Sunday, June 23, 2024

Action needed to support home and community services

BY JAN PENTECOST - National President Grey Power NZ Federation INC

I have recently been involved in lobby visits to key political contacts in Wellington with the particular view of getting them to address the problems affecting home and community support services for older members.

Grey Power’s objective has been to repeatedly emphasise the importance of this issue in order to persuade politicians that action is urgently required. The rational for action is simple:

Cuts to the Home and Community Support Services (HCSS) are impacting negatively on some older people who require help to “age in place” with dignity.

Grey Power fears for the overall well-being of numerous older people who live at home with the help of HCSS because we have been inundated with information about members and other older people who are not now receiving the care they need and were used to receiving.

“Ageing in place” is the preferred option for many older people because it provides them with choices about where they live, connection, feelings of security, familiarity, identity, independence and autonomy (See the Meaning of “Aging in Place” to Older People, Janine L. Wiles, PhD, Annette Leibing, PhD, Nancy Guberman, MSW, Jeanne Reeve, PhD, Ruth E. S. Allen, PhD – The Gerontologist, Volume 52, Issue 3, June 2012, Pages 357–366, https://doi.org/10.1093/geront/gnr098 – Published 07 /10/11).

It is also favoured by government and others because it avoids the costly alternative of residential care.

Grey Power’s health/home care policy coincides, more or less, with the values espoused by one of the NZ Healthy Aging Strategy’s priority actions which is to ‘identify and implement models of care that are person-centred, needs-based and equitable, and [to] deliver high-value, high-quality and better outcomes through home community support services across New Zealand’ (Ministry of Health. 2020. National Framework for Home and Community Support Services (HCSS). Wellington: Ministry of Health.)

Gap between theory and practice

However, there is a huge gap between theory and practice, which was recognised by Rosa Kornfeld-Matte, the UN human rights independent expert on the enjoyment of all human rights by older people in New Zealand, who visited NZ in March 2020. In her report she stated that there is a “persistent lack of urgency” regarding older peoples’ issues, which is evident at all government levels

(https://www.theguardian.com/world/2020/mar/12/new-zealands-intention-to-improve-older-peoples-lives-is-falling-short-says-un-expert). I include home care as part of her observation.

What our narratives disclose is that many Grey Power members and other older people who receive HCSS to enable them to remain at home, instead of living in rest homes, are in danger because of the way home support is funded, coordinated, and delivered currently.

In other words, good home care requires home support workers who receive adequate compensation for their work, who are well-trained and who are supported by providers using professionally managed systems, including an emphasis on adequate communication.

Grey Power’s experience is that many older people rely on this care to enable them to live at home as long as possible and they believe that this is government policy, but we have received many stories from older people and their families of the removal or reduction in this service.

Specifically, this can include a complete loss of assistance, reduction in hours of care, different carers each week/fortnight, no set arrival time, lack of carer training, withdrawal of shopping assistance, re-assessments for care being done by providers’ employees, insufficient travel time between jobs for carers, and denial of domestic assistance unless a client requires personal care. These issues are all causing insufficient and inconsistent care for older people.

Evidence provided to the former MOH

This has already been provided to the former MoH at the request of the previous Minister of Seniors (summary provided below)

  • Estimated contacts to Grey Power – more than 100 contacts of lack of care – not every contact has been recorded.
  • Method of contact with Grey Power: emails, snail mail, phone calls and face-to-face contact with members via the president’s visits to 10 associations and 5 zone meetings (which consist of association representatives) held in 2021 – 2022.
  • Other evidence has been gathered from carers unions (Nurses Organisation, PSA and E tū), and from numerous media articles.
  • Locations from which complaints have been received: Central Otago, Dunedin, Nelson, Blenheim, Golden Bay, Christchurch, North Canterbury, Wellington including Kapiti Tauranga, Napier & Districts.

The narratives we have received disclose that older people are: climbing on ladders to hang out and retrieve their washing because this home care assistance has now been withdrawn; trying to vacuum while using a walker or walking stick, are no longer wearing compression stockings because the carer does not turn up to put these on. The withdrawal of shopping assistance which can mean no food. There is also a sad story of a lady who was told by her carer that there was no time to make the bed, so she slept in her bed which was saturated with urine.

One of our members has told us very recently that after a mastectomy she was discharged from hospital with no post-operative care and no family or friends to help her.

These instances could all have very unhealthy outcomes for older people, which may well mean hospital stays that could have been avoided and then lack of post operative home help on discharge or no available beds in aged care facilities.

Our recommendations

Grey Power has recommended that the government and opposition parties support E tū, the Nurses Organisation and the PSA’s call for sufficient investment in home support services to enable high quality care and support for our most vulnerable, so people who need support services can continue to live safely and with dignity in their own homes. The lives of all older people, including Grey Power members, who live in their own homes and need care depends on this.

Home care workers need:

  • permanent regular shifts like other health workers,
  • hours and income which do not fluctuate all the time,
  • a proper wage, including payment for travel,
  • genuine access to breaks so jobs can be done safely.

And a member has suggested from his experiences with home and community support services that all aged care workers be required to pass certified courses, prior to being employed and that a fair pay agreement that recognises the certificate courses for aged care workers is mandatory. He also says that the Aged Care Commissioner should investigate the inconsistency of services supplied by providers. Grey Power’s key question for politicians was: What will you do to resolve the desperate situation in home and community support services in this country?

Please see page 5 for further details of our lobby visit. The lobby team included Jo Millar, David Marshall, and Pete Matcham as well as our president.

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