Remarkable staff do best for the elderly

By Julia Holmes
It is 8.30am at Cedar Manor and I have just met up with care worker Barbara Tolley and registered nurse Marie Monk-Burling.
I will be accompanying them on their morning rounds to get an insight into their jobs at the Sixth Avenue establishment, which includes a rest home, hospital and apartments for the elderly.
It is surprising that management has let a nosey journalist on to their premises in a week when care workers across the country are striking over poor pay.
But it would seem that they have nothing to hide.
At the end of last year Cedar Manor, like many elder care facilities, was having problems with staff retention so the board got all the staff together, opened the books and asked them what they thought they should do.
In June the staff got a modest pay rise, although they are still being paid well below those in the public sector.
It is Ms Monk-Burling who tells me this, not management.
"It was a brave move on management's part. They showed us how much money they have got and asked us to prioritise how we spend the money," she says.
"It did break down barriers ... we felt listened to. That's ongoing."
Things are not so amicable at Melrose Park in Waihi Road where 33 care workers went on strike on Thursday.
The six-hour joint action by the New Zealand Nursing Organisation and the Service and Food Workers union also affected other MacPherson Group and Guardian HealthCare rest homes and geriatric hospitals throughout the country.
But, industrial action or not, Melrose Park and Manor Park face the same underlying problem - there just isn't enough money to go round.
Robert Lee, KPMG financial adviser and accountant for five of the largest rest homes in the Western Bay, describes the sector as being in "survival mode".
"They won't get a return on their investment this year," he says, elaborating that other businesses of a similar size would expect at least a seven per cent return.
Rest homes are underfunded by 21 per cent, he adds, citing a report commissioned by the Health Funding Authority in 1999.
They have difficulty recruiting and retaining staff because they can't pay them as highly as the public sector and there is little, or no, money to invest in maintenance and repairs.
"There's no investment going into the industry. In five years' time it will be a disaster."
Adam Yates, chief executive of Tauranga Manor Group Holdings, which owns Cedar Manor and Accadia Manor, says at the moment the future looks "bleak".
A 3 per cent increase in funding from the government last year barely made a dent.
"We have been experiencing a continual slide in profitability in that rates have effectively, up until last year, not increased since 1997."
Rest homes are funded per bed through District Health Boards.
"It's a complicated issue in that DHBs say they are constrained by public policy."
Furthermore Mr Yates says health inflation is twice as high as normal inflation, given the rising costs of medical equipment and supplies.
"I don't know what the future is. A large number of not-for-profit facilities have already been sold and closed down. From an economic perspective people want to get out because there's no money."
A booming real estate market in the Western Bay makes it particularly vulnerable because many rest homes are sited on valuable land and their owners could easily be tempted to sell up to developers.
"It hasn't happened yet but it is only a matter of time."
The region can ill afford this to happen because, not only are rest homes under-resourced, they are also running to maximum capacity, he says.
Ms Monk-Burling, formerly a Plunket nurse of 22 years, says she is earning at least $5 an hour less now that she is working for a rest home.
"I had to take a big reduction in pay. I had to bite my lip about it because I have a mortgage."
The 58-year-old made the change two years ago after moving to Tauranga from Porirua.
"I believe there are similarities," she says of the work.
"People need the best of care and they also need us as care givers and nurses to be aware of safety issues."
A senior care worker with 15 years experience, Mrs Tolley is one of the higher paid care workers. She gets $13 to $14 an hour.
"My son works for a supermarket. He's only been with them five years and he's on $13 an hour," she says.
When she was younger she wanted to be a nurse but it no longer appeals because she has come to prefer the more personal care a rest home can offer.
"These people have worked all their lives, paid their taxes and served society and this is what they get so we have to give them the best we can with what we've got.
"They are people's mums and dads, sisters and brothers. People have a tendency to lump them together, push them to the side as worthless. After all they have contributed and all the knowledge they have, I like to give them as much respect and dignity as possible. I love my job. It is a privilege to give them care - to the end. To walk that walk with them," she says, her eyes misting with emotion.
W E are standing in a carpeted corridor in the hospital wing of Cedar Manor.
The dull smell of urine that greeted me is beginning to fade and pleasant fragrances waft from doorways as residents are showered and preened for the day.
But I am only seeing the finished product. Behind closed doors carers are changing incontinence pads, sponging down frail bodies and helping the immobile to get out of bed.
Mrs Tolley's day started at 7am with a handover from the previous shift, detailing any changes overnight and the residents' needs for the day.
Each care worker has six residents to attend to but they often work in pairs because health and safety requirements state they are only allowed to lift a maximum of 16kg - and it takes two people to use the hoists.
"I tell them it's like storks bringing them from one place to another because they are like cradles," Mrs Tolley says of the lifting apparatus.
Around her waist she also wears a black belt with handles on it so they can hold on to her.
"It's very physical work. I'm starting to feel it. I remember the days before hoists and before they had products to help with incontinence. It's very emotional too. I'm really tired at the moment. I've applied for a holiday. You know when you need a holiday. It takes from you because you're giving all the time."
Breakfast trays have been cleared away and it's time to get the residents dressed.
"You have some people who want to get up now and you can't be with everyone at the same time. It's hard to prioritise," she tells me.
I am about to see just how hard.
It's not long before Mrs Tolley's pale complexion becomes florid with exertion.
She is moving at a pace akin to the head chef at a busy inner city restaurant.
While attending to an elderly gentleman she suddenly downs tools and runs off at full speed.
An alarm has sounded. It could be a fall, someone choking, or even worse - or it could just be a false alarm - but everyone has to attend.
It turns out she is not needed and she returns to the room.
"Over this way honey," she says, as she gently rolls the man on to his side.
He appears unresponsive but the two women chatter away to him about rugby, apparently his favourite sport.
86-year-old Leila Bulman is next on the list. It's her turn for a shower today.
Time constraints mean each care worker can only shower two residents a day, while the others are sponge-bathed in their rooms.
Mrs Bulman has an appointment with the hairdresser at the in-house salon and is also keen to take part in the craft activities on offer during the morning.
The pressure is on.
But she ends up having to wait a little longer.
A woman in the next room is demanding attention.
"She yells if she's not attended to," Ms Monk-Burling explains.
"Barbara will have to do her first."
No soon has she gone in to attend to her than Mrs Tolley comes whizzing out of the room waving an incontinence pad in the air.
"Pads are an ongoing issue," Ms Monk-Burling explains.
Each resident has a daily allocation and if they run out it's a case of beg, steal or borrow.
"Permission to borrow," Mrs Tolley chortles, before going on a reconnaissance mission.
Soon after an angelic-looking elderly woman emerges from her room looking her Sunday-best, her snowy curls primped to perfection and a string of pearls around her neck.
She is wheeled down to the lounge and Mrs Bulman finally gets to have her shower.
The perky octogenarian came to Cedar Manor eight years ago after having a stroke.
"I think the staff are very kind and they're very helpful. They do all kinds of things for us from dressing us to undressing us, putting us to bed and they assist with meals," she says.
"Feeding the helpless," she adds with a cheeky grin.
"They're not paid what they're worth. I've maintained for a long time they're overworked and underpaid. But the government is very stingy."
When we have finished chatting, Ms Monk-Burling wheels Mrs Bulman to her hair appointment and I accompany them.
"It was nice to meet you," I say, bidding her goodbye as she settles in to get her hair set.
There is no time for such pleasantries with either of the two remarkable women who have let me observe their busy morning.
Mrs Tolley is busy attending to the remainder of her assigned residents and as Ms Monk-Buller guides me to the foyer she is abruptly called away by the shrill squeal of her pager.
"Thank you," I call after her as she sprints off.
This week rest home care workers across the country went on strike for better pay, highlighting a sector in crisis. Julia Holmes visits a Tauranga facility to find out what the issues are.
Body1: I T is 8.30am at Cedar Manor and I have just met up with care worker Barbara Tolley and registered nurse Marie Monk-Burling.
I will be accompanying them on their morning rounds to get an insight into their jobs at the Sixth Avenue establishment, which includes a rest home, hospital and apartments for the elderly.
It is surprising that management has let a nosey journalist on to their premises in a week when care workers across the country are striking over poor pay.
But it would seem that they have nothing to hide.
At the end of last year Cedar Manor, like many elder care facilities, was having problems with staff retention so the board got all the staff together, opened the books and asked them what they thought they should do.
In June the staff got a modest pay rise, although they are still being paid well below those in the public sector.
It is Ms Monk-Burling who tells me this, not management.
"It was a brave move on management's part. They showed us how much money they have got and asked us to prioritise how we spend the money," she says.
"It did break down barriers ... we felt listened to. That's ongoing."
Things are not so amicable at Melrose Park in Waihi Road where 33 care workers went on strike on Thursday.
The six-hour joint action by the New Zealand Nursing Organisation and the Service and Food Workers union also affected other MacPherson Group and Guardian HealthCare rest homes and geriatric hospitals throughout the country.
But, industrial action or not, Melrose Park and Manor Park face the same underlying problem - there just isn't enough money to go round.
Robert Lee, KPMG financial adviser and accountant for five of the largest rest homes in the Western Bay, describes the sector as being in "survival mode".
"They won't get a return on their investment this year," he says, elaborating that other businesses of a similar size would expect at least a seven per cent return.
Rest homes are underfunded by 21 per cent, he adds, citing a report commissioned by the Health Funding Authority in 1999.
They have difficulty recruiting and retaining staff because they can't pay them as highly as the public sector and there is little, or no, money to invest in maintenance and repairs.
"There's no investment going into the industry. In five years' time it will be a disaster."
Adam Yates, chief executive of Tauranga Manor Group Holdings, which owns Cedar Manor and Accadia Manor, says at the moment the future looks "bleak".
A 3 per cent increase in funding from the government last year barely made a dent.
"We have been experiencing a continual slide in profitability in that rates have effectively, up until last year, not increased since 1997."
Rest homes are funded per bed through District Health Boards.
"It's a complicated issue in that DHBs say they are constrained by public policy."
Furthermore Mr Yates says health inflation is twice as high as normal inflation, given the rising costs of medical equipment and supplies.
"I don't know what the future is. A large number of not-for-profit facilities have already been sold and closed down. From an economic perspective people want to get out because there's no money."
A booming real estate market in the Western Bay makes it particularly vulnerable because many rest homes are sited on valuable land and their owners could easily be tempted to sell up to developers.
"It hasn't happened yet but it is only a matter of time."
The region can ill afford this to happen because, not only are rest homes under-resourced, they are also running to maximum capacity, he says.
Ms Monk-Burling, formerly a Plunket nurse of 22 years, says she is earning at least $5 an hour less now that she is working for a rest home.
"I had to take a big reduction in pay. I had to bite my lip about it because I have a mortgage."
The 58-year-old made the change two years ago after moving to Tauranga from Porirua.
"I believe there are similarities," she says of the work.
"People need the best of care and they also need us as care givers and nurses to be aware of safety issues."
A senior care worker with 15 years experience, Mrs Tolley is one of the higher paid care workers. She gets $13 to $14 an hour.
"My son works for a supermarket. He's only been with them five years and he's on $13 an hour," she says.
When she was younger she wanted to be a nurse but it no longer appeals because she has come to prefer the more personal care a rest home can offer.
"These people have worked all their lives, paid their taxes and served society and this is what they get so we have to give them the best we can with what we've got.
"They are people's mums and dads, sisters and brothers. People have a tendency to lump them together, push them to the side as worthless. After all they have contributed and all the knowledge they have, I like to give them as much respect and dignity as possible. I love my job. It is a privilege to give them care - to the end. To walk that walk with them," she says, her eyes misting with emotion.
W E are standing in a carpeted corridor in the hospital wing of Cedar Manor.
The dull smell of urine that greeted me is beginning to fade and pleasant fragrances waft from doorways as residents are showered and preened for the day.
But I am only seeing the finished product. Behind closed doors carers are changing incontinence pads, sponging down frail bodies and helping the immobile to get out of bed.
Mrs Tolley's day started at 7am with a handover from the previous shift, detailing any changes overnight and the residents' needs for the day.
Each care worker has six residents to attend to but they often work in pairs because health and safety requirements state they are only allowed to lift a maximum of 16kg - and it takes two people to use the hoists.
"I tell them it's like storks bringing them from one place to another because they are like cradles," Mrs Tolley says of the lifting apparatus.
Around her waist she also wears a black belt with handles on it so they can hold on to her.
"It's very physical work. I'm starting to feel it. I remember the days before hoists and before they had products to help with incontinence. It's very emotional too. I'm really tired at the moment. I've applied for a holiday. You know when you need a holiday. It takes from you because you're giving all the time."
Breakfast trays have been cleared away and it's time to get the residents dressed.
"You have some people who want to get up now and you can't be with everyone at the same time. It's hard to prioritise," she tells me.
I am about to see just how hard.
It's not long before Mrs Tolley's pale complexion becomes florid with exertion.
She is moving at a pace akin to the head chef at a busy inner city restaurant.
While attending to an elderly gentleman she suddenly downs tools and runs off at full speed.
An alarm has sounded. It could be a fall, someone choking, or even worse - or it could just be a false alarm - but everyone has to attend.
It turns out she is not needed and she returns to the room.
"Over this way honey," she says, as she gently rolls the man on to his side.
He appears unresponsive but the two women chatter away to him about rugby, apparently his favourite sport.
86-year-old Leila Bulman is next on the list. It's her turn for a shower today.
Time constraints mean each care worker can only shower two residents a day, while the others are sponge-bathed in their rooms.
Mrs Bulman has an appointment with the hairdresser at the in-house salon and is also keen to take part in the craft activities on offer during the morning.
The pressure is on.
But she ends up having to wait a little longer.
A woman in the next room is demanding attention.
"She yells if she's not attended to," Ms Monk-Burling explains.
"Barbara will have to do her first."
No soon has she gone in to attend to her than Mrs Tolley comes whizzing out of the room waving an incontinence pad in the air.
"Pads are an ongoing issue," Ms Monk-Burling explains.
Each resident has a daily allocation and if they run out it's a case of beg, steal or borrow.
"Permission to borrow," Mrs Tolley chortles, before going on a reconnaissance mission.
Soon after an angelic-looking elderly woman emerges from her room looking her Sunday-best, her snowy curls primped to perfection and a string of pearls around her neck.
She is wheeled down to the lounge and Mrs Bulman finally gets to have her shower.
The perky octogenarian came to Cedar Manor eight years ago after having a stroke.
"I think the staff are very kind and they're very helpful. They do all kinds of things for us from dressing us to undressing us, putting us to bed and they assist with meals," she says.
"Feeding the helpless," she adds with a cheeky grin.
"They're not paid what they're worth. I've maintained for a long time they're overworked and underpaid. But the government is very stingy."
When we have finished chatting, Ms Monk-Burling wheels Mrs Bulman to her hair appointment and I accompany them.
"It was nice to meet you," I say, bidding her goodbye as she settles in to get her hair set.
There is no time for such pleasantries with either of the two remarkable women who have let me observe their busy morning.
Mrs Tolley is busy attending to the remainder of her assigned residents and as Ms Monk-Buller guides me to the foyer she is abruptly called away by the shrill squeal of her pager.
"Thank you," I call after her as she sprints off.