Millions in the Netherlands forced into unpaid care, costing economy €1.5 billion yearly

The Dutch government is increasingly leaning on unpaid family caregivers to fill critical gaps in the healthcare system, but the economic toll is staggering. Informal care for loved ones with dementia alone accounts for the equivalent of 21,500 full-time jobs, draining more than 1.5 billion euros from the economy each year, according to an analysis by Follow the Money. Yet, despite the mounting financial and labor strain, policymakers have offered little response.

For Jacquelien Noordhoek, caregiving has been a relentless reality. The director of the Dutch Cystic Fibrosis Foundation has spent nearly two decades looking after her son with cystic fibrosis, her father, a neighbor, and, most recently, her mother, who suffered from dementia. The burden was overwhelming. “She was what they call a ‘care refuser,’” Noordhoek told Follow the Money. “She had behavioral problems and, due to dementia, trusted no one.” The situation escalated dangerously—once, her mother was found wandering a market alone, prompting a late-night call from the police while Noordhoek was overseas.

Successive Dutch governments have pushed for “self-reliance” as a pillar of elderly care policy, urging citizens to stay at home longer and depend on personal networks. The 2022 program ‘Living, Support, and Care for the Elderly’ reinforces this approach, effectively shifting the weight of care from professionals to family members. But the hidden costs are immense. Many caregivers are forced to cut back on paid work, leading to significant productivity losses. Follow the Money estimates that caregiving for dementia patients alone wipes out the workforce equivalent of ASML, the Netherlands’ largest tech employer.

Data from Nivel and Alzheimer Nederland confirm the financial strain. Among surveyed caregivers, 44 percent held paid jobs, and 20 percent had to reduce their working hours—on average by 12 hours per week. The result? An estimated 21,589 full-time jobs disappear annually, costing the economy more than 1.5 billion euros.

Experts warn this estimate is conservative. The Social and Cultural Planning Office (SCP) suggests that indirect costs—such as stress-related workplace inefficiencies and missed economic opportunities—could push the real figure between 2.1 billion and 5.1 billion euros per year, with total societal costs reaching as high as 30 billion euros.

And the problem is reportedly only growing. As the Netherlands’ population ages, the demand for unpaid care is set to skyrocket. By 2040, the number of dementia patients will nearly double, requiring 70 percent more informal caregivers. The government itself estimates that in just 15 years, every Dutch citizen will be responsible for a loved one’s care. This expectation clashes with policies encouraging people to work more, raising urgent questions about sustainability.

“There is a limit to what unpaid caregivers can handle,” said Esther Hendriks of MantelzorgNL, a national advocacy group. “We’re heading toward a crisis, and policymakers haven’t provided solutions.”

For Noordhoek, the demands of caregiving are far from over. Now facing her husband’s cancer diagnosis, she remains uncertain about the future. “If necessary, I will care for him with love,” she said. “But after all these years, I am truly ready for some rest.”