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Families are already expressing concern about the possibility of telephone interviews to reassess elderly relatives' need for housework help, Age Concern Otago chief executive Susan Davidson says.
This follows discussion at this week's Otago District Health Board of plans to reassess the needs of 2400 people over 65 who are receiving up to two hours of housework help a week.
The move is designed to try to rein in the board's spending on the elderly.
Ms Davidson said yesterday she had received calls from people concerned their relatives would agree to anything over the telephone.
Family members needed to be consulted, they said.
An elderly person's first reaction on the telephone was likely to be "I'm fine thank you".
"Older people don't necessarily want to say they are in need."
It was a complex issue and needed to be treated as such.
The board has been trying to reduce this service to national average levels, but planned reductions are not on track, prompting the plan for telephone reassessments to cut down the $4.8 million being spent annually on the targeted group.
Board management is to discuss the plans next week with staff and organisations involved in the aged-care sector, but regional general manager of planning and funding David Chrisp, under pressure from board members, revealed some details of the proposal at the board meeting on Thursday.
Ms Davidson questioned whether the technique had been used successfully elsewhere, as claimed.
Recent reports of telephone reassessments in the Wellington area had not been positive.
Presbyterian Support Otago chief executive Gillian Bremner was keen to learn of examples of where it had worked well.
She appreciated the board's financial position and accepted some people would be receiving services they did not need, but arbitrary reassessment by telephone was "rather a blunt instrument" to deal with that.
For some people, a small amount of help could be very beneficial, making the difference between them staying at home or not.
A "one-size-fits-all" approach was not desirable.
She hoped the meeting next week with board management would also allow some discussion of long-term solutions to the provision of care which concentrated on what the elderly wanted to achieve - "adding life to their years, rather than years to their life".
The need to save money always dominated the discussion, whereas sometimes "you have to be brave and go down a new path that doesn't immediately save money, but it will in the future".
Both Ms Bremner and Ms Davidson said they looked forward to next week's meeting and hoped to be able to give positive input.
Ms Davidson said she was pleased the board acknowledged staff should discuss the issues with people outside the hospital.
"That might not have happened in the past.
"That's a gain."
Mr Chrisp told the board longer-term work would be done to look at how the board could change its contracting approach to consider alternatives to the existing home-based support systems.
This could mean people remained in their homes six to 12 months longer than at present before moving into residential care and might include such things as two hours of weekly nursing input.
Rest-home occupancy in Otago is now at 85%, the board was told, prompting board member Richard Thomson to reiterate his concerns that as occupancy dropped, there was a risk of poor care.
He said he wanted to know what the board was doing to actively monitor quality in those rest-homes where occupancy was dropping.
"There will be examples of poor care and we'll find out after they occur.
"If that happens I'll be bloody angry."