Health reporter Elspeth McLean looks at its " restorative" model of care being tested in the Taieri area.
Changes can be made to the way care is provided for the elderly which are better than what is generally available now, but they are not simple and they should not be rushed.
That is the message from Otago Presbyterian Support chief executive Gillian Bremner, whose organisation is in the middle of a trial called "Enliven" which provides support for people in their own homes.
Since last February, about 130 of Presbyterian Support's clients in the Taieri area have come under the programme, which involves goal setting by the elderly in conjunction with those involved in their care.
Getting approval from the Otago District Health Board for the pilot, which ends next February, involved some months of negotiation and making the new arrangements work took about six months.
The contract pays the same rate as the traditional model of home care, but allows flexibility.
The programme, which is used in four other Presbyterian Support regions, challenges the idea that once a client is entitled to a service then that remains forever.
Services are provided according to the needs and goals identified by the client, and rather than the level of service constantly increasing, it will ebb and flow as regular reassessments occur.
It could reduce over time or remain stable despite an increase in needThe programme also does not define support narrowly as personal care or housework help, but looks at ways of connecting people with their communities.
Mrs Bremner says older people's worlds often become smaller as they age due to such issues as mobility problems and depression and the restorative model looks at how they can be involved in their communities.
"Having the cleanest toilet in the street doesn't do a lot for you, does it?"
The pilot programme has meant changes for 30 support staff who are now expected to do both household management and personal care and are also involved with shopping and socialisation outings, assisting with exercise programmes and meal preparation.
They also take part in meetings to assess progress and are expected to undergo extra training.
They are asked to see themselves as working alongside clients, rather than "doing for" them.
Mrs Bremner said it was hoped making the job more diverse would give greater job satisfaction in an area of health care where attracting staff had traditionally been difficult.
An evaluation of the project is being carried out by the University of Otago and funded by Presbyterian Support and the district health board.
The preliminary results of this are expected to be out later this year and Mrs Bremner is confident these will show the model is better than the traditional one in many respects.
