Sam Johnson’s Herald opinion piece yesterday no doubt irked both residential aged care providers and home and community support providers. He slammed rest homes, describing the residential aged care sector as “broken” and suggested there was no alternative.
“The broken institutionalised care system has to change. We have one option and it’s a rest home – I have yet to meet anyone whose aspiration is to actually move into one,” he wrote.
The point is older people need choice to best suit their needs. Many will want to remain in their own homes, but for many, this may not be appropriate and residential care may be the answer.
For those who want to remain in their own homes, the home and community support services sector (HCSS) has been doing a good job at this for many years now.
As chief executive of Home and Community Health Association Julie Haggie says, there are around 75,000 older people getting home support, more than twice the number living in aged residential care facilities.
“It is great to have organisations wanting to be part of supporting older people. People need a variety of options to meet their needs. Some people need someone to provide company, or help them with shopping, gardening or social events – organisations like MyCare and Driving Miss Daisy are very useful in that regard.”
But Haggie points out that at least three quarters of older people getting home support, need assistance with personal care like showering, dressing and medication support.
“That is what home support organisations do best, and they are regularly audited against high quality standards and contracts, and have clinical oversight to make sure they do it well. The provider organisations take on responsibility for what is called ‘duty of care’, which is an obligation for a reasonable standard of care where there is a risk of harm. It is something that should not be taken for granted, and cannot be traded away in favour of ease of technology, or local availability.”
It is about meeting each person’s needs. And if a person’s care needs to be delivered in a rest home, we should feel reassured that the quality of that care is high.
There have been some instances of poor care, and these have been highlighted in the media. But evidence shows that generally residential aged care delivers good outcomes for people.
The New Zealand Aged Care Association has always been clear that it doesn’t condone a single incident of inadequate care. However, it points out that the vast majority of providers are doing an extremely good job of caring for more than 35,000 older people living in 600 aged residential care facilities around New Zealand.
The NZACA’s Caring for Older Kiwis report, released earlier this year, backs this up with evidence based on interRAI assessment data of the benefits of residential aged care.
It shows that across all the key indicators of an older person’s health and well-being – health stability, pain, mental health, aggressive behaviour, pressure ulcer risk, activities of daily living, communication and cognitive performance – their health and well-being improve over a six-month period after entering aged residential care.
Of those people who reported feeling lonely at the time of their final home care assessment, some 82 per cent no longer feel lonely after around six months of aged care, and only 18 per cent continue to report feeling lonely.
The report also shows 37.5 per cent improved their independence, 74.5 per cent improved overall health stability, 26.8% had improved cognitive performance, and for those who were showing signs of depression, 62.1% showed an improvement.
Christchurch GP Dr Tim Wilson is an advocate for rest home care in the report.
“The quality and structure of aged care facilities which are available today means it is a missed opportunity for many people when they feel too apprehensive to move into care – I have seen numerous examples of the considerable benefits people receive when they enter a facility,” he states.
So, there isn’t just one option for older people in New Zealand. And we’re fortunate that we have good options available, too. Both home care and residential care have their place. It’s about delivering the right care necessary for each individual.