Is NZ Super enough to fund a comfortable retirement?

It is no secret that New Zealand has an aging population. As medical care improves, we’re living longer – on average, 80% of Kiwi men aged 65 can expect to live until they’re 90, and women until they’re 94.

A longer life means a longer retirement, and a longer retirement means more spending. But with everyday costs becoming more expensive, many are finding New Zealand Superannuation and their retirement nest eggs are not enough.

New Zealand Super is not enough to pay for retirement

Considering the rising cost of housing and food, increases in council rates, and the low-interest rate environment for savings accounts, it can be incredibly challenging for retirees who no longer have salaried income to live a comfortable retirement on NZ Super alone. Research from the Financial Services Council shows that as at June 2020, a retiree living alone receives $873.88 fortnightly (after tax), while a couple receives $1,344.44 total.

According to the New Zealand Retirement Expenditure Guidelines, a couple wanting to live a ‘no frills’ lifestyle in a major city would need $1,670.68 per fortnight – and a couple wanting the freedom to live more comfortably with some luxuries would need $2,846.78 per fortnight.

As you can see, funding a dream retirement lifestyle is no longer possible on NZ Super alone.

Unlock an unexpected source of wealth

When it comes to managing these financial concerns, the good news is many Kiwi retirees are lucky enough to be homeowners – and house prices have increased immensely, meaning there may be some good capital gains to be had. However, many people would prefer to stay in the family home rather than sell up – and this is where equity release options, such as a reverse mortgage, can be helpful.

A reverse mortgage allows people over 60 to access some of the equity in their home, giving them the freedom to relieve financial pressure and fund a more comfortable retirement. Importantly, with a reverse mortgage you continue to own and live in your home and community for as long as you choose.

Unlike a regular mortgage, you’re not required to make repayments, as the total loan amount (including accumulated interest) is repayable when you move permanently from your home.

By unlocking some of the equity in your home without needing to make regular repayments, you could access the funds you need to cover day-to-day expenses, consolidate debt, complete home improvements, or even just go on a once in a lifetime trip you didn’t think you could afford.

Heartland has helped over 19,000 Kiwis fund a more comfortable retirement. To find out more about how a Heartland Reverse Mortgage could help you take the stress out of increased living costs, get in touch with their customer care team on 0800 488 740 or reverseinfo@heartland.co.nz to discuss your options.

Applications are subject to loan approval criteria. Heartland Bank Limited’s responsible lending criteria, terms, conditions, fees and charges apply.

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Senior living: a place to call home

Guest Blog by Private Care NZ

Getting older, it’s often said, is a privilege to be cherished. It’s different for everyone: some of us are keen to carry on working, some will retire, and some have whanau or family members whom we live with or care for. It’s often more than not one of these.

We also have our hobbies and community commitments, as well as health considerations. All these factors come into play when planning where we will live.

A choice that fits

In Aotearoa New Zealand today, and especially around our main centres, there is no shortage of choice in specialised retirement living. From the ‘village’ style communities, where single residents or couples choose from private, self-contained homes, through to partial-care or serviced apartments, and on to a more purpose-built, full-care environment.

These do suit many people, but of course, not everyone. Moving to a new neighbourhood can be a challenge, emotionally and physically – especially with the potential for lots of new people to deal with, and a change in access to our usual friends and support network. Moving can also be a rather large cost financially once we factor in real estate agent fee, moving costs, and the price of the new place we move into. 

Other considerations, like safety and independence, need to be weighed according to our own needs and capabilities. As these can change over time, it helps for both us and our loved ones to keep an open mind – as with most things in life!

Independent living

The benefits of staying in our own home, or downsizing to a similar one independently, are many. Not having to relocate helps provide a reassuring continuity to daily life, and allows us to keep our preferred routines and privacy.

If we don’t own our home, or if downsizing is less of an option, sharing with friends as housemates can be a sociable and more cost-effective way of maintaining our independence.

Getting the right support

Those of us living with certain health conditions can be eligible for government-funded care. However, private carers are also available – allowing you to specify exactly the kind of help you need. It might be making meals, certain household tasks or personal care and grooming – anything that will support you to keep living comfortably and safely.

Making the most of technology

Throughout our lifetimes, we have seen extraordinary leaps forward in the tools we use to communicate. Video calls were once a concept for futuristic fantasy movies, and now they’re part of many people’s daily life.

As with any tool, smartphones and computers are easy to use with a bit of practice. Most care providers will have a tool for you to request and change carer visits, which connects straight into their system and is free for you to use around the clock.

There are also personal medical alarms, like Freedom Medical Alarms, which provide peace of mind knowing that help will find you fast in an emergency.

Where to from here?

If you’ve got these matters on your mind, a good first step can be talking to your GP – potentially alongside a whānau member or support person. They can advise you on your current health needs, how these might change in future and what support options are available to suit.

If you’re keen to know more about personalised care that lets you stay in the comfort of your own home, get in touch with Private Care NZ by calling 0800 55 55 88 or visit www.privatecarenz.com.

For more information about how medical alarms can keep you safe at home, call 0800 380 280 or visit www.freedomalarms.co.nz.

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Active Travel – barriers and enablers – Part 2

Judith Davey

The second part of the Centre for Ageing Better (CAB) 2021 report covers the role of the environment in encouraging or discouraging active travel (walking and cycling) among older people.

Supportive infrastructure for walking and bicycling

There should be continuous and easy-to-follow routes for travel for the duration of a journey, whether on foot or by bicycle. Any danger, posed by motorised traffic and other risks and obstructions should be minimised. Supportive infrastructure also requires good streetlighting.

Connected street networks

Environments that are connected and create shorter and more direct routes to key local destinations encourage walking or cycling, compared to driving. These would feature a high density of intersections, crossings at junctions that are safe and easy to use, minimal dead-ends (cul-de-sacs) and traffic calming measures, such as low speed limits. In several; New Zealand cities 30 KPH speed limits have been introduced in central areas, but need to be enforced. In Wellington there are attempt to improve “lane-ways” – traffic-free alleys between the main streets, which can be attractive and safe for pedestrians.

High population density and mixed land uses

Areas with high population density and mixed land use – where shops, housing, workplaces and other amenities are close together – meaning journey distances are short and can encompass a range of activities in one trip.  Places where people can meet their everyday needs within a short walk or cycle, have become known as 20-minute neighbourhoods or 15-minute cities – concepts which are being adopted in urban planning in this country. Aiming for this type of development will boost not only levels of physical activity but also local economies, while at the same time tackling climate change (by reducing vehicle emissions). Wellington City is promoting higher densities in the central area through increased zooming for apartments.

Implications for policy and practice

Many local authorities and local transport authorities have not given specific consideration to older people and those approaching later life when designing active travel schemes. To increase active travel options policymakers and planners should:

Invest in walking and cycling infrastructure

This includes improving and maintaining pedestrian pavements; keeping an eye on deteriorating surfaces and making them smooth; fixing potholes; providing good pedestrian and cyclist bridges and crossings; and implementing traffic-calming measures such as reduced speed limits. This ideally means walking and cycling paths that are physically separated from motorised traffic of which there are already some examples in New Zealand. Good street lighting is also important.

Invest in street networks to provide connectivity

Design and re-design street networks that start from the doorstep and are connected to key local destinations, maximising accessibility and allowing pedestrians and cyclists shorter, more direct trips.

Emphasise safety

Fear of traffic, whether real or perceived, is a key barrier among people as they grow older, so emphasis should be made to improve infrastructure and crossing facilities to increase accessibility, convenience and safety. They should also provide easy and safe connection to public transport for longer journeys. Neighbourhood street networks should dovetail with ‘whole town/city’ networks.

Invest in aesthetic improvements

Seating, planters, community parks and green spaces add to a greater visual sense of pleasure and comfort.

Aim for longer term plans to increase population and housing density

Increased density, alongside mixed land uses supporting diverse local amenities, services and facilities – will help to ensure that distances to be travelled are short and therefore more amenable to walking and cycling.

Recognise the role of public transport

The availability and accessibility of public transport can increase walking (and, to a lesser extent, cycling). Street networks should be designed with direct access to numerous bus stops (with shelter) and a convenient and extensive network of bus routes. The buses themselves must be accessible and safe for everyone.

Conclusion

Findings from the CAB reviews lead to the view that combining environmental interventions with behaviour change approaches is likely to have a greater impact on uptake of active travel than environmental interventions alone. Actions to encourage active travel must take account of, and be based on an understanding of, attitudes, beliefs, and motivations as well as improving the built environment.

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Active Travel – barriers and enablers

Judith Davey 24/8/2021

In early August the Centre for Ageing Better  (CAB), in the UK, published Active travel and mid-life: Understanding the barriers and enablers to active travel, The CAB (https://www.ageing-better.org.uk/) is a charity which produces relevant and well-researched material on current issues related to ageing. It commissioned research on the barriers and enablers to participation in active travel for the 50-70 age group. The report draws on a wide range of relevant recent literature. This blog post looks at the results on barriers and enablers. The second blog post looks at findings on the role of the built environment in encouraging or discouraging active travel.  

Active Travel and its benefits

The promotion of “active travel” – defined as walking and cycling – is based on the belief that:

“being physically active helps to prevent and delay the onset and progression

of many age-related diseases and conditions that cause disability in later life. For individuals who have already developed a health condition, physical activity can help them manage their condition and maintain their functional ability, their independence and their quality of life as they grow older.”

Yet the UK data show that the proportion of people who are physically inactive (meaning they are doing less than 30 minutes of physical activity per week) generally increases with age, beginning to drop around the age of 50. About a quarter of adults aged 55-74 are currently inactive, and nearly half of all adults aged 75 and over. Active travel – walking or cycling for everyday journeys -is a key approach to increasing levels of physical activity.

What are the motives for active travel?

There appear to be two distinct sets of factors that influence participation in

active travel – 1. psychological, social and cultural factors, and 2. the impact of the built environment. Motivators for active travel, as found in the relevant literature, are –

Health benefits – this was the most important motivator, often expressed in general terms, such as ‘getting exercise’ or ‘helping the weight’, rather than specifically in relation existing health conditions or reducing the risk of developing health conditions. Mental health benefits (relaxation and stress reduction) are almost as likely to be identified as physical health benefits.

Enjoyment of the outdoors – expressed as enjoying fresh air, being in green spaces, feeling free, being open to social contact and feeling part of the community, were all noted in the literature. The report comments that ”protecting the environment”, “saving the planet” or “reducing carbon” was more likely to be mentioned by people aged 65 plus. It would be very interesting to know if these patterns would also apply in New Zealand.

Feeling free, independent and in control – this related especially to independence from cars.  Walking and cycling were seen as quicker and more predictable than car travel. This, of course might depend on location, whether in a city or a rural area, and also on the time of day.

Preparing for an active retirement – many people make a deliberate choice to become more active on retirement, perhaps because they find they have more time. Retirement, or the contemplation of it, can thus prompt changes in active travel habits.

What are the barriers to active travel?

Personal safety or feeling unsafe – older people may feel safer in a car than waking or cycling. And in some areas there are obstacles and hazards in the walking infrastructure. There has been considerable discussion in New Zealand about the hazards to pedestrians posed by other footpath users, such as scooters and, skateboarders. Not to mention advertising material, shop displays and outdoor café furniture.

Declining health or disability – people with health problems or a disability are less likely to see walking or cycling as viable alternatives to short car journeys. They may also be discouraged by lack of accessibility.

Prevailing car culture the car is commonly viewed as the ‘normal’ mode of transport. For many people, using the car has become habitual and a part of a normal lifestyle, even for short journeys. In rural areas, the car is often seen as essential for transport especially in the absence of public transport. 

A lack of motivation or desire to prioritise active travel – perceptions of not having the time, that it is “too far to walk”, and bad weather. This will be encouraged by perceptions of congestion and danger, already listed.

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Music: for Good or Ill

Dr Doug Wilson – 20/08/2021

There are few people who don’t have happy or sad memories based around music. It appears to be a fundamental, almost primeval emotion. Primitive tribes, unsullied by exposure to the choruses of great music from other civilisations, each have their own music and dances, based on rhythms, drums and singing. We interpret the sounds of whales as songs, even if they might be communication vehicles. Old people remember hit songs of their youth far better than hot music of today. Patients with dementia frequently are roused by musical memories, and temporarily break from their locked in shells.

The power of music. At its best it uncovers deep, honest emotions, even many years after an event often recalled in curdling clarity. In June 1968 Bobby Kennedy was assassinated. After the death of his brother Jack it seemed the world desperately needed a new leader of hope, and maybe that was Bobby. I’d recently met some American Rhodes scholars based at Oxford University. Bobby had just visited them and they were converts. Two day later we had tickets to a concert by the great African American soprano Leontyne Price in the 10,000 seat Albert Hall in London. She was booked to sing with one the great London orchestras. An opening announcement said she was a close friend of Senator Bobby Kennedy, and wished to honour his memory by singing, unaccompanied, 3 spirituals. She asked that there be no applause. As the huge audience sat on their hands and sniffed tearfully this great opera singer filled the historic hall with her peerless voice. She sang from the very bottom of her soul, tears streaming down her face, the orchestra still and silent behind her, heads bowed, many crying. Ten thousand captured by the intertwined magic, drama and tragedy of the event ached to stand and clap. But silence was a far more powerful conclusion. The power of music.

For those of us able to recall the 1960s, there were the phenomena of Elvis Presley and the Beatles. Rock music burst from the steady jolly beat of 1950s pop music, into the wonderful 1960s wild world of rock, and the extraordinary creativity of 4 guys from Liverpool. The impact was global for these overlapping influences. TV, radio and film built them into musical, almost religious cults. From then and since the popular music world has found its stars and super stars. Longevity is reserved for the very few, like Elton John, Michael Jackson, Stevie Wonder, Rolling Stones, Prince, and Bruce Springsteen. Others on records, movies, TV clips and you tube have outlived their lead singer, like AIDS victim Freddie Mercury of Queen, and their visit to Wembley stadium. Some of these older musicians are now star turns as they reprise their great days of decades before. I have friends, 60 years and plus friends, who are Rolling Stone groupies, and try and attend as many international concerts as they can, and love it. Those were their days.

The power of music to bless. It converts most everybody to happy and warm emotions, when the stars align. For the older community these memories don’t disappear; they may fade but play their favourites and the memory banks light up, and smiles and glowing harmony abound. Play for the poor sufferers with dementia and see how they respond. Amazing are the stories of individuals suddenly emerging from the dementia fog, to reprise a tiny view of themselves decades before. Glen Campbell was one of those; he could play and sing, but not recognise close friends, causality from his Alzheimer’s. Play for those who struggle with vision and support their hearing, their major alternative sense.

Various countries’ national anthems can stir the blood, even of their opponents at large sporting events. The French La Marseillaise, and Wales Land of my Fathers sung by 70,000 locals is are classic calls for patriotism, tears and country.

At my high school it was tradition for the entire school to sing the Messiah, the great oratorio of Handel, with the Hallelujah chorus as the star. Five hundred boys, as loud as each was able, a few wonderful voices, many shrill sopranos, the crackling of pubescent voices, the newly minted basses and tenors, the blazing roar of the organ at full blast, and we glowed and loved this thrilling event, boys enthralled and captured with 18 Century religious music. That must have brought in the faithful in the mid-1750s. It certainly still does today around the world.

Once, in the 1990s my wife and I attended a great restaurant in Paris. The maître d, learning we were from New Zealand declared he was a rugby aficionado. Zey recently had ze All blacks to dine. They sang these Mori songs, fabulous. Can u sing? My wife Adele, with her great voice, sang unaccompanied the Maori Po Kare. The restaurant was silent, the boss directing them to hush. Then they customers stood up hollering, cheering with joyful French élan. We were friends of the city. The maître d, with tears in his eyes kissed my wife and thanked her and presented a fine cognac. Who ever suggested the Parisians were not friendly.

The power of music over the generations builds communities of certain ages where they gather and share their emotions, learnt with the common love of music which had burgeoned in their time, their musical highlights, genres and performers. Behind that are the great music of the classical and operatic traditions. Even today an aria like Nessun Dorma from Puccini’s Tosca, and Beethoven symphony 9, the great choral symphony, can attract thousand even hundreds of thousands together to share, love and enjoy.

But the power of music is not always reserved for the good and the joyous. The Nazis in Germany were masters of the huge assemblies, big bands and Wagnerian tributes to supremacy of the Fatherland. William Sargant, a 1960s English psychiatrist, author of a book on brain washing: Struggle for the Mind, proposed that many robust religious groups, laudable music events, but also evil assemblies were brought together by various contrived musical performances and rhythms. He showed films of such disparate groups as Mayfair drug parties, fundamental Christian church services with wailing and speaking in tongues, voodoo rites in Haiti, Nazi rallies and rock bands. Rhythms were a major common factor, but all could engender similar states of ecstasy and escape and, if needed, unsavoury objectives. Ah the power of music.

Music is for everyone, just about. Treasure its power to entertain, to lift spirits when they are low, to move, and to give visible face to deep emotions, and as haunting accompaniment for permanent farewells, where the shared music and emotions tie close friends and loves together for ever.

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Elder Abuse – What can be done about it?

Judith Davey 19/7/21

Reporting Elder Abuse and Neglect.

Most studies of elder abuse and neglect conclude that the great majority of cases are never reported to the authorities. Why is this?

  • Social and cultural attitudes that dissuade disclosure through fear of community disapproval, shame, and embarrassment.
  • Lack of awareness of the problem at societal level and among professional groups.
  • Social isolation among vulnerable older people, lacking access to and knowledge of services.
  • Fear of retaliation or escalation of the abuse, wishing to protect the abuser/s (whom the older person may depend upon), being reluctant to damage relationships.
  • Inability to report abuse, or not being believed, because of cognitive impairment.
  • The financial cost of potential remedies, especially those involving the use of lawyers.

Given these barriers to disclosure, how can abuse come to the notice of services which may be able to help? Elder Abuse Response Services offer free assessment, intervention support, and advice where an older person’s safety may be in doubt. These services are throughout the country as part of Age Concerns and other community agencies.

Health services – reporting abuse

General practitioners and practice nurses are in frequent contact with older people and are well placed to identify signs of elder abuse and neglect, especially if they have long standing relationships with their older patients.

Currently there is no requirement on health professionals to report suspected elder abuse and neglect, although the Ministry of Health encourages voluntary reporting and has published information on identifying abuse. The InterRAI assessment tool, can assist. This has triggers to identify abuse, such as being afraid of a caregiver or family member. Residential aged care services must comply with the Health and Disability Sector Standards mandated in contracts held with the DHBs. These require safe care and practices but depend on how well each facility adheres to reporting requirements.

Mandatory notification of elder abuse is a requirement in some countries, by specified groups – doctors, nurses, and residential care staff. But there are challenges, given the complexity of the issue; handling information on different types of elder abuse and neglect, in different settings (especially private/family settings), and involving a wide range of individuals and government, NGO and commercial (e.g., financial) institutions.

Prevention – public awareness and education

Primary prevention initiatives focus on the general population.Many forms of elder abuse and neglect have their origins in ageist social attitudes and behaviour towards ageing and older people.

International Initiatives

The United Nations International Plan of Action on Ageing (2002) strongly recommended that more emphasis be put on preventing elder abuse and neglect through a multi-sectoral, community-based approach. It called for changes in attitudes, policies and practices at all levels and in all sectors in order to ensure that people are able to age with security and dignity.

In 2006 the International Network for Prevention of Elder Abuse designated June 15 as World Elder Abuse Awareness Day, when an increasing number of events are held across the globe to raise awareness of elder abuse, and highlight ways to challenge it.

New Zealand Government Initiatives

The Positive Ageing Strategy, released in 2001, set out the Government’s commitment to the wellbeing of older people and aimed to shift attitudes on ageing. Its successor- Better Later Life: He Oranga Kaumatua, covering the period 2019 to 2034 also aims to “combat elder abuse and neglect by raising awareness and reducing its prevalence.”

In 2007 the Family Violence Intervention Guidelines: Elder Abuse and Neglect were released for health professionals. The Ministry of Health and DHBs work with community agencies to increase awareness and strengthen support available to older people at risk of abuse.

From 2017 the Office for Seniors produced the report Towards gaining a greater understanding of elder abuse and neglect in New Zealand. A 24-hour telephone service was set up to report concerns about elder abuse and neglect and to get help.[1] Community-based agencies, including Age Concerns, are contracted to deal with referrals from this service phone line and any service or the public

Other government statements note the importance of elder abuse awareness.

  • The Health of Older People Strategy, 2016, promotes the importance of fostering and modelling positive attitudes to ageing and older people.
  • The New Zealand Carers’ Strategy, 2008, identifies actions needed to ensure informal carers are supported, valued and recognised. This aims to help in preventing abuse and neglect by care\
  • rs. The strategy covers informal carers only, not paid residential or home care workers.
  • The Community Action Fund for Family Violence Prevention Initiatives is part of the national campaign. The fund has supported events to raise awareness of elder abuse.
  • The Media Advocacy Project offers media training to elder abuse and neglect services to help address the poor media coverage of elder abuse and neglect.
  • The Taskforce for Action on Violence within Families, 2005, built on Te Rito – New Zealand Family Violence Prevention Strategy and identifies priorities for action with a focus on elder abuse and neglect.
  • The Ministry of Justice has recently formed a joint venture involving 10 government agencies working together to eliminate family and sexual violence. This implicitly, but not very overtly, includes elder abuse.

Intervention – Legal initiatives

Legislation on domestic violence

Amendments to the Protection of Personal and Property Rights Act came into force in 2008 and 2012 to strengthening legislative safeguards and protections against misuse of enduring powers of attorney. The Office for Senior Citizens undertook a public awareness and education strategy to enable lawyers, doctors, attorneys, and those thinking about making an EPA to be aware of these protections.

The Crimes Act amendments from 2011 included the additional wording of “vulnerable adult” to several criminal offences. These are the ill-treatment or neglect of a vulnerable adult by a person and the failure to protect a vulnerable adult who is part of a household.

The Family Violence Act that came into force in 2019 deliberately changed from previous domestic violence wording to indicate that family violence can happen in any intimate or family setting and isn’t private. It also extends the family relationship to include people sharing a household and caregiver relationships, this law denoted physical, sexual, psychological abuse as part of family violence.

Protection orders

Protection orders are available for cases of elder abuse and neglect. The police and courts have prosecuted cases of physical and financial abuse. These are a civil process, but breach of the orders is a criminal offence. Most use of protection orders has involved partner violence rather than elder abuse (although the two are sometimes the same). Protection orders apply to family and household members, and people in close relationships, but not employment relationships, so paid carers are outside their scope.

Civil proceedings

Civil proceedings can address material or financial abuse and offer ways of claiming damages for financial or material injury. However, such options are expensive, involve time and stress, and outcomes are uncertain. Neighbourhood Law Centres may provide advice, and civil legal aid may be available in certain circumstances.

Restorative Justice

This is a voluntary process that gives victims a voice in the criminal justice system and enables them to receive reparation, apologies, and answers. It requires offenders to face their victims, redress the harm caused, and examine the causes of their offending.  Before a referral for a restorative justice process can be made both the victim and the offender must agree to participate.

 The Ministry of Justice contracts community-based providers to deliver restorative justice services to District Courts.  Facilitators meet with the offender and the victim separately to decide whether it would be appropriate to hold a restorative justice conference. This will usually result in agreement on reparation or restitution from the offender to the victim and/or their families, as well as changes intended to alter the behaviour of the offender.

The use of restorative justice processes in elder abuse and neglect cases may not always be appropriate. A close and ongoing relationship between a victim and offender may further complicate the issue. Adequate protection and support for the victim should be paramount when decisions about the restorative justice process are made. 

Alternative dispute resolution

This covers a range of alternatives to adversarial law processes.
In Mediation a neutral mediator assists disputing parties to solve the problem themselves through communication and co-operation. Because of power imbalance in elder abuse and neglect cases this may not be appropriate. But mediation may be the only option where the adverse behaviour is neither a criminal nor civil offence, nor a breach of any regulation or contract. Mediation lacks legal enforceability and accountability, but it may be a way of dealing with unintended neglect, or where the perpetrator had not understood how the abuse was affecting the older victim.

Any person – relatives, friends, concerned outsiders,or any organisation speaking on behalf of an abused older person may be involved in Advocate Intervention. This can be successful where the issues are straightforward, or have the potential of a clear solution, e.g. notifying rest home management about the inappropriate behavior of their staff.

These approaches use the advocacy intervention mode, where service providers aim not to intrude unnecessarily in the lives of the victims. They identify the ‘acceptable limits of intervention’ and the importance of the older person’s rights and autonomy. Support for intervention may be provided by community groups and individuals (including carers), churches and spiritual leaders, who have contact with older people. It could also be used for government agencies, by Māori, Pacific and other culturally specific organisations. It seems clear that awareness of elder abuse and neglect and its serious effects is growing, and population ageing makes it an issue for the future. What is needed now is careful and in-d


[1] https://www.superseniors.msd.govt.nz/elder-abuse/index.html

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Elder Abuse – what do we know about it?

Judith Davey 19/7/21

Elder abuse and neglect in all its forms detracts from the health and wellbeing of older people. It creates mental and physical harm and distress, and can strip them of their voice, their rights, and their possessions. Despite evidence that elder abuse has occurred throughout history and across social groups and cultures, it has only recently been studied and named as a social problem. Tackling this problem is hampered by the lack of clear definitions of what it is; by the difficulty in obtaining data on its extent and characteristics; and the lack of initiatives to avoid and address elder abuse.

Definition

There is no single internationally accepted definition of elder abuse and neglect. New Zealand and many other countries use the definition adopted by the World Health Organisation in 2002: “A single or repeated act or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person”.

Within this statement are elements which, in their turn, require definition and which highlight the complexity of the problem. Firstly, what is an “older person”? Many organisations, including Age Concern New Zealand, which has been very active in providing elder abuse and neglect prevention services, defines “older person” as 65 years or older. What sort of harm is involved? It may be physical, psychological/emotional, material/financial, or sexual. Not all of these are crimes in the legal sense.

The phrase “where there is an expectation of trust” means that “stranger” crimes against older people would not be covered by the WHO definition. These would include criminal activity, such as burglary, assault by strangers, fraud and “scams”. And where does institutional abuse come in?

What about neglect, where” lack of appropriate action” causes harm? Self-neglect by older people is an important issue, seriously threatening wellbeing. Definitions also require consideration of the cultural context. Interpretations of what constitutes abuse, and the appropriateness of responses will vary. For example, disrespect, dishonour, lack of esteem shown to kaumatua/elders may be seen as abuse in the Maori and Asian communities.

Types of abuse and neglect

Abuse, neglect and violence against older persons take many forms and occur in different settings (private homes, residential care, etc). Several types can happen at the same time. The following categories are roughly in order of prevalence.

Psychological abuse refers to behaviour that causes the victim anguish, stress, or fear. It includes verbal abuse, intimidation, humiliation, harassment, removal of decision-making powers and control of choices, and threats of damage to property or physical abuse.

Material/financial abuse is the illegal or improper exploitation and/or use of older people’s funds or resources. Examples include theft of money or property, appropriation of assets by people with legal powers over them (such as Power of Attorney). For example, a family keep an old man with multiple health issues at home because paying rest home fees would erode his assets – their inheritance.

Physical abuse is the infliction of pain or injury, physical coercion and restraint. including medication abuse (deliberate misuse of prescriptions that sedate or result in harm) and inappropriate use of restraint or confinement. For example, an older woman has been giving her son cash. When she doesn’t have enough to spare, he pushes her, twists her arm and forcibly takes her handbag with her purse. Physical abuse could also be a continuation of partner abuse which has been a life-long issue.

Sexual abuse is non-consensual sexual contact of any kind; forced, coerced or exploitive sexual behaviour or threats, especially where a person lacks mental capacity to give consent or understand.

Institutional abuse arises from the policies or practices of an organisation that impinge on the rights and well-being of older people (institutional racism is a comparable concept). This may occur within a residential care facility, hospital, or other public or private sector agency, including financial and social service organisations. It may arise where there is insufficient staff or where practice focuses more on organisational convenience than client needs.

People in residential care may be subject to abuse from their family and visitors or by staff. Examples include neglect, forced feeding, rough handling, inappropriate use of restraints, or cultural insensitivity. There are also cases of stealing from residents.

Neglect is when another person fails to meet the physical and emotional needs of a person. Passive/unintentional neglect may arise from carers’ inadequate knowledge, illness or lack of trust in prescribed services. Active/intentional neglect is the conscious and deliberate deprivation of care.

So why does elder abuse and neglect happen?

Some of the theories about the nature and causes of elder abuse and neglect relate to the vulnerability of older people, who may be dependent on others. Social isolation from family and friends and from supportive services increases the potential for abuse, because it offers opportunities, and the ability to conceal it.

Elder abuse and neglect are predominantly perpetrated by family members, making it an intergenerational issue, especially where there is a history of family conflict and issues of power and control. Alcohol and drug abuse, psychological and behavioural problems may be involved as well as financial stress and unemployment. The older person may be dependent on others, making them vulnerable to abuse. Or the abuser may be financially and emotionally dependent on the older person.  Older people may choose to remain in a living situation which is not physically, psychologically, or financially safe for them out of loyalty to family.

In the case of older people with significant disabilities, carer stress can lead to abuse, but this is not seen as the dominant cause. Dementia or other medical conditions may produce behaviour which is abusive of carers. Both victims and their carers may be isolated older people, in a powerless and dependent position.

The ‘ecological model’, links elder abuse and neglect with broader social issues, instead of focussing solely on individual and family contexts, associating it with older people’s relatively low status in society and lack of economic power.  This suggests that to the need to explain why and how elder abuse and neglect occurs needs an exploration of social structures and ageist attitudes. 

Because of the problems of definition and reporting, reliable statistics on the prevalence of elder abuse and neglect are difficult to find. As with other forms of family violence, elder abuse and neglect is likely to be under-reported. This may be due to a lack of awareness of the problem or reluctance to report suspected cases. Older people especially may be reluctant to report abuse by their closest relatives.

Research by the Family Centre Social Policy Research Unit used data from the New Zealand Longitudinal Study of Ageing in 2012 to measure the prevalence of elder abuse in New Zealand[1]. This used self-reporting and aimed to identify types of elder abuse and neglect; to calculate prevalence and produce future projections. Associations with gender, marital status and ethnicity were tested alongside a range of health and wellbeing measures.

This study demonstrated that elder abuse was prevalent for at least 10% of participants aged 65 and over. It gave insights into the extent of different types of abuse. Other broad findings included:

  • Psychological abuse was more frequent than coercion and physical abuse.
  • Women were more likely to experience interpersonal and financial abuse than men, but men were significantly over-represented in coercion and more likely to have property taken without their permission.
  • Māori experienced significantly more elder abuse compared with non-Māori.
  • Divorced, separated and widowed older people experienced a greater level of sad and lonely feelings than partnered people and were more likely to have property taken without their permission.
  • Married people had the lowest elder abuse scores.
  • Statistical correlations were found between elder abuse and lower levels of health and wellbeing, and higher levels of depression and loneliness.

The authors concluded that, if nothing is done to reduce elder abuse and neglect, there could be substantial increases in the percentage of older people experiencing abuse. The projections show that it is essential to address these matters sooner rather than later, because of the personal distress to many older people and the increasing costs to government.

For more information about elder abuse, you can go to our website www.ageconcern.org.nz or phone 0800 652 105


[1] A summary of this research was published by the Office for Senior Citizens in 2015 – “Towards gaining a greater understanding of Elder Abuse and Neglect in New Zealand”.

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Breaking down barriers to social connection

by Louise Rees, Age Concern New Zealand.

My mother tells stories of huddling in a bomb shelter with her whanau and neighbours, singing and joking as German bombs pounded our hometown of Swansea during the Second World War, flattening a large part of the town centre.

New Zealand, like the rest of the world, is now caught up in another global crisis, but instead of huddling together, people are facing unprecedented social restrictions in order to combat the spread of Covid-19. At a time of increased anxiety and hardship for many, we are required to isolate and distance ourselves from others as never before.

The social and psychological effects of the resulting changed patterns of interaction are causing concern amongst experts and policy makers in New Zealand and overseas:

  • Vivek Murthy, former US surgeon general writes about the potential for a worsening social recession in the wake of the virus, as restrictions on social interaction cause our “social muscle” to atrophy.
  • In the UK, a multidisciplinary group of experts have published a position paper in The Lancet on the need for a research strategy to understand the neurological, psychological and social effects of Covid-19 on people who have had the virus, on vulnerable groups, and on the general population.
  • In New Zealand funding has been allocated for research into the mental health effects of the pandemic.

Age Concern is here to help in a crisis

During lockdown, local Age Concerns reported a surge of enquiries from older people who were not online, and were struggling to pay bills, or access groceries. Some of these individuals were also severely lonely (many isolating in a bubble of one) and required social support as well as help to address practical issues.

The Age Concern Accredited Visiting service moved from face-to-face to phone communication during levels 4 and 3. This worked well for some clients, but less well for others, especially those who were hearing-impaired. At level 2, visitors were able visit their clients in person again, but a survey of visiting service volunteers in late June found that 15% had yet to resume in-home visits for a variety of reasons, which included ongoing anxiety about the pandemic.

Advice and information from government

As the pandemic continues to disrupt normal social interaction, individuals, families and organisations face the challenges of maintaining distanced social connection at restrictive alert levels, and then rebuilding our “social muscle” and getting back out there again as restrictions lift. This can be particularly difficult for those who are anxious by nature, or who are facing other challenges.

The New Zealand Office for Seniors website provides information on the impacts of Covid-19 on older New Zealanders. Tracking of selected wellbeing indicators has shown that, whilst young people are still the most likely to be lonely, the increase in loneliness during the pandemic has been greater for older people than for other age groups, particularly for women aged 75+.

Office for Seniors also communicated with key stakeholders in Auckland, and heard from them that:

  • Older people who were vulnerable before the pandemic are struggling, especially those who are digitally isolated.
  • There has been a decline in social participation even at alert level 1, which has been exacerbated by the second lockdown.

The Ministry of Health website offers general  guidance on looking after mental wellbeing during the pandemic, as well as a free 24 hour counselling helpline and other suggestions of where to find help.

Let’s End Loneliness website

In 2018, before Covid-19 existed, seven organisations already concerned about increasing feelings of loneliness in our communities –  Age Concern New Zealand, St John New Zealand, Carers New Zealand, Student Volunteer Army, Royal New Zealand Returned and Services Association, Alzheimers New Zealand and The Salvation Army – got together to set up a coalition to work together on tackling the issue.

In August, the group launched the ‘Let’s End Loneliness’ website as a resource for anyone experiencing or concerned about loneliness. The website offers research, news stories, and practical evidence-based ideas on how to tackle loneliness:

  • For ourselves
  • In our community
  • In our workplace

This has never been more relevant. Loneliness is a normal human experience, and most of us will feel lonely at some points during our lives. Right now, though, the pandemic is creating additional barriers to social connection and is causing more people to feel lonely.

This is important because if loneliness goes on for a long time and becomes chronic, it can seriously damage health and wellbeing. So, it’s important to do something about it. The good news is that loneliness can be addressed and solved.

The ‘Let’s End Loneliness’ website is a place to connect with others to learn about loneliness and to share ideas, challenges, and successes. To find out more about loneliness, how to tackle it, where to get help, and how you and your organisation can get involved go to letsendloneliness.co.nz.

Together we can end loneliness one person, one community, one workplace at a time.

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Improving the Safety of Older Pedestrians

Judith A.Davey, April 2021

Updated from a blog post published by Age Concern New Zealand in September 2013

Older people are especially vulnerable as road users. The 65 plus age group is over-represented among road deaths and this is especially true for deaths of pedestrians. Linked to this is the fact that walking accounts for a higher proportion of time spent travelling for older people than for the total population of all ages – 15% for those aged 65-74 and 19% for people 75 plus (all ages 13%).[1] Among the key areas for action set out in “Better Later Life: He Oranga Kaumatua 2019-2034” (which replaced the Positive Ageing Strategy) is to “Enhance Opportunities for Social Connection and Participation” by older people. Improving the safety of older pedestrians is clearly a vital step in enabling older people to live more active and involved lives.

The road casualty figures do not include trips and falls on footpaths. A broken leg or hip as the result of a fall can signal the end of independence for older people. But pedestrians often appear to take a “back seat” to vehicles. As a report from the United Kingdom Department for Transport makes clear:

Making walking easier is an equal opportunities issue; as long as walking is disproportionately carried out by people on lower incomes, women, children and older people, it will be seen as a lower status mode of transport.   

The New Zealand Institute for Research on Ageing carried out a study of pedestrian safety for older people in 2007[2]. The study included focus groups with older people and interviews with road safety coordinators, traffic engineers and traffic planners. These three groups came up with similar areas of concern.

Pedestrian infrastructure

In many suburban areas there are no footpaths or they serve only one side of the road (photo 1). Where there are footpaths, their surfaces may be less than ideal for walkers; paving stones are often uneven and slippery when wet, especially if covered with leaves. The steepness, gradient and design of kerbs and cut-downs may provide further risks for pedestrians.

1. Lack of footpaths in Kapiti district

Footpaths in central areas are often obstructed by sandwich boards, shop goods and café furniture, which reduce ease and safety for walkers, especially those visually or mobility impaired (photo 2). The fear of collisions with obstructions and other footpath users, including inconsiderate skateboarders, cyclists, electric scooters and mobility scooter users, can constitute a constraint for frail older people.


2. City launches bid to tidy up sandwich boards

A particular problem is central cities are driveways and building entrances which cross footpaths. Often drivers using them do not give way to pedestrians. Pedestrians give way to drivers on the roadway, so when vehicles cross footpaths they should give way to walkers, who, in fact have the right of way (photo 3)!


3. Vehicles crossing footpath – Central Wellington

Crossing roads

Often there are not sufficient safe crossing points for pedestrians, particularly on high traffic volume roads and in areas with high numbers of older people, such as near retirement villages. Even where there are formal pedestrian crossings, not all drivers are considerate enough to let people cross or who do not know or obey the road rules. A particular problem at signaled crossings is that the time given (when the “green man” appears) is too short for many older people to cross without anxiety and many drivers fail to give way to pedestrians on signaled crossings as they turn (photo 4).



4. Sign to indicate pedestrian right of way to turning vehicles

Crossing point design can improve safety, for example pedestrian refuges between lanes offer some protection against traffic and allow the crossing to be done in two stages (photo 5).

5. Railings and staged pedestrian crossing – Wellington

Awareness, consultation and education

Older people may experience a reduction in physical abilities, such as vision, hearing, walking speed and ability to judge the speed of traffic, which affects their safety as pedestrians. Traffic planning and management strategies need to bear this in mind, given our rapidly ageing population. A two-way approach is clearly needed, matching education with consultation. All groups who contributed to the research called for planners and others in a position to improve pedestrian safety to consult more widely with older people and community groups to ensure that they are aware of their special concerns.

[1] New Zealand Household Travel data 2011-2014

[2] Judith Davey and Virginia Wilton, Improving the Safety of Older Pedestrians, supported by the  John Bailey Road Safety Research Fund, published in January 2007.

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Are You Past Your Peak?

Dr Doug Wilson

Many of us would like to revisit our Golden years, our peak years of performance in some sphere or other. I was something then. Well most of us are still something now, no matter your physical status. Your high point may have been in a sporting event; you represented your school, or local club, or at best your country. You can look back at reports of your striking performance, and may even see it on replay TV. Wow!

But most athletic competence peaks in your late 20s or early 30s, no matter what the sport. It still remains a curiosity in international professional golf that the majority of major championships are won by players in their 20s, or early 30s. And yet playing golf for 20 or 30 years should enhance short game skills, to compensate for any minimal falloff in power for long distance driving. And yet only two players over the age of 45 have won a major since 1945, one of them being the great Jack Nicklaus. You may retain power, but optimal coordination of hand, eye, and muscle has already begun to fade in your 30s. So returning to the physical heyday is a rare option. Tiger Woods may break that barrier after his first win in recent years in late 2018, but let’s see.

In other spheres various skills are well retained and even improve with age. Many musicians, are able to maintain a high level of performance with age. The Rolling Stones are still prancing around on stages in their 70s. A number of outstanding musicians have performed well into their 80s. Vladimir Horowitz, the pianist in New York City in 1989. He had been giving public concerts in his mid-80s. Arthur Rubinstein, also a pianist, followed the experience of Mozart as a child prodigy, giving his first concert aged 7, and performing with the Berlin Philharmonic Orchestra at the age of 10. His last concert in New York was when he was 89. He was a buoyant, outrageous and magical spirit. He left his wife at the age of 90 for a woman aged 33. Verdi, the great Italian opera composer, died at the age of 89. His composing career after the early wonders of La Traviata, and Il Trovatore, continued into his 80s, with great works like Falstaff and Otello.

Politicians often exhibit great longevity, Konrad Adenauer was Chancellor of Germany at the age of 89. Churchill became Prime Minister again in the UK in his early 80s. The recently elected Prime Minister of Malaysia is 93. The present U.S. Senate includes a number of senators who head various influential committees, despite the fact they are in their 70s and even one or two in their 80s. Of course persistence in such elected positions is no indicator of quality of performance. But at least they were persistent in holding their job.

Of course our various faculties fade with time. The great majority of people need spectacles for reading by their mid-40s. Mental function reaches a peak in your late 20s before your thinking speed starts to slow in your 30s. Performance slows with some minor episodes of forgetfulness in your 50s. Other aspects of memory and executive function are already slowing at that stage. In your 70s and 80s most people struggle with working memory, both short-term and long-term.

Judgement and experience are entire other facets of life and competence, and worthy of a fresh story line.

But as you can’t turn back the clock, you can at least reminisce and enjoy the memories. Even failed attempts to relive past glories can have their impact.

Some years ago my 80-yearold parents were holidaying in the Pacific Island of Samoa. With them was a widowed friend of the same vintage. She had, in her long forgotten youth, been an old-style singer as a hobby, a talent long since laid to rest. One evening on tour the elderly widow sampled too many alcohol-spiked fruit cocktails, and decided she would return to her youth and to entertain other tourists with some of her golden hits from the 1940s. The rollicking music hall sing along Ta-Ra-Ra-Boom-De-Ay, delivered in the quavering voice of an octogenarian, was a serious mishit for the general audience of semi-inebriated, shiny-faced, 30 years younger tourists. She was persuaded to stop. In time everybody settled comfortably for a recovery night.

At 2am in the morning my father was called. Police here. Do you know a Mrs Walker? He did: She’s been travelling with us.

We have her here at the police station. My father hurriedly dressed. He was collected by a police car and taken to the station. There, looking very puzzled, was his elderly friend. She wore a police jacket over an ankle-length flannel nighty and bare feet. Apparently her vision of return to the old days had resurfaced She went walking at 1.00 am seeking an audience. She was eventually picked up from the side of the road by a local Samaritan, a bar tender on his way home, and brought on the back of his motorbike to the police station. Probably not a bad adventure, but one that emphasises we usually need to match our ambition to our current abilities.

Our biological and mental functions fade over decades, yet some balance is always being found so the real you remains, just a little more tottery over time. We may think more slowly, but the final thoughts emerging may well be better than ever, or at least very original. One caution for some is to regret what skills they’ve lost. That serves no end other than unresolved disappointment. Discard the regret, and replace with a soft smile remembering the good times gone by. For your age you may well be at your new peak.

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