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Home / Rotorua Daily Post

Rob Rattenbury: More flexibility needed in aged care arrangements

Rob Rattenbury
By Rob Rattenbury
Columnist·Rotorua Daily Post·
27 Jun, 2021 09:00 PM4 mins to read

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More than 22,000 care workers and 5000 nurses work in residential care facilities in New Zealand. Photo / Getty Images

More than 22,000 care workers and 5000 nurses work in residential care facilities in New Zealand. Photo / Getty Images

OPINION

One of the side effects of us all enjoying longer life spans is the explosion of the residential care industry.

The numbers are mind-blowing.

More than 22,000 care workers and 5000 nurses work in residential care facilities in New Zealand.

By 2026, up to another 20,000 people will need the support of the aged care residential industry.

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A further 16,000 caregivers and nurses work in the community with people in their own homes.

By 2036, about 23 per cent of the total population will be aged 65 or over, compared to 14 per cent in 2013.

By 2051, the number of older people with a disability is expected to grow by 60 per cent.

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It is simply a huge industry. The issue of buying places in residential villages is currently making the news, with reports recommending a review of a system that is definitely slanted against the residents.

At least such a review has been promised by Associate Minister of Housing Poto Williams.

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The lengthening of the human life span and the support available to keep older people in their own homes as long as possible has an outcome perhaps not foreseen by the people who write the rules about funding for aged residential care.

Many older people in the 85 to 95 age bracket are perhaps nearing the end of their time living independently and need a comfortable, secure and welcoming environment to spend their final years. Their children are likely to be pensioners themselves, with associated health problems that come to light when they hit their 60s and 70s.

These people are tasked with trying to find their dear and loved parents decent places to spend their final days at whatever level of care funding they are assessed as needing.

Both my wife and I have been involved in this exercise with our mothers over the past 10 years.

Both mums were fiercely independent and private and both were dearly loved by their children, all ranging in age from 55 to 68.

They both required hospital care in the end and it was a nightmare dealing with not only our emotions and guilt at having to place our mothers in care but the mechanics of meetings, decisions on funding levels, requirements to shift Mum from one rest home to another because of changing needs and, therefore, changing levels of care.

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My wife was a nurse all her life and worked in her later nursing career in residential aged care so we are informed but it still became a minefield at times.

My wife knew the questions to ask to get the proper information, she knew how to hold providers to account and did so while still having a good working relationship with them.

The added problem, especially for my wife's mother, was that her closest children were 100km away, as she was living in the old family home in a small country town.

My wife, the holder of power of attorney for her Mum's health matters, lived hours away.

The country town has a good variety of residential care options at all levels so it made sense to leave Mum in the town and for us all to travel to visit her.

An anomaly in the requirements for residential-care funding is that the residents are clients of the local DHB.

Nowadays, with many children making their lives in towns and cities well away from their home towns and parents, when the time comes for Mum or Dad to be cared for it is the local DHB which provides the basic funding.

A dear friend of ours has the power of attorney for her mother's health needs.

Her mum lives in another small country town and is in care.

Our friend lives 200km away and is close to her mother. She would like to move her mother to the main centre where the whole family lives, a different DHB area.

This sounds a common-sense, practical and loving thing to do for a parent but is not permitted as our friend's local DHB is not interested in funding her mother's care.

Her mother can pay but under the present system this is not a factor to be considered.

Travelling is stressful for our friend - she herself is in her 60s - in terms of cost and time and her mother misses her children and extended family greatly.

Policymakers need to allow more flexibility in DHBs being able to fund care for people coming into their territories to be closer to their families in their final years.

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