Is NZ’s aged-care accommodation squeeze only a short step away from tipping point?
“It's not a job you'd choose – it’s a job that chooses you.”
Amanda Millar’s voice trembled a little as she continued: ‘it’s work that you fall in love with, little by little. It’s a humbling job and not something you can take for granted.”
Amanda was talking about her work as a healthcare assistant in the hospital care wing of Kerikeri Retirement Village, a retirement and aged-care provider established and led entirely by the community it serves in New Zealand’s Bay of Islands region.
It’s about as far from the anonymous, international corporate retirement living developments as it’s possible to get. Spacious independent-living cottages and apartments set in the expansive and luxuriant gardens so typical of this part of New Zealand, cater for active and mobile retirees. And the Village’s care facility caters for those who can no longer live independently and need varying degrees of specialist care.
It’s demanding, being an aged-care staff member, but Amanda and her colleague, healthcare assistant Bronwyn Pickery, would have it no other way.
“It’s our job to make their days brighter and that means leaving our own personal baggage at the front door. We’re pretty much ‘on stage’ from the moment we arrive on shift to the minute we leave.”
Kerikeri Retirement Village’s community focus and the small size of the town mean that staff like Amanda and Bronwyn quite often end up caring for neighbours, friends or friends of friends. These include 21 people in the ‘rest home’ wing, 30 in hospital care and 15 in dementia care.
These 66 people are the lucky few. Lucky, because in a part of the world where care beds are like hens’ teeth, they’ve hit the jackpot.
“It breaks our hearts to know that there are families in our community that simply aren’t able to cope with looking after their elderly or incapable relatives, and there isn’t a thing we can do about it,” Bronwyn says.
Kerikeri Retirement Village chief executive Hilary Sumpter is a little more direct.
“It’s shameful that our national healthcare system is failing our elderly in such a massive way. We are having to turn away people with the most heart-wrenching stories, people who desperately need to find care for either themselves or their loved ones, and there is just no way we can accommodate them.”
Amanda agrees. “You should hear the stories that these wonderful old people tell of trying to secure one of our beds,” she said. “We make it as easy as possible for them but, even so, the waiting process and the general uncertainty around whether we are going to be able to accommodate them adds a huge amount of stress. And many of them are in a stage of life where this just isn’t healthy.”
Kerikeri Retirement Village funds its aged-care facilities partly through selling ‘occupational rights agreements’ for its independent living retirement accommodation. It also receives money from the Northland District Health Board for the care services it provides. This includes dementia care. Unbelievably, this little community facility provides the lion’s share of residential dementia care in the Mid and Far North.
But these income streams are finite and stretched to breaking point just maintaining existing levels of staffing and care in the 66-bed care wing.
In the meantime, the Village is borrowing as much as its Board of Directors feels comfortable with to fund new retirement accommodation. This is needed almost as desperately as new care beds, as a “silver tsunami” of Baby Boomer retirees starts to head shoreward.
So how to cater for the growing number of elderly in this proud little provincial community requiring care? This is a question that has been exercising the minds of Village directors and management.
The Village wants to boost the number of care beds it can offer from 66 to 100. It also wants to upgrade its entire rest home wing so it can introduce the concept of care suites, the latest thinking in aged-care best practice. This involves en suite rooms with access to the outdoors and large enough to accommodate an increasing level of care as the patient ages. These allow the appropriate level of care to come to the patient’s bedside, rather than constantly shifting the patient. This has a huge positive impact on the patient’s comfort, peace of mind and, importantly, dignity.
But it’s expensive and, with all income streams already spoken for, the Village finds itself turning to the community it serves for support. It has launched a bequests appeal to help raise the $8.5 million it needs for this work.
Bronwyn says the upgraded facility would make the world of difference not only to the Village’s ability to meet the need for aged care in Kerikeri, but also to the lives of care patients and staff.
“You know, moving these precious old people from pillar to post is hugely unsettling for them. We do our very best for them with what we’ve got but there is a better way. It would be wonderful to be able to make it happen.”
Village resident Bridget Watson couldn’t agree more. She has lived independently in one of the retirement cottages for 17 years but has been admitted to the care wing twice in recent years; once for respite care following a major operation on her legs and the second time after coming a cropper after driving her mobility scooter into a flower bed.
She giggles at the memory. “There I was, sprawled on the floor and completely unable to move. A nice man helped me up and I staggered into the Village reception to tell them my story. Before I could get all the words out I was scooped up and whisked off to hospital and then back to the care wing where, thank goodness, they were able to find a bed for me.”
There she spent some time in recovery, before returning home to her independent-living cottage.
“Bridget was lucky. We just happened to have a bed that was available at the exact moment she needed it,” Hilary said. “But for every Bridget we have a dozen people we’re not able to help. Turning these beautiful but desperate old people away from the help we know they absolutely need has to be one of the worst parts of our job.”
Bridget has nothing but praise for the care unit and the staff who work there but says an upgrade of the facility is needed.
“It was all lovely apart from having to share a toilet with an old man who seemed to live in there,” she said.
“When you’ve been used to living on your own, in your own space, it’s quite a thing to have to get used to moving into a care facility. Your self-esteem takes a big knock and things like privacy become more important than they ever were. I think this idea of having your own self-contained space is so important.”
She pauses for a moment. Then her voice strengthens and her chin juts out with the stoicism of her generation. “I’m not yet ready to go into care but would be happy to go into the care facility here if I had to. I went to see a big retirement development with lifts and things, and it wasn’t for me. This is where I want to be.”
And this is where she will be if Amanda, Bronwyn and Hilary have anything to do with it!
1: Village resident Bridget Watson has lived independently in one of the retirement cottages for 17 years but has been admitted to the care wing twice in recent years.
2: Kerikeri Retirement Village healthcare assistants Bronwyn Pickery (left) and Amanda Millar in one of the care unit rooms that the Village wants to upgrade to avoid the need for elderly to be moved around as they age, and as they experience a need for differing types and level of care.