Innovation: Sustainable Trynwalden

Netherlands

AAI Domain: Independent, healthy and secure living (independent living, access to health services, physical safety)

Ageing populations and the general trend towards urban living means that many rural communities have seen younger people leave in search of work and opportunities for a better life that are available in larger towns and cities. This results in rural communities often having an older population profile, fewer people and over time the loss of businesses and services as the purchasing power of the area declines.

Older people in rural areas may have to move from living independently in their own home to a long-term care institution that may be some distance from the place where they have spent their lives and have family and friends. Older people in such a situation want to live independently in their own homes for as long as possible so it is important to develop social innovations that provide the means for older people and rural communities to be socially sustainable.

Trynwalden is a rural area in north east Frieseland in the Netherlands that had a declining population of around 10,000 people in the mid-1990s spread relatively equally across seven villages. Facing the prospect of an ageing and declining population, the Sustainable Trynwalden project was formed as a partnership of the local municipality, a health insurance company, local health and social care providers and older people in the form of an advisory council.

Under the prevailing model of long-term care funding they were able to apply for funding and have the freedom to develop innovative solutions to the local challenges that they faced. Under the leadership of Foeke de Jong, a trained architect who had a career in nursing care homes, Trynwalden took a number of radical and innovative steps. The long-term care home was demolished and replaced by an apartment complex containing state-of-the-art assisted living technology to enable older people to live independently and safely in a purpose built communal environment.

The complex has a restaurant, offers a range of social and educational activities, occupational and speech therapy, childcare, library, assistance with daily care, physiotherapy and a meal service at home. There is also scope for inter-generational activities in the social centre that caters for the needs of people of all ages. In addition, Trynwalden developed a specialist role – the Omtinker – who liaises with older people to establish how they perceive their care needs and then acts as a commissioner using a voucher system to purchase care services that are offered in a ‘supermarket’ model with different levels of service and price.

There are four Omtinkers who work with approximately 300 older people each and they effectively act as a voice for older service users while not being restricted by as much bureaucracy as is often present in social care commissioning. The final element that makes the Trynwalden model operate effectively is the five multi-disciplinary teams of health and social care workers – the Doarpstallen – who provide services across the area that can provide assistance at any hour of the day. The preventive emphasis of the project, with the extensive use of occupational therapy and support for older people to live independently in the home has lead to higher cost and quality services being chosen but at a lower level of demand meaning that it is a cost effective programme.

In relation to active ageing, Sustainable Trynwalden provides older people with the built environment and social support that they need in order to live independently and in physical safety. The Omtinker and multi-disciplinary teams of health and social care workers improves access to health and care services and enables older people to stay in the local community that many have lived in for their whole life. The inter-generational activities at the social centre of the apartment complex provides a community hub that contributes to social connectedness and provides scope for care to grandchildren as well as older adults.

More information

The Verwey-Jonker Institute – Providing integrated health and social care for older persons in the Netherlands (PDF, 317KB)