Assessing genuine need for home care

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I BELIEVE in taxes. These pay for our schools, hospitals, police, benefits and much more that underpins our civil society.

I am more than willing to pass over some of my income to our benevolent state, which is mostly there for us when we need a little help. The reality is that it can just take one accident to turn people of any age from earners to beneficiaries.

Some conversations stick in your mind and I will never forget one I had with a dairy farmer on the plains 32 years ago. A father of five, he told me that he had not paid taxes for many years, as though proud of this accomplishment. At that stage of my life I was still far too polite, and failed to ask him whether he thought it was okay for wage earners such as myself to carry the burden of his children’s healthcare and education.

I don’t know who pays what taxes now. It may well be that farmers pay their fair share in this day and age. However, worrying trends, such as increasing poverty, homelessness and deteriorating hospital buildings, seem to point to the need for more taxes to come from somewhere.

On top of those problems we keep hearing about the “grey tsunami”. That’s us old people. I hate the term, as it implies we will destroy all ahead, and ignores the contribution we still make to the economy. However, I do acknowledge that, as our numbers grow, we are going to cost more in healthcare and superannuation. This may deprive our children and grandchildren of their fair share of benefits.

Right now though, I am thankful for the portion of our taxes that goes towards the home care that enables so many of us to remain in our own homes as we age. We held a public meeting last month where the managers of two home care providers, Disabilities Resource Centre Trust and Healthcare NZ gave honest and lucid explanations of the challenges they face in providing home care services.

Their willingness to listen, to try to shape their services to meet so many individual needs and provide straight-up answers to hard questions was appreciated.

But before we receive such support, we first have to go through a system of assessment and allocation. Just how much care do we need and how is it determined? It is true that some seniors feel their allocation of support is parsimonious. Others find it more than adequate.

Support Net, a part of our district health board, does the assessment and allocation for individuals. No, they have not yet been taken over by BUPA, as one senior firmly believes. I shudder to think of the difficult decisions that have to be made by these gatekeepers.

Some older people are fiercely independent and reluctant to ask for help. Others feel entitled to a generous allocation. Against this variation, it is up to the assessors to determine the genuine need and it must be impossible to always get it right. This is not an easy task and I admire those who take up these roles. At the same time, I agree with a home care provider who suggests all seniors have someone with them when being assessed, to ensure all their needs are noted.

One bone of contention is the need for seniors to go shopping or to doctors. If they cannot drive and cannot get a bus then that is difficult. I understand that the health board is reluctant to provide this support – although they do if pushed.

They would prefer seniors to order their groceries to be delivered. This means that the small social outing shopping provides is denied them and they become even more isolated.

One home care provider approached Eastern Bay Villages to ask whether we could fill this gap. We don’t have the capacity to do this for many people at present so had to reluctantly turn this down.

I have heard the health board is $14 million over budget so they are unlikely to become more generous. There are issues that need to be faced and discussed.

To that end we have organised another public meeting, this time with Support Net staff and our health board’s planning and funding portfolio holder for older people. It will be at Knox Presbyterian Church, Domain Road on Tuesday, May 14 at 10am.

If readers want to meet the people grappling with the hard decisions, do join us. We can hear the perspective of the budget holders, and also let them know how life is for recipients of support. Sharing ideas will help us understand each other’s views and may uncover both issues and solutions. After all, we have a shared goal of ensuring seniors can live well in our own homes as long as possible.

In reality, I suspect that to reach that goal taxpayers will have to pay more, but that will not be within the scope of our meeting. Such contentious matters are better left in the hands of our politicians.

Grey matters

by Ruth Gerzon