NO TIME TO CARE?
Home-care visits are a lifeline for elderly New Zealanders, so why are they being cut short? Bess Manson reports.
Mary Singleton is 82. The former pianist and teacher has outlived her family and many of her friends. She can go weeks without seeing anyone, apart from her home-care workers, for whom she has great affection.
But those precious visits are being slowly eroded by district health board home-care provider Nurse Maude. Just before Christmas, her carer’s twiceweekly 45-minute visits to shop, clean and cook were cut to 39 minutes. They had already been reduced by an hour a week last year.
‘‘These 39 minutes were to be broken down to 13 minutes vacuuming, washing floors, cleaning the kitchen, bathroom and toilet; 13 minutes preparing food; and 13 minutes shopping,’’ says Singleton, who lives on the Ka¯ piti Coast, north of Wellington.
‘‘It’s ludicrous and impossible to implement. I know of one customer who receives help in taking medication who has had her time cut from 15 minutes to 13 minutes.
‘‘There is no time for even minimal socialising with clients who may be isolated and lonely.’’
Sometimes she does not see another person for days, and her home-care support worker is a link to the outside world, she says.
‘‘I once didn’t see anyone for 17 days around Christmas and new year. When you’re old, your friends and family begin to die and many of my contacts are only by email. Nurse Maude doesn’t have any allowances for individual circumstances – it’s a rigid system. I would say inhumane and disrespectful.’’
John Shrapnell has been receiving care at home through Nurse Maude services for the past year.
Just before Christmas, he says he was told by his carers that his times had been reduced by between six and 10 minutes, though he had had no reassessment.
When he complained to Nurse Maude, he says he received a letter saying there had been no reduction to his visit time but that ‘‘minor adjustments to visit times may occur from time to time’’.
Shrapnell, of Wadestown in Wellington, says he is less concerned for his own situation, but feels for his carers, who talk of being overworked and having to complete too much in their allotted time.
‘‘Too often I have spoken with carers who’ve worked six hours or more without a break, no time for lunch and they’re exhausted.
‘‘Their schedule does not take into account the time taken travelling from one patient to another.
‘‘Nurse Maude is based in Christchurch, so they probably don’t understand the geography of Wellington and the time it takes to get from one client to another.’’
Too few doing too much
One former Nurse Maude homecare support worker says there are too few staff for too many clients.
A care worker for more than a decade, the woman, who did not want to be named, said one client’s care was cancelled after an assessment, despite the elderly woman being virtually housebound with mobility issues.
She had been caring for the client, well into her 90s, for years and was appalled that she was deemed ineligible for care.
She continued going to help the woman for free. She managed to get another assessment for her, and home care visits were restored. The support worker was not reimbursed for her care in the interim.
She was at the woman’s home when she called Nurse Maude to discuss the client’s needs, and says she was shouted at over the phone to leave the house.
She felt bullied, and left her position.
The former carer says she was fortunate enough to be able to afford to leave her job, but many colleagues had young families and rent or mortgages to pay, and had no choice but to continue working.
A Christchurch worker, who did not want to be named, says client times are determined by a computer program and appear on an app for staff.
The worker says times for different tasks performed during a visit were cut by two minutes each before Christmas.
‘‘Nobody told us our time was being reduced and, even worse, nobody told our clients. We had to break the news to them, which was very distressing.’’
Funding constraints
Nurse Maude is a registered charity and has been providing support care since 1896.
It has 942 support workers and 6741 clients in Canterbury, Wellington and Nelson/ Marlborough.
Since April last year, Nurse Maude has been jointly responsible for home care in home and community support services for people over 65 years in the Hutt Valley, Wellington