The problem-oriented multidisciplinary approach in Dutch nursing home care

Abstract

In The Netherlands, nursing home medicine is an important branch of geriatric medicine. Therapeutic emphasis in this field is placed on function rather than disease. Multidisciplinary geriatric rehabilitation and long-term care are provided on an inpatient as well as on a semi-outpatient (day hospital) and outpatient ('substitution care') basis. This article discusses the reasons for the adoption of a problem-oriented approach in this field of geriatric medicine. It also outlines the modifications that were necessary to make the method suitable for application in the care of chronically ill elderly patients and describes how it can be used. The teaching of the problem-oriented approach is a cornerstone of the postacademic training programme for nursing home physicians and this method is currently being implemented in university- affiliated nursing homes.