Rest homes, once the domain of still relatively active older 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 the past 10 to 15 years had seen more people 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 likely 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 regional variance was likely to be affected by the number of rest homes in a region and how well resourced a DHB’s home care services were.
Boyd questioned the 20-year-old 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 who you help get dressed anymore. These are medically complex people,” she said.
A Funding Model Review commissioned by the Ministry and DHBs is expected to report back early next year on the relevance of the model now and how it could cope with future growth in the sector.
* The proportion of older New Zealanders living in aged residential care has been decreasing over the past 10 years. Nonetheless, with significant population ageing, the number of aged care residents is expected to increase by up to 72 per cent by 2031.
* Around 33,700 people per year require aged residential care in New Zealand. This number was anticipated to increase to 58,000 people over the next 13 years.
* Population ageing will result in more deaths per year in NZ from 2026. There will be an 84 per cent increase in the number of deaths in aged care residences between 2016 and 2038.
* DHBs spend about $1 billion on support services for older people; 60 per cent of this goes to aged residential care. Over the last 10 years DHB spending on services for older people has increased twice as fast as their overall expenses and five times as fast as the consumer price index
To learn more about the research we are doing to support palliative and end of life care in Aged Care please check out the ‘ELDER’ tab on our home page or previous blogs tagged ‘Residential Aged Care’.