“New Zealanders are staying well and independent until a much more advanced age than they once did, and only go into residential care when they really need to,” says lead researcher Dr Michal Boyd. “When they do enter care they often require more assistance, and it’s important that we recognise and respond to this.”
The researchers attribute these changes to improvements in how well people age, our attitudes towards ageing, and the options available to older people, and in particular the implementation of “ageing-in-place” strategies.
The Older Persons’ Ability Level (OPAL) study involved four census surveys of people living in rest homes and private hospitals (“residential aged care”) across the Auckland region in 1988, 1993, 1998, and 2008.
The data show that since 1988, despite a 43 percent increase in the number of people over 65 years of age, the number of residential aged care beds increased by only three percent. The proportion of the population over 85 years living in residential aged care dropped dramatically from 40 percent to 27 percent.
Over the same period the median age of residents increased from 83 to 86 years, and their length of stay decreased from a median of 3.0 years to 2.5 years.
Residents’ level of dependency, which considers mobility, continence and cognitive function, increased steadily over the study period and the proportion of people considered highly dependent rose from 36 percent to 56 percent.
“These results will not come as a surprise to aged care providers,” says Dr Boyd. “Increases in dependency have a significant impact on their workload, and providers have seen that the care of aged residents has become more difficult in recent years.
“We need to recognise the reality of the population we’re serving and re-evaluate the way we provide care. In particular we need to acknowledge that many residents are close to the end of their lives, and better support those people and their families through proper end of life planning. This is a change of philosophy that requires both systemic changes in processes and procedures, and up-skilling and supporting the workforce.
“There are also opportunities to develop models of care not currently available in New Zealand, including rehabilitation-focused short stay options for those people with the potential to return to independent living.”
The findings have been published as a report available at http://researchspace.auckland.ac.nz/handle/2292/5594, and further analysis and interpretation will appear in subsequent publications.
The research was funded with the support of the Freemasons’ Roskill Foundation.