Homing in on an age-old problem | Stuff.co.nz

PETER MEECHAM/Fairfax NZ

MAVIS HAYDEN: 'This is mine. And I?ll stay here until I die.'

Hayden says she is not going anywhere.

Sitting in her sun-baked Pukekohe unit, the walls are a mosaic of family portraits, framed pictures of graduations and wedding days.

The pictures once covered the walls of a big farmhouse before Mavis, an 83-year-old mother of seven, downsized into her unit. She does not want to move again.

"This is mine. And I'll stay here until I die," she said.

"Sometimes when I do silly things, and don't seem to be coping, my daughter Maureen thinks that I'm ready for a rest home. But I don't think that I am as yet."

Aside from the fact that she likes her unit, she "still quite able to do for myself".

She starts her day by making her own porridge and cup of tea she has made herself. Help arrives around 7.30am.

"She comes and she makes my bed, and dresses me. She comes every morning, and there's one who comes at night and showers me," said Hayden.

"My daughter does the grocery shopping."

For the things Hayden has trouble doing, Manukau Home Help and her daughter Maureen fill in the gaps.

According to Hayden, her daughter is there whenever she needs.

"She's always on hand, put it like that. If I need her for anything, she will be there."

Hayden is one of many elderly people living in their own homes, getting by with a little help from family and some social services.

Like many elderly people, she may yet face choices about where to live when she can no longer look after herself.

For others younger than Hayden, those choices may not be there.

With an increasing number of elderly people to house and care for, there is a growing strain on facilities in rest homes, retirement villages, and hospitals.

New Zealand's 600,000 over-65s make up around 13 per cent of the population today. By 2031, the over-65s will total one million - around 21 per cent of the population, according to Statistics NZ.

Between now and then, the Government, aged care associations and New Zealand families will need to work out where they will live and who will look after them.

Martin Taylor, chief executive of the Aged Care Association, says New Zealand does not have the capacity to look after this looming battalion of ageing boomers.

"The demographic tsunami facing us is unavoidable," he said. "The level of building new capacity is minimal, and at the same time we are seeing the closure of facilities. Over the past two years it has been almost one a month - that's 22 in last two years."

The reason they are shutting down is because they are no longer economically viable, because the subsidy the Government gives for aged care does not cover the build cost, he said.

"It costs about $160,000 to $180,000 per bed, that's after you include common areas and car parks," said Taylor.

"If you borrow that money at 10 per cent, you would need to generate an extra $18,000 a year over and above care costing in order to pay the loan off for that room."

Jo Goodhew, the Associate Minister for Health, said the Government was already investing more than $1.5 billion in aged care, and spending had increased by almost 4 per cent per year since 2008.

"DHBs have been instructed to pass cost-pressure funding increases on to aged residential care providers," she said.

But Goodhew admits it will be a "challenge" for the Government to balance the competing demands for extra funding in the sector.

According to the Aged Residential Care Service Review, a report by Grant Thornton that the Government paid for, between 12,000 and 20,000 extra residents will require aged residential care by 2026.

The report says sector bed numbers need to increase by between 78 per cent and 110 per cent by 2026 to accommodate the projected increase.

"The model in that report shows that by 2015-16 we will start to see shortages in the country," Taylor said.

"But though the national picture says shortage, it is variable around the country. Rotorua has a lot of beds but the Hutt Valley will have shortages."

Taylor said the only building that is going on for this demographic is the care facilities within retirement villages.

The report looks at two scenarios for how the country would cope with higher numbers of elderly people needing beds in residential care facilities.

One scenario says demand for aged residential care will continue to decline until 2015, and then start to increase, but the current capacity of 34,000 beds will be enough.

The other says demand for aged residential care will start to increase significantly from this year. It says the current capacity of 34,000 beds will be exhausted, and there may be a need to provide extra beds much earlier.

"Part of the increasing demand for hospital beds will be met by converting rest home beds," says the report.

"As some facilities will require significant investment to make the conversion, there may be shortages of hospital beds earlier."

According to Goodhew, the Grant Thornton report identified expanding dementia care provision, both beds and services, as a key funding gap. Addressing this is "a priority", she said.

"Budget 2011 delivered an extra $44 million over four years to look after people living with dementia - $40m for residential dementia services and the remaining $4m over four years for additional dementia respite care."

This year, the budget delivered another $30mn over four years for residential dementia care beds and $10m over four years for DHBs to develop dementia care options by region.

One thing keeping the issue at bay is most people over 65 own a home, so superannuation can be spent on quality of life, and if they need to shift or downsize they have equity in their homes.

But that is also changing because the rate of home ownership is on the decline.

According to Retirement Commissioner Diana Crossan, four out five people over 65 own their own home and are mortgage-free. The rest are either paying rent or still paying off a mortgage. "For some, that will be a worry," Crossan said. "For others, they would have planned for that."

Crossan's main concern is the renters, many of whom will struggle in retirement as money going toward rent means there is less for other bills.

"It is a real concern that people can't afford to own their homes. I've been shouting it from the hilltops," she said.

"In a review that we're doing next year, we're going to focus on housing and we can see people around 30 to 40-years-old not being able to own their home becoming more of a concern."

Crossan says New Zealand will find a way to deal with the problem. "I'm not doom and gloom about it. We'll have organisations that crop up and say let's make it affordable," she said. "In the past people have done it. New Zealanders want this to happen - we won't be living in tents."

Though retirees may not end up living in tents, they may have to look at other options, like staying in the family home.

According to Alan Johnson, an analyst for The Salvation Army's Social Policy and Parliamentary Unit, the middle-class could have the hardest time sorting out accommodation.

"It's a feast or famine when it comes to housing for retirees," he said.

"You're either a pauper, and you can get into a council house, or you're well off and you can get into one of the life care facilities. It's the people in between that are an issue."

Because of this situation, Johnson said there would be more people living into old age in the family home.

"This means they could be rattling around in a house that's too big and they can't keep up with the maintenance.

"Then it could be up to the kids [but] they may not live near, or their visits might be intermittent because they're busy doing other stuff."

As home ownership wanes and aged care facilities close their doors across the country, the challenge of configuring forms of support remains.

Furthermore, the capacity of existing hospitals, rest homes, and retirement villages is yet to be tested.

Today's retired population, like Mavis Hayden, are not directly facing the issues that loom ahead for New Zealand's over-65s.

She has her own unit, supportive family and social services that can come and see her morning and night for the things she can not do herself.

It is the rising tide of Baby Boomers who need to prepare for the shortfall.

- ? Fairfax NZ News

Source: http://www.stuff.co.nz/auckland/local-news/7904872/Homing-in-on-an-age-old-problem

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