Age-old dilemma
Rest homes, once the domain of still relatively active elderly people, have become what one expert calls ‘‘de facto hospices’’, housing people with complex and serious health needs.
And where residents once drove and needed parking spaces, ‘‘now they were arriving in ambulances’’.
Auckland University associate professor and aged care expert Dr Michal Boyd said that in the past 10 to 15 years more people were being discharged from hospitals to residential aged care for the end-of-life stage.
Aged care was becoming the nation’s ‘‘de facto hospice’’, she said.
‘‘What we’re getting in residential aged care, which is tough for us, is these really complex end-of-life situations. We’re getting more people staying less time,’’ Boyd said.
Today the life expectancy of someone in a rest home while receiving government funding is 1.7 years, 2017/18 Ministry of Health figures show.
And, generally speaking, the fact it’s a short length of time was a good thing because it meant the person probably lived nearly all their life at home.
The figures only included those people whose stay was government funded, and not those who pay the full cost themselves (because they have assets and income that make them ineligible).
People entering a West Coast rest home have the longest median funded stay – more than three years – while those in Nelson-Marlborough have the shortest at less than 10 months.
The ministry was not aware of any factors leading to regional variations. Manager of healthy ageing Jim Nicolson said the age of people entering aged residential care had been gradually increasing over the past decade or more – from 83.2 years in 2006/07, to 84.1 years in 2017/18.
The length of stay had varied little since 2006/07, when it was 1.3 years.
Nicolson said the ministry started collating this information ‘‘because providers told us that people entering aged residential care were more frail than in the past, which they believed would mean residents would stay a shorter time in care before they died’’.
‘‘However, our data shows that does not appear to be the case.’’
Life expectancy for those entering psychogeriatric care (for those suffering with severe dementia) has always been a little longer than for those entering rest homes, and in the latest year was 2.4 years.
Those in dementia care could expect to live 1.8 years and those in hospital care 1.4 years.
Chairman of Grey Power’s age care committee, Roy Reid, said the figures didn’t surprise him.
‘‘Rest home owners will tell you that people entering a rest home now are in a poorer state of health than what they used to be. I spoke to one rest home owner who’d been in the business for 30 years.
‘‘When he first started, he said people drove their cars and they needed parking spaces for residents’ cars. Today nine times out of 10, they’ll arrive in an ambulance,’’ he said.
‘‘Today home support is being provided to keep people at home as long as they can. That’s a good thing, provided they have a reasonable standard of living and that they’re happy and have social contact. At a rest home they sort of lose all that contact.’’
The regional variance was likely to be affected by the number of rest homes in a region and how well resourced a district’s homecare services were.
Boyd questioned the 20-yearold funding model for aged care and acuity. ‘‘The issue is are we actually resourcing aged care adequately to do this increased load of care? It’s complicated. It’s not nice, old confused grandmas whom you help get dressed any more. These are medically complex people,’’ she said.