In around thirty years time it’s expected there will be more older people than children – for the first time in history.
In Aotearoa, 1.2 million New Zealanders will be aged over 65 years in just twenty years. To celebrate this growing population group and raise awareness of their needs, the United Nations (UN) holds International Day of Older Persons around the world on 1 October.
The theme for 2019 is ‘the journey to age equality’ with a core focus on the health care sector. The UN says to make health services relevant for older adults, services need to:
- shift their focus from the management of individual diseases to building and maintaining physical and mental capacities
- coordinate across health and social care
- meet the needs of all older adults in the poorest communities
- ensure sustainability.
The Health Quality & Safety Commission is working to improve care for older people, with a focus on aged residential care. It is developing a quality improvement programme in partnership with aged residential care sector stakeholders and aged care facilities.
Dr Michal Boyd, clinical lead for the Commission’s aged residential care programme, says the Commission is seeking to support the sector to build a culture of continuous improvement, learning and development, and ultimately improve older persons’ experiences of care.
The Commission has several resources for older people and the health care providers who support them.
Ngā aratohu maimoa hauwarea | Frailty care guides
Dr Boyd says that as Aotearoa’s population of older people increases, the recognition and treatment of frailty has become crucial to all health care environments.
Ngā aratohu maimoa hauwarea | Frailty care guides offers health care providers practical advice on frailty.
The guide comprises 26 practical tools covering the full spectrum of frailty, from deterioration and specific health concerns to communication and advance care planning.
The tools are intended to be used in any setting where people at risk of frailty receive care, including aged residential care, primary health care, community care, hospice and acute hospitals.
‘These new guides will form the basis of future education and quality improvement initiatives within the aged residential care and community sectors. We hope this is a valuable resource for those caring for older people requiring specialised frailty support,’ she says.
Nau mai, haere mai ki tōku kainga hou | Welcome to my home
‘Another resource is a collection of personal stories about what’s important to people and their families and whānau when entering aged residential care in Aotearoa,' she says.
He kōrero mai i ngā tāngata e noho ana ki te tiakitanga ā-noho mō te pahake | Stories from people living in aged residential care summarises the stories of 13 people and whānau experiencing life in aged care, based on ‘What’s important to me?’.
It highlights common themes drawn from the residents’ stories, and provides a discussion guide for aged care providers.
One of the stories is from Raina, whose mother is in aged residential care. Raina began running a bi-weekly kaumātua kapa haka waiata for her mum and the other residents.
‘I’m glad we put mum here,’ says Raina. ‘I even say sometimes, “Mum do you want to come home to live or do you like being here?” And she’ll say “Nah, I don’t want to come home. It’s alright here”.’
Te whakamahere tiaki i mua i te wā taumaha | Advance care planning
Advance care planning discussions are an opportunity for you to understand what is important to your patients; what matters and what makes life meaningful to them.
Dr Chris Kalderimis, the Commission’s clinical lead for advance care planning, says when a patient has an advance care plan, knowing their values and what is important to them can make their treatment approach clearer and easier to follow.
‘It is very important that we maintain a patient’s integrity and mana when we make plans for their future.
‘The value of advance care planning is in the conversations and the shared understanding between you and your patients, making it easier for you and others to make treatment and care decisions on their behalf, if and when the situation arises.’
Kia kōrero | Let’s talk advance care planning campaign this year featured six diverse stories of people who have done an advance care plan. Noel Tiano was worried about confronting his end-of-life care, but now he says doing an advance care plan has given him the freedom to deal with death on his own terms.
‘My plan is all about making sure that there is laughter in the house. I want people to be happy,’ he says.