Rest homes accuse Government of ageism
A failure by the Government to adequately fund the growing number of elderly being admitted to rest homes to die has been labelled ‘‘ageism’’.
New Zealand Aged Care Association chief executive Simon Wallace said the lack of investment in palliative care was symptomatic of ageist policy-making and a ‘‘real issue’’ in New Zealand.
His comments follow publication of an Otago University, Wellington study showing rest homes were increasingly providing palliative care for elderly, terminally ill patients sent to the facilities by hospitals and hospices under increasing pressure to free up beds for acute or urgent care.
The study authors recommend the Ministry of Health fund some agedcare facilities to provide more expensive specialist end-of-life care.
Since 2016 more New Zealanders died in a rest home than in a hospital or hospice, Wallace said. ‘‘By 2038, there will be 20,000 people die in a rest home out of the 45,000 projected deaths, annually. So that’s almost half.’’
Rest homes did not have the same resources as hospices or hospitals, including access to palliative care nurses and other medical professionals.
Wallace said the Government’s failure to provide adequate funding for palliative care meant some providers were relying on volunteers to fill the gaps, while others became economically unviable.
Insufficient funding was ‘‘at the heart’’ of the closure of five rest homes in the past year, he said.
‘‘We’ve been lobbying the Government on this issue for many years.’’
Ministry of Health spokeswoman Clare Perry said aged residential care was covered by district health boards from their population-based funding. DHBs had increased funding in line with increased numbers in residential care, she said.
An Ernst and Young review recommended increased recognition of palliative care needs. Perry said it had been agreed the recommendations ‘‘have merit and warrant further consideration’’.
In the university study, researchers assessed clinical notes of seven patients admitted to Te Hopai Home and Hospital in Wellington for end of life care. All seven patients died within three months of admission.
They suffered from multiple chronic medical and mental illnesses including conditions such as arthritis, gout, diabetes, faecal incontinence, heart disease, asthma and substance abuse in addition to a primary terminal illness such as cancer.
High level specialist medical care ‘‘beyond the level of care that aged residential care facilities are set up or currently funded to provide’’ was required, the study found.
External professionals contracted to provide care included registered nurses, social workers, physiotherapists, podiatrists, oncologists and general practice doctors.
Staff at the facility reported being under huge pressure to cater for highneeds, palliative patients.
One nurse reported having to monitor syringe drivers for pain relief medication for three palliative patients, do medicine rounds for 30 regular patients and attend to family members in one afternoon.
‘‘And you want to sit with this patient who is actually dying,’’ they said.
Te Hopai manager Dave Stewart said 39 palliative patients had died within three months of admission at the 150-bed facility in the past year.
Dedicated and caring staff were trained in palliative care but struggled with the high volume of patients, he said.
‘‘The current funding model does not cover the level of care required for the numbers we are having to cope with.’’
Wallace said rest home patients were older and sicker when first admitted, compared to previous years.
Hospital-level care was funded at a rate of $600 per bed but the same level of care in a rest home was funded at one-third of that, Wallace said.