Community care for the elderly involves much more than showering and cleaning, and the Otago District Health Board needs to be more imaginative in its approach to buying services, board member Louise Carr says.
She told the board meeting last week she had heard about care of the elderly since 1995, but apart from the work being done by Presbyterian Support, there did not seem to be much change in thinking.
Shifting the costs from rest-home care to services covering on;y housework and showering were not the answer.
Such services were "staid", and the board was not buying services that improved the quality of life and tackled issues such as depression, isolation and social pressures, she said.
Board regional general manager of planning and funding David Chrisp said the board was looking at buying some different types of services next year, including a daycare service for people with dementia.
The risk was the board might buy another service but the cost of that might not be offset by reductions in the cost of other services.
The board has been trying to reduce the cost of its community services for the elderly because it is spending much more than it receives for them.
Graphs showing the progress on the reduction targets show rest-home care decreasing, but the amount of personal care increasing significantly in the last year and the hoped-for reduction in household management not achieved.
Board member Richard Thomson said it was vital the board managed effects of reductions in rest-home care, and members needed to be able to monitor that.
He suggested the way the information was provided needed to be altered so it was clear when the board was close to the target.
"The real grief has not really started to happen," he said.
Mr Thomson had previously expressed concern rest-homes would come under financial pressure as their occupancy abated, saying the board would need to monitor quality closely.
Mr Chrisp said targets for all services would be considered again towards the end of the financial year.
The data available nationally had changed, so a different way of looking at how the board's services compared with others would be needed.
Board members also asked that information on the differing rates of longevity around the country be included.
Mr Thomson said it was relevant because if Otago had many more people in a higher age group, say over 80 years, it could expect a higher hospital bed occupancy rate.
