Where does the community fit into the picture of elder
care? Richard Thomson asks. Photo by Jane Dawber.
The debate over reducing some aspects of care for
the elderly is in danger of becoming a single-issue
controversy. Richard Thomson argues that it must be considered
in the full context of the ODHB's service provision.
The current debate on the Otago DHB's decisions to reduce
some aspects of its aged care provision is in danger of
becoming a single-issue one.
One side is apparently hellbent on cutting costs in aged care
and the other side is adamant that old people will be put at
risk and it must be stopped.
But is it really a single issue? I don't think so and we do
our community a disservice if we don't look at the wider
issues.
It's for precisely those reasons that I have supported the
need to make reductions in some of our service delivery.
Let's start with some facts.
Otago has more elderly people than the national average and
so we would expect to deliver more services than the national
average.
However, you can adjust for this, and when you do, you
discover that we are actually providing 28% more rest-home
beds in the over 75 age group (and even more if you include
the 64 to 75 age group).
This begs some questions, not the least of which is whether
we are doing enough to keep people in their own homes.
We know that most people would prefer to stay at home as long
as they can and we know that we are putting them in rest
homes in Otago earlier than average.
The clear implication is that we may not be doing as much as
we should to help people stay at home in Otago.
Well, yes, I hear you say, but at the same time you have
announced that you are cutting out the very care that allows
people to stay at home.
Really? I think we need some more information as it's clear
that, generally, people do not understand the range of care
services that are provided and the differences between them.
There are a whole pile of support services that operate,
including meals on wheels, district nursing services, day
services, domestic support and personal care.
It is clear that the distinction between the latter two is
not well understood.
"Personal care" has as its primary target keeping someone in
their home. This includes things like helping with showering,
dressing and the like. It may be accompanied by "domestic
support", which includes things like cleaning and vacuuming.
Almost all people at risk of rest-home care will be receiving
personal care and there is no proposal to reduce this.
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