CARERS CAN EASE THE STRESS OF QUAKE RELOCATIONS

The on-going evacuation of Christchurch’s “red zone” is continuing to cause severe stress to some residents, and Miranda Smith Homecare wants people to be aware that its carers can help ease the burden of relocating. Property close to the city is at a premium now, and many of those forced to leave their red zoned homes are finding the only option is to move well out of the city centre and often into unfamiliar suburbs. Miranda Smith Homecare has clients who have called on its services to help with the transition, and have been pleased with the results. Assistance has included driving in areas unfamiliar to clients – often on a damaged and difficult roading network - shopping, help around the house, and simple companionship. The agency’s experience has been that clients – not necessarily elderly – have suffered from nervous exhaustion after having routines and social networks severely disrupted by being forced from the red zone. They have simply found it difficult to function. Home care services for such situations might typically begin with a carer visiting a few days a week, with contact reducing as clients become refocused, and more confident and familiar in their new surroundings. Miranda Smith Homecare is happy to discuss the needs of anyone who may find themselves in this situation, and can tailor a care plan to suit. See www.mshomecare.co.nz for more information.

SORTING CARE ARRANGEMENTS FOR FESTIVE SEASON

With the festive season once again almost upon us, Miranda Smith Homecare is urging people to get in touch as early as possible to arrange respite care for elderly family members. Christmas and New Year is traditionally a busy time for us and many families find our in home care services a perfect fit for elderly family members who have memory or mobility issues and need care and monitoring. Whether it’s daily visits or short term live-in care, clients appreciate the lack of disruption and ability to stick to daily routines in their own homes while family members are away. Those family members can also rest assured that their loved ones are getting the attention required while enjoying a holiday or break from their own routines.

CLEAN HEALTH TRIAL A SUCCESS IN WELLINGTON

Miranda Smith Homecare has successfully trialled an initiative which aims to eliminate the risk of cold or flu viruses being passed from carers to vulnerable clients. The initiative involves awareness and education around the risks of contracting viruses, with early identification of exposure and symptoms being the key. Carers who may have been in contact with others with colds or flu and experience early symptoms themselves, can feel comfortable about contacting management and pulling out of an appointment, in the knowledge that replacement on-call carers will be immediately on hand to step in until their illness is no longer contagious. The early intervention process has been made easier by the close communication already existing between carers and coordinators. Clients have appreciated the agency’s concern for their wellbeing and the reassurance their continuity of care won’t be affected. The Wellington team has reported that with plenty of forward planning, the initiative has been successful and there have been no reports of clients contracting colds or flu from their carers throughout the winter season. The success of the initiative has been acknowledged by the local district health board.

CHRISTCHURCH KEEN TO HEAR FROM POTENTIAL CARERS

The Miranda Smith Homecare team in Christchurch remains busy and is keen to hear from mature people who have what it takes to operate as contracted carers in Canterbury and the wider South Island region. Clients appreciate continuity of care in their homes, and a familiar face, and many also find the best match is sometimes someone closer to their own age. Miranda Smith Homecare aims to continue ensuring that client’s wishes in that regard can be delivered upon.

NEW SERVICES CO-ORDINATOR IN AUCKLAND

Occupational therapist and mother of four Kiran Peddie has joined Miranda Smith Homecare’s Auckland team as its new services co-ordinator. Kiran previously worked as an occupational therapist mainly in the Assessment, Treatment and Rehabilitation unit at Middlemore Hospital. She is very excited to be working back in the health industry, but with the different focus of being in private home healthcare.

Great outcome thanks to flexibility and knowledge

One of the benefits of enlisting a carer from Miranda Smith Homecare is the flexibility of service. It can be tailored to suit and altered at short notice when one’s circumstances change. While all cases are different, a recent one in the Wellington region was a good example of how private home care can take the anxiety out of difficult situations and help ensure temporarily disabled clients get every chance of a quick recovery. It involved a couple in their 90s living independently with no funded supports, but some self-funded housekeeping and gardening help. When one of the couple (Mrs W) had a fall and fractured her neck of femur she had to spend 10 days in hospital following surgery before being moved to a rehabilitation ward for five days. Upon discharge she needed a high level of assistance including personal cares, assistance in and out of chairs, using her chairlift and doing her exercises. Keen to help with the meals and household tasks, Mr W was busy himself, but it was a situation that also took its toll on him. In this case the support from Miranda Smith Homecare began when Mrs W was still in hospital. A carer began by visiting Mrs W in the hospital ward to discuss her wishes and requirements. She visited Mr W at home prior to discharge to assess the home situation and plan for care, and also liaised with the discharge planner on the ward. There was also communication with the hospital occupational therapist regarding the setup in the home prior to the therapist’s home assessment. Several hazards were identified during our home visit, including a strong smell of gas in the house which was tracked to a leaking pipe behind the stove, and plans were quickly made to eliminate other potential dangers and make day to day tasks easier. Three Miranda Smith Homecare carers began by providing around the clock care after having attended a training session on the ward with the occupational therapist and a physiotherapist. The training was specific to Mrs W’s rehabilitation needs. The personal aspect of the service also involved carers liaising with Mr and Mrs W’s out of town family members and keeping them in the loop. The fulltime care was reduced over a four week period as Mrs W’s mobility and strength improved. A pressure area on Mrs W’s heel, present on discharge, was a setback to some of the exercises and a quick recovery, but we arranged for a home visit by her GP and the carers gave it on-going attention as it healed. The GP visited twice in the first week and was pleased with the care Mrs W was receiving, giving full credit to the carers for preventing skin breakdown in the affected area. After two weeks ACC became involved and provided a carer as the Miranda Smith Homecare hours were reduced. We liaised with the agency to streamline services and avoid double-ups. By week four, Mrs W was able to use her chairlift independently to move between her bedroom upstairs and the living room downstairs. After six weeks, Mrs W was almost independent again and able to move comfortably and freely around her home, and support was reduced to a minimum. Mr and Mrs W and their family and GP were very pleased with the caring and professional support offered by the Miranda Smith Homecare team, and credit both the absence of setbacks and Mrs W’s steady recovery to this care. (See www.mshomecare.co.nz for more information about out services) ENDS

Care in own home mooted for ageing population

THE FOLLOWING STORY IS FROM THE WAIKATO TIMES, MAY 10. Keeping the elderly out of rest homes and in home care longer is being touted as the best way to deal with our ageing population. But at-home carers need to be better trained and recognised for that to succeed, says one academic. Waikato is predicted to have around 69,000 people aged over 65 by the year 2021 – or 17.6 per cent of the population. That's an increase from 52,340 currently (or 14.1 per cent of the population). Those over 85 are also predicted to rise from 1.6 per cent of the population now (6040) – to 2.1 per cent (8160). The figures formed part of a discussion about the care of older people during a Waikato DHB disability advisory committee meeting yesterday. "There's rapid growth – 25 years from now you'll be walking down Victoria St [Hamilton] and one in five people will be over 65," AgeWise strategic advisory chairwoman Professor Peggy Koopman-Boyden told the meeting. "So we need to adapt not only our health services, but also our attitudes," she said. It is expected the DHB will spend $86.64 million funding healthcare for older people this financial year – up from $43.93m in 2004-05. But that figure will rise substantially with the ageing population. Prof Koopman-Boyden said the development of the elder care workforce outside hospitals and care facilities was a key to managing an ageing population. "What other profession in the workforce relies so heavily on the unpaid workforce to help it?" "There are thousands of community workers ... if they're not well trained, not well motivated and recognised, or the next generation wants to keep getting paid in the workforce, what are we going to do?" She said supporting community groups like Alzheimers NZ, which pick up a lot of the burden, was paramount. "Because if they fall, so does the system." Health of older people portfolio manager Fiona Murdoch agreed that keeping people out of rest homes and at home longer was the best way of ensuring they had the facilities to cope. "We're managing to keep pace at the moment ... this is a good news story, we are living longer, but there's a rest home with your name on it if we can't get the community stuff right." The DHB spends $16.8m a year on home and community support services for older people – and $1.57m for respite care for at-home caregivers. In comparison, it spent $62.69m last year on residential care. Hamilton woman Mary Russell-Bethune is right behind a push to see older people cared for at home, rather than in residential care. The 86-year-old came close to having to go into rehabilitative care in March after falling and fracturing her femur. But after spending 17 days in hospital, she knew she had to get home to her husband Don, who is terminally ill. "It would have been terrible," she said of the thought of going into a home. Instead, she got the help of Home Instead Senior Care – a private older persons service provider. A carer comes three times a day for an hour to cook three meals and do household chores, as Mrs Russell-Bethune is fairly immobile at present. It's a service Mrs Russell-Bethune thinks should be afforded to all that need it. "They always come in with bright smiles on their face. I would have been very terribly worried and distressed if I couldn't have been at home."

Carers Deserve a Better Rate of Pay, Says Home Care Agency

Wednesday, 9 May 2012, 7:41 pm Press Release: Miranda Smith Homecare MEDIA RELEASE For immediate use Thursday, May 10 National private home care agency Miranda Smith Homecare is supporting calls to increase rates for carers working in the residential and in-home care sector. A draft Human Rights Commission report obtained by Radio New Zealand says staff working in residential facilities and in home-based community support barely earn the minimum wage. The report says those doing the same work for district health boards get about 16 percent more than their counterparts. Miranda Smith Homecare says those caring for the elderly are a vital part of the community. Some have been doing the work for many years and their pay rates should reflect that. Managing director Miranda Smith says it’s important that carers are competent and committed to clients. “It’s difficult to get an acceptable level of service when those carers are barely being offered enough to look after themselves,” she says. Ms Smith says it’s also important to give recognition to competent and long-serving carers. Miranda Smith Homecare already pays contracted carers well above the minimum wage and is currently in the process of rolling out rate increases around the country. Grey Power and the Aged Care Association are also both pressing for the issue of low wages and wage inequality in the care sector to be addressed. ENDS

WHY WE NEED TO SUPPORT THE CARERS

We keep going on about it, but we at Miranda Smith Homecare believe that early intervention and the help of one on one care improves the likelihood of dementia clients staying at home longer. We also believe that if we invest more into family/non-paid caregivers they will help reduce government or state spending: The following quote was reported by AP from Dr Shekhar Saxena of the World Health Organisation: “And rich countries should reconsider the drive to place dementia patients in institutions," said Saxena. "That's a mistake that some developed countries have made that is neither financially viable nor providing the best care," he said. To Saxena, the increasing rate of dementia is a "paradox" of medical progress. "The better we do, the more we expect to have problems with dementia and we need to be prepared for that." The following passage is taken from the World Health Organisation's report: A Public Health Priority. Dementia has an immense impact on the lives of the family, and particularly the person who takes the primary role in providing care. Most care is provided by family and other informal support systems in the community and most caregivers are women. However, changing population demographics may reduce the availability of informal caregivers in the future. The provision of care to a person with dementia can result in significant strain for those who provide most of that care. The stressors are physical, emotional and economic. A range of programmes and services have been developed in high-income countries to assist family caregivers and to reduce strain. The beneficial effects of caregiver interventions in decreasing the institutionalisation of the care recipient have been clearly demonstrated. Evidence from LMIC also suggests that home-based support for caregivers of persons with dementia, emphasizing the use of locally-available low-cost human resources, is feasible, acceptable and leads to significant improvements in caregiver mental health, and in the burden of caring. Despite evidence of effectiveness, there have been no successful examples of scale-up in any of the health systems in which the evaluative research has been conducted. Support is needed to enable informal caregivers to be able to continue in their role for as long as possible. Support includes information to aid understanding, skills to assist in caring, respite to enable engagement in other activities, and financial support.

Elderly care worries become more acute

THE FOLLOWING IS AN INTERESTING OPINION PIECE ON CHINA'S RAPIDLY AGEING POPULATION, AN ISSUE WHICH IS THROWING UP SOME BIG CHALLENGES THERE AND THROUGHOUT MUCH OF THE DEVELOPED WORLD.

By Geoffrey Murray www.china.org.cn

A recent report on the shortage of nursing home beds for the elderly in China is a prime example of how the country's rapidly ageing population has become a major financial and social issue.

When I first came to Beijing in 1990, I was highly impressed by the way the city's senior citizens were encouraged to remain active members of society, and not shut away in a grim "old people's home," as is the norm in my native home of England.

One could see large groups of senior citizens dancing, practicing qigong, sword play, playing chess, bringing their songbirds out for a walk in the park and enjoying quality time with their children and grandchildren. I'd hate to see this tradition abate in the face of fiscal austerity, yet economic realities seem to be eroding China's image as a "paradise for the old."

A report delivered to last month's annual session of the Chinese People's Political Consultative Conference (CPPCC) said the country is now facing the biggest and most rapid age shift in world history. This is due to improvements in life expectancy and a declining birth rate. China only has 3.15 million nursing home beds, representing less than two percent of the nation's retirees.

This would not necessarily be a problem if most senior citizens were healthy enough to look after themselves or have family to take on the responsibility once the debilitating effects of old age manifest. However, one can no longer make this assumption.

In my opinion, the best approach is epitomized by Beijing City's 12th Five-Year Plan, setting a target of 90 percent of the elderly receiving care at home through improved social services by 2020; six percent staying with community centers supported by the government; and four percent in nursing homes where their condition demands more intensive care.

As I age I want to stay clear of institutionalized care at any cost. At the same time, I am anxious about the prospects of loneliness if I am cut off from regular contact with society in my own home. Yet, whether one stays at home or moves into a "home," there's a question of cost. Private homes for the elderly do exist in China, but they're prohibitively expensive. That's also the experience in Britain, where much of the care is in private hands, is nothing other than a profit-seeking business like any other.

I have personal experience with private nursing homes, beginning some years ago when my late father suffered his first stroke. There is great demand for hospital beds, and after doctors determined they were unable to do anything further for him medically, my mother reluctantly agreed to move him into a private nursing home.

The owner of the nursing home painted a glowing picture of the loving care he would receive, but the opposite was true. Inmates were stuck in a single room all day, with nothing to do but stare at the television screen and sleep. The neglect was so complete that two hours past before anyone noticed one man was not dozing but was dead! Poor George – his children had placed him in the home but never came to visit him, handling everything regarding administrative matters such as payments to the home through their lawyer! We moved my father out the next day.

Staying at home can be no better. A UK charity reported: "Thousands of elderly people die alone in their homes every year without being noticed, and increasing numbers spend their final years in abject isolation. Britain's ageing population is "losing the will to live" through a lack of personal contact with friends or visitors."

A study of the social isolation of senior citizens in New York stated: "More than three million people in the United States need help from another person in order to remain living 'independently' in their own homes. Without this help, many of these elderly and disabled individuals face going hungry, falling, or experiencing other problems that could increase the risk of institutionalization and death."

Regular reading of the Chinese media shows that such problems also occur in this country, and may become worse with the break-up of the "nuclear family" and development of the "empty nest" phenomenon. This subsequent urban renewal results in the elderly being forced to move to remote new suburbs far from their "roots."

China long nursed the concept of filial piety and respect for the aged through Confucianism. Today, studies show that instead of retirees being able to rely on support from their children, they often have to supply it – whether in monetary terms or babysitting duties.

Hopefully the country can keep alive old traditions as the ageing population expands. But it's going to be terribly expensive – in providing home care facilities, subsidizing families willing but financially unable to provide support, community programs for social integration, medical care and – as a final resort – state-financed or subsidized nursing homes.

The author is a columnist with China.org.cn. For more information please visit: http://www.china.org.cn/opinion/geoffreymurray.htm

PLAN URGENTLY NEEDED FOR AGEING POPULATION

With the budget approaching, the Government urgently needs to start thinking smart about the future of aged care, says a national home care agency.
New Zealand is experiencing rapid and prolonged growth in the elderly population, a situation which is putting pressure on health and long-term care budgets.
Miranda Smith Homecare managing director Miranda Smith says a comprehensive plan is needed to tackle the problem, and that includes ramping up support for the non-paid carers whose work saves the country huge amounts of money.
The NZ Carers Alliance of 45 national not for profits is also lobbying the Government for greater support.
Meanwhile, an Auditor-General report released last year on home-based care talked about how effective home-based support services could delay or avoid a person’s admission to a rest home, reducing the cost of their care to a fraction of what it would otherwise be.
It also says elderly generally prefer to live at home, even when restricted by age and affected by disabilities.
While some of the spotlight was on dementia care in last year’s budget, and a provision was made for extra dementia beds, continuing down that path is not a long term solution, Ms Smith says.

She says elderly should be able to expect state assistance, but there will be an increased requirement for individuals and families to ensure they do all they can to provide for themselves in their twilight years.

“People should be able to expect a basic level of state care, but it is becoming a reality that there is only so much taxpayer money to go around, and some of the financial burden has to fall on the individuals.”
Ms Smith says, however, there needs to be more support from governments for the people who make huge sacrifices to look after ageing family members, in some instances putting their own health at risk.
“These people are saving the country huge amounts of money, and to keep encouraging them, their efforts must be rewarded - and health maintained - through more access to government-funded respite care.”
The NZ Carers Alliance of 45 national not for profits is lobbying for greater support for the country’s 420,000-plus family carers at www.wecare.org.nz
The alliance is asking Prime Minister John Key to take an interest on the role and needs of family carers.
Auditor-General manager Gary Emery recently told a Parliamentary select committee that demand for elderly care was increasing, yet there was no obvious plan to deal with it.
"There needs to be a collaborative approach between the ministry, the district health boards and providers”, he said.

LOOKING AHEAD AFTER BUSY FESTIVE SEASON

Miranda Smith Homecare is looking forward to continuing relationships and establishing new ones following a busy festive season, and urges people to start thinking about their twilight years heading into 2012.
The holiday season was a busy one, and our special deals including free, no obligation initial home visits and free daily check-up phone calls to clients were popular.
Our on-call carers were busy with respite care and covering for families who were on holiday and wanted peace of mind while away from their elderly family members.
Looking ahead, Miranda Smith Homecare continues to urge leading stakeholders in the aged care industry to find efficiencies and use technology to ensure elderly can be easily monitored, quickly diagnosed and remain as healthy and independent as possible.
Strategies to encourage family support are needed, and with a rapidly expanding elderly population, it’s a reality that government spending in the sector is not likely to keep up.
Those affected need to start thinking about taking responsibility and making arrangements to ensure they – or their elderly relatives – are as content as possible when the time comes to move towards some form of assisted living.
All the best for the year ahead.