Say No To Postcode Healthcare
It’s always gratifying when research validates the work we do here at aged care facility, Radius Care, in looking after elderly New Zealanders, especially when it’s credible, large-scale, and based on internationally accredited assessment tools. An in-depth look at nationwide data has highlighted strong improvements in health, mental health and well-being, pain management and sociability, for elderly people living in aged care facilities.
The New Zealand Aged Care Association (NZACA) commissioned the research because they were concerned that many elderly people are receiving inconsistent access to care. There was anecdotal evidence that people who have been assessed as being at risk at home are facing barriers that are not health driven and are staying at home longer than is safe or in their best interests. There were also concerns that decisions around when a person can access residential care and the level of care they receive, vary depending on which region in New Zealand they live.
I believe in people staying in their own home as long as possible, provided they are safe, their health and wellbeing does not suffer, and they are well supported. However, even with home support, an older person may be isolated, lonely, and sacrificing better health. Family support can be put under pressure, and older carers may be struggling to cope, often facing health issues themselves.
A senior data analyst was engaged to examine what happens to the health and social outcomes of an older person when they enter aged residential care. The data comes from resident assessment tools developed by the international not-for-profit organisation interRAI. The interRAI tools, made mandatory in the aged care sector in 2015, use common measures to help doctors and providers improve continuity of care and to bring a person’s care and support services together identifying when help is needed.
The analyst looked at 300,000 anonymous clinical assessments carried out nationwide over the past three years. The resulting report ‘Caring for Our Older Kiwis’ found that there were “significant benefits of aged residential care for an older person’s health and well-being” provided they were given access to the care when needed.
The dedication of our industry is proving valuable. “Analysis shows that across all the key indicators of an older person’s health and well-being, their health outcomes improve over a six-month period after entering a rest home,” says the report. Six months after older people moved into care:
82% no longer felt lonely
74.5% had improved health stability
62.1% had improved mental health
62.6% had improved levels of pain
While Radius Care is very happy with these outcomes, I am worried about the report’s other findings; that many people, who have been assessed as needing aged residential care, are facing barriers to moving into care. When it comes to deciding when a person can access residential care and what level of care they receive, the outcome varies depending on where in New Zealand they live. The cynical view might suggest that some DHBs are acting under the misguided view that they are saving money by making people suffer at home.
My concern is summarised in the report’s tag line: “Say no to postcode healthcare.” One thing I know for sure is that as part of Radius’ commitment to excellence, we work hard to make sure that we treat our residents with the same high level of care irrespective of where they live.
Nationally during 2015/2016, 41.2% of people were admitted to aged residential care within 12 months of a Home Care Assessment. Yet in some DHBs only 28% of people got the care they needed within one year, while in others well over half did. For example, an elderly person living in the Bay of Plenty, who has been assessed as needing aged residential care, may wait to access a care facility for nearly 6 months longer than someone who lives in Waitemata, Auckland. That means more ill health, more pain, more loneliness. It’s unacceptable. We should applaud DHBs like Waitemata for taking a patient focussed view.
One of the reasons for the regional differences is that these interRAI tools are not applied consistently across all DHBs. Some DHBs appear to be simply not using the interRAI results or are using other assessment criteria despite having a government mandated tool. In other words, some DHBs are making care decisions based on criteria other that what is best for the person.
InterRAI is in place to make sure our elderly people have consistent and decent access to care through standardised assessments. The information collected by the NZACA under the Official Information Act from each DHB shows that, in many regions, interRAI is not being used how it was intended. This is leading to inequity of access to care for our elderly around the country.
Again, the cynic may suggest it’s easy to deny frail elderly people the care they need because they have the quietest voice. Perhaps it’s time we spoke up for them – after all it will be us one day.