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Retirement in Belgium: A guide to home care, residential care and alternative living arrangements

15:00 14/12/2020

Belgium’s long-term care policy, in common with most European countries, is based on allowing older, care-dependent residents to keep on living in their own homes for as long as possible. Adapting your home to changing circumstances and relying on home care facilities allow you to live comfortably and postpone the move to a residential care home.

Adapting your house

Tailoring your house to reduced mobility and specific needs does not always require you to break out the sledge hammer. Adjustments may be small and cheap: a bath board, light sensors under the bed, thermostatic faucets, non-slip coating underneath your rugs, inverting the bathroom door. These changes can make a big difference and prevent accidents in the home.

Renovations can include limited work such as getting rid of doorsteps or differences in level, installing handles, enlarging doorways or replacing the bath with a step-in shower, or more extensive renovations such as installing the bedroom and the bathroom downstairs.

Governments and communes in Belgium award adaptation premiums for technical installations and technical aids (i.e. stair seat lift) and for renovations making the home safer and more accessible for seniors. Communes, provinces, home care providers and health insurance providers advise and accompany seniors when adapting their home or choosing technical aids. For further information, check with your health insurance provider

Home care facilities

All regions have a panoply of home care services allowing seniors to live safely and comfortably at home: hot meals, cleaning services, domestic services, help with odd jobs, home care or night care. Furthermore the corona virus crisis saw a spike in the growth of spontaneous networks for help and social support for the elderly in many Belgian communes. Ask for a list of services available where you live with your commune or health insurance provider.

On online platforms such as Listminut or Helpper people advertise their services for all matter of odd jobs. For further information see also:

Residential care

When living at home is no longer possible, there are various residential arrangements to cater for different levels of need. For those needing sheltered accommodation, Belgium has “maisons de repos” either public or private, which take in people over 60 years of age, offering them residential accommodation and all services, help with daily life and, in some specific cases, medical help.

“Maisons de repos et de soins” – again, public or private – are for those with more serious health dependencies, but who do not require (acute) hospital treatment. In Flanders both types go under the name of “woonzorgcentra”.

Both public and private care homes are subject to the same regulations. Elderly care and residential care homes fall under the competency of the communities in Belgium: the Flemish Community or the Brussels-Walloon Federation. These set residential care home standards and regulations. Public homes are run by the Centres Publics d’Action Social (CPAS) / Openbare Centra voor Maatschappelijk Welzijn (OCMW’s) of the communes.

The bulk of services is being provided as part of the federal public health insurance system, mainly financed by your social security contributions and taxes. Long-term care services provided through the health system only cover nursing and rehabilitation care, and a portion of personal care for dependent seniors: food and accommodation costs are not covered.

In addition, there are “serviced” residential arrangements, privately or publicly run and more intense, designed for those who are still relatively mobile and who live in studios or apartments with a la carte services available – meals, domestic help, cleaning, round the clock emergency assistance. They can be expensive.

How to choose the right care home

When it is time to move into residential care, it has to feel like home. It is best to thoroughly prepare your choice of care home, especially since admission often happens after an emergency, leaving little time to compare and weigh all the options then.

  • Make a list of main concerns. Do you need an intensive form of care? What is important for you?
  • Visit websites of residential care homes to get an idea of what is on offer. Pay attention to accessability. Is the care home within walking distance of shops, a park, a coffee house?
  • Verify which costs are included in the daily rate and which aren’t.
  • Visit care homes, allowing you to compare. Ask for an extended guided tour. Pay attention to the attitude of managing and care staff during the visit. Talk to residents or relatives. Ask about their experiences with staffing and staff interaction with residents.
  • Meals help structure the day. Ask for the monthly menu.

Further information on residential services and care homes in Brussels can be found here. Contact details for the 19 CPAS/OCMW branches in the Brussels-Capital Region are at www.ocmw-info-cpas.be

Alternative residential formulas

There are many alternative formulas for (communal) housing. Some span different generations, others don’t. Projects can be initiated by OCMW’s/CPAS, social housing companies, non-profit organisations, private companies or equal-minded individuals. These projects are less care-oriented and allow elderly residents to maintain a high-autonomy lifestyle. However, residents can appeal to each other or professional services for help.

Written by The Bulletin with the King Baudouin Foundation and the Federation of Notaries