of retirement homes were cut back about ten years ago. There are still elderly people living here, but in independent apartments. Like Ria, the only seventy-something on the route (79).
With a cheerful “good morning!” Linda steps into the apartment. Ria shuffles around a bit. A colleague, Carla Rosinga (66), is already present. She takes the laundry off the rack in the pantry, where there are sixteen packs of incontinence products on the shelves. Linda sees that Ria’s medicine dispenser is empty. The exact medicines Ria needs roll out of that electronic device on her bedside table in a set rhythm. Beta blocker, diuretic, blood pressure lowering, folic acid. “Has your medicine roll not been delivered?” Linda asks. “I don’t know,” says Ria. Linda inquires downstairs at the on-site pharmacy: yes, there is Ria’s medicine bag. “She apparently didn’t answer the door when they were delivered,” says Linda. Back in the apartment, Ria has settled into her armchair, feet on the ottoman. It’s almost half past eight – has she had breakfast yet? “I was having an ice cream,” she answers. “A cornetto.” Carla stays, Linda leaves.
Home care worker Lillian van Sprang talks to Lex in Rozenburg.
Photo Hedayatullah Amid
On your bike, into the neighborhood. Wies lives in a terraced house. Short gray hair, velcro shoes, Dutch Dagblad on the table. “Am I now 96?” she says. Linda checks it: “97.” “Weljá,” says Wies. “My, my, what an age.” She recently fell, but she can’t remember exactly where or when. She picks at a loose bandage on her forearm. “It doesn’t sit well.” Linda puts on plastic gloves. “You were picked up by ambulance, right,” she says. Wies nods slightly. The still healing wound covers a third of her forearm. “Something still needs to be done because if you bump it it will be broken in no time,” says Linda. She sticks a firm, absorbent bandage on it. “Is it all right, do you think?” “Fine.”
Linda looks at Wies. “We have one more thing to do, right?” “What then?” “What should we always do in the morning?” “Oh,” says Wies, “exercises.” And a minute later the women are standing side by side in the kitchenette, stomachs against the counter, hands flat on the counter top. Raise the knee five times on the left, five times on the right, ten times on the toes. “There,” says Linda, “now let’s rest.” “That’s not necessary,” says Wies and hop on those toes ten more times. Yes, she wants to continue living at home, she says back in her chair. “I think everyone would like that.” There are plenty of visitors: children, acquaintances, friends, people from church. She occasionally cooks herself, does some shopping, the store is not far. Moving to the nursing home? “Haven’t thought about it yet.”
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Serious physical ailments
About 120,000 elderly people live in the nursing home. The care they receive there is financed through the Long-term Care Act (WLZ). A growing group of elderly people receive long-term care at home. At the end of 2025, this amounted to 77,000 people. At the beginning of 2023, there were ten thousand fewer: since that year, people with a slightly less serious need for care can no longer go to the nursing home. And what’s more, the vast majority of elderly people don’t want that either. Certainly, they have physical disabilities or are forgetful, but they prefer to stay in their familiar environment. This also increasingly applies to elderly people whose need for help is serious enough. That category makes up the vast majority of Linda’s clients. People with serious physical conditions, but especially: people with advanced dementia.
Lex, 90, uses a stair lift.
Photo Hedayatullah Amid
They receive the intensive help they need through a scheme called ‘complete package at home’. From wound care to house cleaning, help with showering to transport to day care. Or simply keeping company so that the partner can take a walk. The care is financed under the Long-term Care Act, but people do pay a personal contribution, depending on income, assets and household composition. Minimum 212.60 euros per month, maximum 1,115.80.
If people walk out the door four times in a row in the wee hours and their partner can no longer get them into bed, then yes, that is the turning point
Linda rings the doorbell of Afke (84), a widow with blue-gray eyes. Widowed since when? “Even if you kill me.” She just finished her bowl of yogurt and takes it to the kitchen. Slowly. “Oo-oo-oo,” she says, “I feel so bad.” Five minutes later: “My legs are good.” Stairs to the attic? No problem. “Medication taken in my presence,” Linda reports on her phone.
On to Lex and Magda, Linda’s old acquaintances. One of Linda’s colleagues has already arrived, Lillian van Sprang (26). Together they put Lex in the shower. Lillian is not a caregiver, like Linda, but a ‘living support worker’, a position that employer Careyn created at the beginning of 2024 after two years of experience with nursing home care at home. Because why should healthcare professionals like Linda actually have to make clients’ sandwiches and fold the laundry? Quite expensive and also inconvenient, given the staff shortage in healthcare. “About two hours of nursing and care is actually required per day,” says Careyn director Chantal Beks (52). “The rest of the time is about well-being, keeping company, attention, cleaning.”
Hedayatullah Amid, Photo Hedayatullah Amid
Careyn has been recruiting people from many sectors for two years: Lillian worked as a domestic helper in healthcare, others as a hairdresser, beautician, employee of Hema, Rituals, branch manager of Zeeman. “They often come for meaning, to mean something to others,” says Beks. Linda’s team includes two caregivers and six life support workers. The coordination is in the hands of Ilona Rooimans (46). If a client requires more intensive nursing assistance – a male catheter needs to be changed, a wound will not heal – she calls in a community nurse. A geriatric medicine specialist and a general practitioner are also involved in the team.
Acute notifications
When is it still necessary to move to the nursing home? “When people become a danger to themselves or others. Or when it is no longer feasible for informal caregivers,” says Linda. Things often go wrong at night, when people start wandering. A night team is ready for acute reports. “We are close to 24 hours,” says Chantal Beks. “But if people walk out the door four times in a row in the wee hours and their partner can no longer get them into bed, then yes, that is the turning point.” Linda experienced it recently. The gentleman had dementia, his wife could no longer cope. There was also a woman who kept walking to the supermarket at night.
Half past eleven in the morning, Linda rings the doorbell of Miep (82), the last client on the route. Her husband (84) opens the door, Miep is lying in bed. Now she’s coming out. Linda comes to give the blood thinner, but Miep prefers to talk about the new washing machine. “Beautiful, isn’t it?” In her dress she sits down at the kitchen table opposite her husband. She says that she no longer goes to day care. She went a few times but didn’t make it to the toilet in time. “It was far away and then it was occupied.” Miep was diagnosed with dementia, her husband says. Lewy body. It is not completely certain, the doctors are not clear.
Shortly after the diagnosis, Miep and he visited a nursing home. But he doesn’t have to. “We have been married for 58 years, we live together.” Miep doesn’t want to either. “And do you know why?” She pauses and says: “All crazy people there.”
Home care worker Linda Vermeer says goodbye to Lex and Magda, 85, after her work.
Photo Hedayatullah Amid
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