Elder abuse and neglect has been a hot topic in the news media recently, sparked by a Weekend Herald investigation into aged care facilities which found “a litany of problems, many that come up again and again”.
“They include staffing levels so low that there is a risk to the safety of residents, no response when residents lose large amounts of weight – a common sign of serious illness – expired medication, disconnected call bells and alleged elder abuse.”
Unsurprisingly, these reports have prompted discussion within the industry. “We take the NZ Herald investigation findings very seriously,” says Summerset CEO Julian Cook. “When we provide care, we are providing it to someone’s mother, father, and grandparents … we are disappointed to hear of any ill treatment within the sector.”
Julian believes that “on the whole”, the cases reported are isolated instances, a view shared by all the providers we spoke to. “However we don’t want these to happen at all. One instance of ill-treatment or neglect is one instance too many.
“I think it’s good they’ve been exposed and a conversation has started,” says Julian, “as it encourages improvement across the sector.”
In response to a well-publicised case in which Bupa was ordered by the Disputes Tribunal to pay $10,000 to a Tauranga man whose mother endured ”systemic failure” by a rest home, Jan Adams, Managing Director of Bupa NZ, said, “Bupa accepts and acknowledges that Mrs Love’s care was not of an acceptable standard.
“Bupa has apologised to the Love family, and worked to put better practices and policies in place for our residents, including improved management of continence care.”
A theme that was repeated in responses INsite received is that aged care providers are constantly striving for improvement.
“We have invested in improvements to our care systems and in additional training for staff in the past two years,” says Gordon MacLeod, Chief Executive of Ryman Healthcare. These include the introduction of myRyman, an electronic records system, to replace paper-based files, and 1Chart, an electronic medication system.
Self-monitoring and internal checks are standard practice in the industry, alongside Ministry of Health certification and surveillance audits.
“We have our own clinical team who are making improvements daily to how we run and operate,” says Julian Cook. “We annually measure satisfaction scores from our residents and their families to pick up any issues that may arise, and we respond to these seriously and efficiently.
“We enjoy our quarterly meetings with families and residents to gauge where we are doing well, and discover areas where we may need to improve.
“On a monthly basis, we measure key clinical indicators across each of our care facilities to ensure the standard of care we are providing is good. This also makes sure we pick up on any unusual things early, such as falls or pressure wounds.”
Responding to a recent Herald article headlined ‘Vulnerable elderly restrained in chairs all day’, aged care manager Chris Sanders says, “The media seems to latch onto these incidents and extrapolate that across the whole industry.”
The Manager of Sprott House, an independent trust providing care to 97 residents in Karori, Wellington, Chris believes people in the industry “work very, very hard to make the lives of residents as happy and pain-free as possible”.
“Nobody does this job for the money,” she says. “They do it for the most part because they genuinely care about the welfare of the people they care for.”
Chris believes underfunding is a major issue and – despite “wholeheartedly” agreeing caregivers deserve more money – she says the pay equity settlement for care and support workers has hit them hard.
“I believe that we look after our residents as well as we can with the resources we have, but we need more funding to ensure we have enough people to look after our older population.”
Earl Gasparich, CEO of Oceania Healthcare, agrees. “Aged Care has been chronically under-funded in New Zealand for decades and this has been made worse by the increased compliance costs on providers over the past few years.
“A number of smaller or charitable operators are exiting the sector simply because they are making financial losses.
“Hopefully the review of the way that aged-care is funded in New Zealand – which is underway at present – will address this issue and ensure our elderly receive the very best care in the very best environments.”
Bupa also welcomes the funding review, says Managing Director, Jan Adams. “We are confident that the review’s findings will shine a light on the true costs of providing quality aged care and the necessary funding improvements that are needed across the sector, especially as residents with high clinical or special needs become more common.”
Summerset CEO Julian Cook says it’s important to note that in the last decade, the average entry age of residents moving into retirement living or care support has gone from 75 years of age, to over 85. “We are seeing that elderly New Zealanders have higher levels of need, which requires more support – and this has not been recognised in funding in any way.
“The care sector’s funding model is currently being reviewed, and I think it’s important it is done in such a way that ensures there are enough care beds and facilities needed to provide for our country’s ageing population,” he says.
“The government’s funding needs to recognise the care we provide is provided to someone’s Mum, Dad, Grandparent, or loved one – maybe their own.”
“It’s getting harder,” Chris Sanders admits. “Smaller operators aren’t going to be able to continue, which will be a massive loss to the country, particularly in rural areas.”
Listing a raft of compliance costs and requirements, she says, “There are constant demands in aged care that people don’t consider.
“It means people who sit in a chair like mine have many sleepless nights wondering how we’ll manage. Which isn’t as depressing as it sounds; if we didn’t care, we wouldn’t be doing this.”