People are living longer, a lot longer. Our investigation of rest homes published today reports the average age of those going into care today is 84. Ten years ago it was 75. And the numbers needing care are rapidly increasing, as are their needs. Our investigation has found too many rest homes are not up to the task.

The consequences are heart-rending. Old people sitting in pain with ulcerating skin sores or quietly enduring incontinence, or hungry because they are not given enough to eat, or dementia has set in and they are forgetting to eat. Worse, we heard of instances when medication was withheld or given late as punishment by caregivers.

Often these deficiencies are noticed by family members who visit their aged parent and draw them to the rest home's attention but naturally they do not want to antagonise staff looking after their loved one.

As most people with a parent in care know, many staff are very good. Aged care demands a special dedication. Frequently the old person is in care because family members are not in a position to provide the very personal help required, and the old person probably does not want them to. Professional care can be better for all concerned. But it must be professional care.


Staff must know how to recognise problems for ageing skin and how to grade and treat ulcers properly. They need to ensure those in their care eat, and move if they can and are turned regularly if they are immobile. The ratio of caregivers to residents is obviously vital and all should be meeting Ministry of Health voluntary guidelines that residents should average two hours' attention from a registered nurse each week and 12 hours of caregivers' time. That is less than two hours a day which, considering how much assistance many need to move anywhere, seems minimal.

It may be high time the voluntary guidelines for staff numbers became mandatory. Labour and the Greens were committed to mandatory standards before the election but the Government sounds more cautious now. Rest homes may not be able to find enough registered nurses to meet a mandatory ratio, and some have already needed extra government funding to pay their present number of caregivers.

Until recently, caregivers were underpaid for the conscientious and often arduous duties they perform. The landmark pay equity claim brought by their union in the name of Kristine Bartlett has lifted them to $19-$23 an hour but rest homes will require higher government subsidies if staffing levels are to be maintained. It is also one of the industries that fears for its ability to find sufficient numbers of suitable staff if the Government tightens immigration rules.

But these problems pale beside the inadequacies of some of the rest homes in our investigation. Clearly the Government needs to set up a better inspection regime for rest homes. The Human Rights Commission's Equal Employment Opportunities Commissioner, Dr Jackie Blue, heads a monitoring group of representatives of the industry, unions, Age Concern and Grey Power, but a more powerful watchdog may be needed. A fulltime commissioner perhaps.

Something must be done to ensure that standards of care in the twilight of life are as high as we expect them to be. If it proves costly, taxpayers should accept it. With rising life expectancy and busy families, everyone faces a high possibility there is a rest home in their future.