DHB apologises for tone of letter suggesting elderly do housework to stay healthy

Hawke's Bay Hospital. Photo / File

Hawke's Bay District Health Board has apologised for the way it communicated cuts to a housework service for the region's elderly.

But a local MP and age care advocates say the HBDHB hasn't back-pedalled far enough and needs to review the decision to make cuts.

The DHB this week sent a corporate services letter to 605 residents aged over 65, many of them frail and incapable of doing housework, saying they would no longer receive help with basic chores, and that doing it themselves would improve their health.

The cuts affect people aged 65+ who only receive DHB-funded housework, and no other health-related support services.

The letter said they could reapply to have help with chores reinstated. This remains the case, as at Friday afternoon.

The letter prompted a wave of anger. As at Friday afternoon 160 people had rung the DHB's needs assessment service co-ordination (NASC) team to ask to be reassessed.

The DHB said it was now reinstating home help to all those who had rung that number, and was committed to making contact with all letter holders as soon as they possibly could.

HBDHB planning and funding executive director Chris Ash said the DHB was committed to supporting older people to live in their own homes for as long as they could and was "disappointed" letters had gone out to people who genuinely still required the support.

"We unreservedly apologise for this and accept the assessment process has not been robust enough.

Ash said extra staff had been brought in to manage client reviews.

"As a further measure, the DHB has also asked providers to make contact with all affected clients to assist them in being reassessed for support, and if they feel they still need it, to reinstate their services until reviews are undertaken."

Taradale's Beryl Browne wished she had more notice about the cessation of the service provided to her for the past 12 years. Photo / Paul Taylor

MP for Tukituki Lawrence Yule welcomed the DHB's apology but said he would be formally asking the DHB and the Minister of Health to review the decision to cut home help.

Yule said the fact remained the DHB, even after the apology, was going ahead with the cut, which was "heartless" and "traumatising".

"I think people in their own home with household help is actually better than having people in residential living. It allows them to remain independent and it is less expensive."

Tukituki MP Lawrence Yule speaks up against DHB cutting basic household services for the elderly. Photo / File

"It [the cut] is completely heartless, and traumatising for a whole lot of elderly people.

"Having to call to be reassessed causes a massive amount of stress because these people have limited modern technology skills. They are our vulnerable elderly and they need respect."

He said there were better ways to make changes.

"If you make changes, justify them, and implement them sympathetically.

"The DHB has completely dropped the ball here."

Grey Power Napier and Districts said on Friday while it agreed to a review of the services it did not agree with the cuts being made.

Grey Power Napier and Districts members, from left, secretary Isabel Wood, vice-president Bruce Carnegie and publicity officer Maxine Boag. Photo / File

President Bruce Carnegie felt the decision and its communication was "too direct and too cold".

Ash said the DHB's suggestion that people use housework tasks as part of keeping healthy and active was written in the wrong tone, and he apologised for that.

"The DHB accepts that receiving this information within the context of the letter has been upsetting for those people who still need this support and we apologise for this.

"The intention was to encourage those who are mobile and can be active, not to be disrespectful in any way to people who are not, and still genuinely require the support."

The criteria for people who had been referred for home management related to their ability to manage household tasks and was assessed on an individual basis, he said.

Any exceptional circumstances were also taken into account as part of the individual situation of each person.

"We acknowledge some elderly people who receive the letter may not want to phone or seem a nuisance, yet they could be one of the affected clients who should never have received the letter in the first place.

"We apologise to individuals and their families as we recognise this is an upsetting time for clients who still genuinely require the support."

He added that if the clinical team determined through reassessments that services should remain for a client, it would.

Anyone who has received the letter and is concerned support is stopping for them can make contact with the district health board's needs assessment service.

Alternatively, a provider will contact them to discuss their needs directly and work with the DHB to log a reassessment request.

After phoning the needs assessment service, clients go through a triage process over the phone to gather further information, before a private home visit is organised to reassess their needs.

Kerry Davies, National Secretary of the Public Service Association, said "We are pleased they apologised, but those letters should never have been sent in the first place," says
"Our members are already worked off their feet trying to do as much as they can to help clients in the short time slot they have allocated with them. The solution to that is to increase funding and allocate more resources to help staff and clients get the job done."

Home care companies are contracted by DHBs to provide services to elderly and disabled New Zealanders and many of their employees complain they do not get enough hours a week.

Despite struggling to get enough hours, support workers are still expected to perform large amounts of work and meet extreme demands in the limited time allocated to them.

A support worker and PSA member who does not wish to be named says she helps some clients in her own time for free.
"It hurts us as much as it hurts our clients if we can't give them the support they need in the time we have," he says.

"I am the only person they see outside of limited contact with family who live in other cities. They are great guys and I care."

The PSA believes examples like this indicate that DHBs, home support companies and central government must work together with support workers and their unions to fix the situation.