Drafts of the Health of Older People Strategy, an update of the 2002 document, have been around for a while and there have been numerous consultation initiatives, which you may have heard of. Fairly late in the piece the name was changed to the “Healthy Ageing Strategy (HAS)” – a change which Minister Sam Lotu-liga claims as his initiative in his foreword to the strategy document. He states that this name change recognises the diversity of older people and the aim to maximise health and wellbeing throughout people’s older years. I am not sure I quite see the logic in this, but the new strategy certainly does recognise diversity and takes a broad view on wellbeing – well beyond the usual narrow definitions of health as based on medical interventions and hospital services. It has a strong focus on prevention, wellness and support for independence. It emphasises equity and giving attention to the most vulnerable.
In the international sphere, New Zealand is a signatory to the World Health Global Strategy on Ageing and Health 2016-2020. Among its objectives are developing age-friendly environments (more about that in later blogs), sustainable and equitable systems for care and a commitment to action on healthy ageing. WHO defines healthy ageing as “the process of developing and maintaining functional ability which enables wellbeing in older age”.
The Healthy Ageing Strategy links with the overall New Zealand Health Strategy, released in 2016, the Disability Strategy and the Positive Ageing Strategy. The latter may also be receiving a make-over this year, not before time, and could build on many of the actions proposed by HAS.
Another aspect of a wider view is the strategy’s emphasis on a life-course approach, recognising how influences from childhood and through adult life affect health outcomes in later life. These include our upbringing and how healthily we live – a strong form of prevention. Environmental factors – housing, workplaces, discrimination and the quality of family life are also important.
WHO defines equity as “the absence of avoidable or remediable differences among groups of people whether those groups are defined socially, economically, demographically or geographically” Persistent health inequities in New Zealand are recognised, affecting Maori, Pacific peoples, migrant and refugee communities, people with disabilities and mental health conditions and addictions, and people with low incomes. Achieving equity means understanding and removing barriers that prevent groups from experiencing equitable health outcomes, which will include enabling access to health services and acknowledging cultural preferences. Also important is enabling equal opportunities to raise capacities and functional abilities.
The next step is to develop an implementation plan for work over the next ten years. This will involve both the health and social systems, as well as a wide variety of service providers, NGOs, communities and older people themselves.
The strategy sets out and prioritises actions, some to be achieved in the next two years, and nominates lead partners for implementation. Here are a few examples which caught my eye-
- Promote the concept of age-friendly communities – led by Office for Seniors.
- Increase the availability of strength and balance programmes in homes and community settings (oriented towards falls prevention) – led by ACC.
- Review the Green Prescription programme and improve its use by older people – led by Ministry of Health.
- Promote volunteering, networking and paid work among older people as a means to support their sense of wellbeing and social connection – led by Ministry of Social Development.
- Support older people’s uptake of technologies for communication with health providers and their family and whanau (application in rural and remote areas specified) – led by DHBs.
- Develop a range of strategies to improve recruitment and retention of those working in aged care – led by Ministry of Health.
- Explore options for aged residential care facilities to become providers of a wider range of services for older people such as restorative care, including non-residents – led by DHBs.
- Improve the support for informal carers, including various types of respite care, guidance and information and training – led by Ministry of Social Development.
A consummation devoutly to be wished, as Shakespeare wrote! Watch this space! The HAS is certainly broad and ambitious. I hope I have encouraged you to take a look, if you have not done so already. It has something for everybody and plenty of good intentions. We should wish it every success.
Foot note: Age Concern New Zealand proposed the name “Healthy Ageing Strategy” as part of their submission and feedback during the consultation process.