Young patients sent to rest homes to cut costs

By Jane Phare

Patients recovering from badly broken bones in Auckland City Hospital are being transferred to rest homes as a cost-saving measure.

Patients, many unable to walk or care for themselves, are given a list of 10 approved rest homes with hospitals attached from which to choose. They are then transferred to the facility.

Two weeks after 39-year-old Karen McGregor-Wilson was injured in a head-on collision involving a 16-year-old driving a stolen car, she was sent to Wesley Rest Home and Hospital.

There, treated as an elderly patient, she was served pureed food and given forms to fill in asking if she had made her funeral arrangements and if she wanted to be revived should her heart stop beating.

The shock of arriving at a rest home hospital, where the next youngest person was 80, reduced McGregor-Dawson to tears on her first day. Confined to her bed she listened to dementia patients calling out and elderly residents singing Ten Guitars.

Now, two weeks into her stay and with her sense of humour restored, she can laugh at what she calls her "practice run" in a rest home, about "the dribble bibs... like bath mats" which come with meals, the pureed and mushy food, and the fact her neighbour is 103.

Last week she even joined the elderly residents on a drive to the Parnell Rose Gardens in the rest home bus.

Visits from family and friends, and a small fridge stocked with fresh food that isn't pureed, keep her spirits up.

The Auckland District Health Board defends its "orthopaedic non-weightbearing scheme" saying it is used as an option when patients who cannot walk are not able to be cared for at home. The scheme was used mostly for people over the age of 65, the chief planning and funding officer, Denis Jury, said.

But McGregor-Dawson, who would have preferred to stay in hospital or a rehabilitation centre, questions how most people in wheelchairs can be cared for at home.

Because of a broken collar bone, she cannot use crutches and she cannot put weight on her left leg which has a titanium pin and bolts to hold a broken femur together. She had planned to recuperate at her parents' home in Paihia but that would have meant extensive alterations, including a wheelchair ramp, widening doorways and alterations to the bathroom. The alterations would need to be reverted once she was out of the wheelchair, she said. McGregor-Dawson questions how people with two-storey homes are supposed to cope and how family members who are working are supposed to provide the 24-hour care needed.

"To me it was a funding issue. As soon as I got my stitches out, I was out of there [Auckland City Hospital]."

McGregor-Dawson had hoped to recuperate at the Laura Fergusson Trust facility in Greenlane but instead was given a list of 10 rest home hospitals from which to choose.

The ADHB pays $162.50 a day for rest home hospitals to care for orthopaedic patients - a hospital bed can cost $1000 a day.

North Shore and Waitakere Hospitals occasionally transfer non-weightbearing patients of all ages to rest home hospitals and residential care hospitals depending on bed capacity. On average they spend six weeks recuperating.

Rachel Haggerty, general manager of adult health services at Waitemata District Health Board, said if a bed was available in a ward it was easier to care for a patient in hospital. But if the orthopaedic wards filled up, the option of transferring to other hospitals was discussed with patients, she said. Transferring patients to rest home hospitals was also a cost-effective way of caring for patients.


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