That was then …..how about now? (Part 1)

In 1982, the New Zealand Department of Health, as it then was, published – “Ageing New Zealanders“a report to the World Assembly on Ageing. This was called by the United Nations in recognition of rapid population ageing. It is worth looking back on this report and examining what issues have changed and what remain of concern nearly 40 years later.

The report begins with a Maori proverb –

Ka pu te ruha, ka hao te rangatahi   – The old net is cast aside. The new net goes fishing.
The authors conclude, wisely, that the new net must go fishing but the old net should not be cast aside. With appropriate repair, new uses must be found for it. Thus, the ageing population still has value in its wisdom and potential to contribute.

Valuing older people
The United Nations report, and indeed all  the major policy statements made since the 1980s, emphasise the need to change public attitudes to older people rather than portraying them as “outdated members of society who have very little to contribute” and who are subject to inevitable deterioration of mind and body. The “elderly” the report asserts “are stereotyped and regarded as a homogeneous group when in fact their individuality is far greater than younger people”. Yes, there has been some change, but are we there yet?

The vision of a “Better Later Life”, dated 2019[1], is that “older New Zealanders lead valued, connected and fulfilling lives” and among its guiding principles are that older people should be treated with respect and dignity and that their diversity should be recognised. Clearly some restatement was deemed necessary.

Terminology
You may have noted one significant change already. Throughout the 1982 report we hear about “the elderly”. The World Assembly on Ageing defined this group as everyone aged 60 plus. “Elderly” as a term is now widely seen as ageist and demeaning, with connotations of frailty and decrepitude. This is not appropriately applied to an age group which now encompasses more than one generation.

Love and Sex (yes, this was a main heading)
The New Zealand report was probably well ahead of its time in its conclusion that – ‘The denial of love and sex in the elderly is perhaps one of the cruellest myths.”

“Sex is a stronghold of negative attitudes towards the elderly, for example that old are asexual or neuter, the “dirty old man” is jeered at or punished, and the old woman is sexually boycotted.”

Despite the fact that adverse changes occur with ageing –

“the broader perspective of sexuality, closeness, sensuality and intimacy is not lost and may become more acute and important with older years. We recognise the importance of keeping active physically and mentally, but often neglect the importance of continuing sexual activity for wellbeing. “

We have seen some changes in popular culture – films, TV – where older people are more often portrayed as attractive and “sexy”. So long as they do not become objects of advertisers’ exploitation.

Workforce
Labour force participation rates for men and women aged 60 plus were declining in the 1980s. In 1976, in the age group 60-64, 58 % of men and 14 % of women were in full-time employment. In 1981 in the same age group the figures were 46 % and 13 % respectively. Some of this decline possibly related to National Superannuation being available at age 60, whereas the previous age benefit was generally available at 65. Age of eligibility has been shown to be a major lever influencing workforce participation, as was the case when the NZS age was raised from 60-65 and this continues to be a potential but controversial policy option.

Even at that time older men and women were over-represented as employers and self-employed workers – a trend which is attracting attention currently (see my post in March 2018).  But some of this was put down to “the elderly’s significant employment in farming”.

Quoting a 1977 report – “The Employment Position of Older Workers in New Zealand” (“older workers” in this case referred to persons aged 45 plus).  The report concluded- “projections show that the proportion of older workers to the total labour force will decline;” that their concentration in certain industries and occupations (for example in the primary sector) will continue and that “long established compulsory retirement schemes may be inconsistent with the present trend towards increased longevity.” Apart from the last, these predictions have not been realised.

The authors were correct, however, when they identified age discrimination as an enduring challenge. They linked this to a misunderstanding of the capacities and attributes of older people and the lack of retraining opportunities for older people. This last is an issue which has still not been addressed in any detail. In fact, the 1982 report’s conclusion is still apropos –

“One of the most neglected fields is education and elderly people in the future will have to become adjusted to being re-educated at a number of intervals during their life, including retirement so that they may realise their full potential.”

 

[1] Office for Seniors, New Zealand Government.

 

 

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Shared Social Housing for Older Women

Dr. Judith Davey

An increasing number of people are reaching age 65 without being homeowners, as I have previously noted, and there is a widespread interest in innovative ways of accommodating this group. The 2001 Positive Ageing Strategy indicated a move towards shared housing as a rental option. And a 2015 Office for Senior Citizens report stated a goal to develop “low-cost communal housing for older people”. I also remember discussions amongst my female friends about sharing accommodation in retirement.

But does this concept require closer scrutiny? Do the benefits of shared housing lie more with the providers and funders than those who are expected to live in them?

Robyn Barry’s 2019 PhD thesis follows five years of the development of a social housing initiative in which women over 65 share living spaces in two purpose-built houses, and reports on their lived experiences. The women rent their own bedrooms, with an en-suite and deck, and co-manage the other communal spaces.  Robyn’s research found that for some this living arrangement appears to be working well. There are instances in which social cohesion and camaraderie are enhanced. These examples could be taken to support the shared housing model as a means of accommodating older renters. However, Robyn found that this view could be misleadingly one-sided; that this way of living is more likely to be a compromise than a choice for those in housing need.

The thesis sets out the limitations to shared housing:

  • Shared housing is not a popular housing option. “There is likely to be insufficient interest from those desiring to live with others to ensure the viability of future shared housing projects that do not provide services.”
  • Local and international literature suggests that shared housing projects have not been as successful as anticipated.
  • Being under one roof does not mean a sociable, cohesive household ensues. “Compelling strangers, for whom sharing with others is not a preference, to live together is likely to create social stressors that may necessitate social service interventions.” Residents do not have control over whom they live with.
  • Whilst providing affordable accommodation, shared housing is a compromise that people may make in the absence of better choices. “It is unrealistic to expect a household of unrelated adults who did not choose whom they live with to act like a cohesive, close family or friends “. The result may be a social environment which can be both convivial and challenging, with variations of lived experiences and no easy reconciliation when conflicts of interest arise. “One person’s attempts to achieve comfort and mastery of their environment can impact on other’s attempts to do the same. “
  • Living with others does not guarantee any level of support. Residents renting individual rooms are not responsible for others and cannot be expected to take on extra responsibilities when others are impaired.
  • Living alone or with others is not a straightforward dichotomy. Sharing should be differentiated, e.g. with friends versus strangers, from preference or need, the number of people, what spaces are shared, the balance between privacy and company, the quality of the relationships, and also the proximity and frequency of social contacts. Sharing with whom and for what purpose are important considerations and contingent on individual circumstances.
  • Sharing provides an opportunity for social interactions and could reduce social isolation; “yet one could still feel lonely if these social interactions are perceived to be negative, exclusive, or problematic.” Living with others who do not share the same social expectations and values may potentially exacerbate loneliness.
  • Negotiating the social spaces in shared housing, especially over a long period, can be stressful and difficult. Examples arise such as having to get dressed to go into the kitchen to make a cup of tea, using mobility aids in the shared spaces, getting to the kitchen only to find someone else is using the space or appliances, and maintaining the household standards.
  • Security depends on household relationships. Personal security associated with having others close by can be found in shared housing, but only if those relationships are trusting relationships.
  • Living in shared accommodation restricts people’s future housing options. To move again, could entail loss of benefits such as lower than market rents and quality-built environments as well as being very disruptive for older people.

Conclusion

This study concludes that the implications of creating more shared social housing need to be carefully considered for policy and practice.  The attraction of shared housing, without services and formal supports, is likely to arise mainly from the need for shelter . Traditional sole-occupancy housing may well be the most appropriate housing option for the majority of single, older renters. An assumption behind shared housing is that it is cost-effective. However, if resident wellbeing is factored in, this may not be the case.

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Facing the Future: Retirement Income Policy Review 2019

The three-yearly review of Retirement Income Policy came out recently, prepared, as is their statutory duty, by the Commission for Financial Capability (formerly Retirement Commission). It is the latest in a series of policy reviews, going back to 1991-2, in which I have taken a lot of interest in and even contributed to. The report itself contains a section on previous reviews and their outcomes. A common conclusion has been that a mixture of public and private sources of retirement income is needed, but exactly what the mix should be has been hard to arrive at.

There is an easily readable executive summary and an interesting forward to the report. Here I pick up what I found the most interesting points, adding my comments.

  • The “Language” of retirement

I could not agree more that it is outdated and misleading. “Retirement” means withdrawal, stepping back. That is certainly not how see my later life . “Transition” is suggested by Peter Cordtz the current (interim) Retirement Commissioner and that is an improvement, if not a complete alternative.

  • The Centrality of NZ Superannuation (NZS)

The main, and sometimes the only, news media reaction to the review was to point out that it did not support raising the age of eligibility for NZS and that its present settings are sustainable for the near future. NZS is seen as “good value”. The report points out that NZS supports 85% of older people to maintain a foundation standard of living. There are other means of ensuring affordability as time goes on – tax clawbacks for the wealthy, changes in length of residence for eligibility and international pension contributions.

  • Oncoming challenges

But the review foresees and documents large oncoming problems for ensuring adequate retirement incomes. Falling home ownership rates, rising debt and inequality make large sections of the ageing population vulnerable to poorer outcome in the future. Accumulated advantage and disadvantage have resulted in significant disparities, particularly for Maori and Pacific people. These have been pointed out in several policy reviews, but have not been seriously addressed, in the opinion of the 2019 review.

  • Preparation for retirement

In view of these trends, the report places considerable emphasis on preparing younger age groups – especially those aged 55-64 – for reaching NZS age. Research findings, backed up by quotes from submissions to the review (which appear in each chapter), show that people are concerned about their future and worried about achieving a decent standard of living in retirement.

This calls for a better coordinated and aligned pre-retirement policy system, so that people have the best opportunities to prepare. Elements for developing a foundation for security in retirement are education, regular employment, home ownership and building up savings. Policies should intervene early in these areas and receive attention on a whole of government basis (see my blog posts for September and October 2018).

  • The importance of home ownership

The review concludes that supporting home ownership is one of most “impactful” ways of reducing financial vulnerability in retirement. A paper prepared for the review goes into this aspect in detail and is a useful read. [1] This suggests that home equity can be mobilised in retirement, extracting capital tied up in housing to support retirement standards of living. But, at the same time the report is doubtful that downsizing is a practical way of doing this (supported by the Savile Smith paper). So……………

  • Decumulation

The terms of reference of the review call for an examination of decumulation – drawing down on accumulated assets in retirement. But there is confusion about choices for doing this; the means are not well known, and people need assistance. Reverse mortgages and annuities are mentioned, but the former get little support, and annuities, although used overseas, have not developed widely in this country. The review suggests an expert advisory group to be set up to look at this area.

  • KiwiSaver and KiwiSpend

Lifelong savings are an important aspect of preparation for retirement.  The review has a range of suggestions for improving KiwiSaver. A particular concern is the use of lump sums as KiwiSaver schemes mature. In their paper the Auckland Retirement Policy Research Centre[2] suggest KiwiSpend. This would involve an annuity, to provide cash for retirement living but also for health services and long-term care. It would require careful management to make the funds last through later life. The state would have to be involved but there appears to be no consensus on the details of its role. This would have to confront the fact that many people are unwilling to lose control over money – the result of their saving.

  • The Role of the CFFC

The CFFC is tasked with monitoring and evaluating retirement income policies. The coordination of diverse public sector agencies is a daunting task.  There is also the challenge of avoiding political influences and frequent policy changes which have caused uncertainty in the past. The review calls for a “purpose statement” for the retirement income system and a Senior Officials Group to work on its recommendations. We await reaction and results.

 

[1] Housing, New Zealand’s Tenure Revolution and Implications for Retirement. By Kay Saville-Smith of CRESA, November 2019 (on-line link in review report).

[2] Decumulation: Time to Act by Associate Professor Susan St John and Dr Claire Dale of the Retirement Policy and Research Centre, University of Auckland (on-line link in review report).

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Researching social isolation and loneliness

Just over a year ago I wrote three blogs on social isolation and loneliness. I looked at how many older people self-identified themselves as being lonely; various ways to measure loneliness and some of the responses which may be effective.  Of course, these issues have not gone away; they remain topics of debate among researchers on ageing as well as organisations working to prevent or alleviate loneliness among older people.

I have recently had cause to look back at some of the academic literature in this area and am left with questions about whether we are going the right way to address these important and growing issues. A 2018 paper[1] examined a whole range of responses to social isolation and loneliness, as reported mainly in international journals. An earlier 2013 paper[2] looked at several initiatives in Queensland. In the discussion of the effectiveness of various programmes the terms contradiction and inconsistency keep coming up –

“Despite considerable research effort, evidence regarding the effectiveness of programmes aimed at reducing social isolation in older people remains inconclusive.”

“Disappointingly, the current evaluation did not return any statistically significant changes in social support and loneliness that can be confidently attributed to the interventions used.”

“Little is known about the range and scope of effective interventions, and what aspects of interventions contribute to their success. “

The researchers appear to be seeking systematic approaches to evaluation which will produce results which are recognised as consistent and comparable across a range of programmes and locations. In these terms “good evaluation” appears to be defined as evaluation that incorporates “validated psychological measures”; “clear identification of an intervention effect, and the use of well-validated measures of loneliness and/or social support”. This criticism is directed especially at community-based and government-run programmes.

It seems that the researchers’ aim is to produce measures of loneliness which can be applied anywhere and the results of which can be compared from area to area and programme to programme without uncertainty. But should this be the aim – finding such a magic wand?

I wonder if this approach is over-simplifying the situation. Programmes to combat loneliness are usually complex, encompassing a range of elements. As Gott et al. conclude, it is “unclear which specific aspects of an intervention contributed most strongly to its success.”

So how do we arrive at “validated psychological measures”.

Many recent reviews of loneliness and social isolation interventions have focused almost solely on quantitative outcomes, and without taking account of other forms of evidence. In reality, qualitative research can be more appropriate and valuable when the complexities and ever-changing nature of individual social networks are involved.

The measures suggested by the researchers to improve their results include:

  • Increasing sample sizes.
  • Standardising sampling, data collection and administration processes across programmes.
  • Ensuring that participants do not have pre-existing relationships with people collecting the data.
  • Ensuring that data are collected by experienced and anonymous researchers.
  • Minimising freedom of participants to join or leave the research at any time.
  • Avoiding convenience samples based on participants available through community organisations.
  • Inclusion of a control group.

The practicality of such approaches may be questioned in the absence of unlimited resources and recognising the realities of working at the community-level. (How to recruit a perfect control group?)

There appear to me to be some contradictions inherent in this more rigorous and inflexible regime. The use of highly standardised measures may not reflect the particular attributes, or circumstances, of local areas or the nuances of society and culture among sub-groups within the population. On the one hand there are calls for involving older people in research planning, implementation and evaluation, and also in the design and delivery of services through extensive community consultations and provision of training for older volunteers. How will this be reconciled with calls for experienced and anonymous researchers?

This is not intended to be an attack on academic researchers. They have their own objectives and processes. It is simply a call for more thought on how locally relevant, sensitive and meaningful research can be used to improve the wellbeing of older people by combating loneliness and social isolation.

[1] Clare Gardiner, Gideon Geldenhuys and Merryn Gott (2018) Interventions to reduce social isolation and loneliness among older people: an integrative review. Health and Social Care in the Community 26(2), 147–157.

[2] Helen Bartlett, Jeni Warburton, Chi-wai lui, Linda Peach and Matthew Carroll (20143) Preventing social isolation in later life: findings and insights from a pilot Queensland intervention study.  Ageing & Society 33, 1167-1189.

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Keeping safe on the road

Judith Davey

10/01/2020

If you are at least 74 years old, an AA member and hold a valid driver licence, you will be valid for a free coaching session to help keep you confident and safe behind the wheel. It is a way to check safe driving skills and road rule knowledge (as advertising recently in the AA magazine and on their website). This is one of several recent initiatives aimed at the safety of older drivers – a growing segment of road users in New Zealand.

Another is a 45-page booklet “The road ahead: Transport options for seniors”. published by the NZ Transport Agency (updated edition February 2019).

I have found both sources informative and valuable. I booked a coaching session through 0800 223 748 (aa.co.nz/senior-driver). A friendly AA driving instructor came to my home for a session which took about 45 minutes. First, we sat in the car to ensure it was correctly set up for me as the driver and I outlined my driving concerns – such as right turns into traffic as I emerge from my garage. Then I drove around my local area – on a route of my choice – pointing out where I have difficulty. We talked about “blind spots”, signalling, hazard identification and positioning on the road. After the drive we had a review and I seem to have scored well. I was even congratulated on driving a manual car, which is becoming much less common.

I am apparently eligible for a free coaching session every two years, so I encourage other older drivers to take advantage of this offer. It would be a splendid preparation for people who are obliged to complete an official on-road safety test to renew their licences.

Which brings me to the NZTA booklet.

This is well produced with large fonts and useful illustrations, for example of give-way rules. After questions to self-check driving ability, there are tips for safe driving and keeping up with the road code.

In New Zealand, a driver licence is valid in periods of ten years up to the age of 75. After this, a licence is valid for five years, then must be renewed every two years over the age of 80. At each renewal a medical certificate from a health practitioner is needed, which includes an eye-sight test.

This is not a straight pass-fail as some people may think.

After completing a clinical assessment, the GP may recommend one of the following:

  1. The patient is medically fit to drive and does not require further assessment.
  2. The patient is medically fit to drive with specified conditions.
  3. The patient is medically fit to drive but an on-road safety test with a testing officer is recommended.
  4. The patient needs further assessment before they can be deemed medically fit to drive (the patient may be referred for specialist medical assessment or to an occupational therapist for driving assessment).
  5. The patient is not medically fit to drive.

GPs may recommend that conditions are imposed on a driver’s licence to improve safety such as:

  • using only an automatic vehicle,
  • no night driving,
  • driving only within 10 kilometres of home,
  • driving only after 9.00 a.m. and before 3.00 p.m.

Older age itself is not a barrier to driving – there are thousands of licence holders in New Zealand aged over 90. However, medical conditions that can affect safe driving increase with age, e.g. dementia, stroke and cardiovascular disease. Other age-related factors that may impair driving include earlier onset of fatigue, slowed responses, visual problems, impaired cognitive function and impaired mobility.

So, take up the opportunities offered,

Age Concern New Zealand recently secured the NZTA national contract to deliver free “Staying Safe” driver education refresher courses across New Zealand. Check with your nearest Age Concern to see when the next course is running!http://www.ageconcern.org.nz

 

 

 

 

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Gym. Any place for me?

With guest blogger; Doug Wilson.

I’ve been going to a gym for two years. I joined when I was 80 which suggests I’m slow to make decisions. I was very concerned at what I might meet: finely tuned young bodies, massive weights lifted by young giants and Brunhildes, and young mothers dancing to loud rock music. My chaotic ignorance, bigotry, and fantasy was demolished at the door. Many of the participants where in their 40s 50s and above. Recovering Individuals after strokes and accidents were fighting to get back to fitness. Most appeared to be serious individuals anxious to improve their health. So I joined in, carefully.

I have long had a scientific interest in ageing. I’ve also been intimately involved in the development of drugs for the treatment of diseases of ageing, such as stroke, heart attacks, high blood pressure, chronic bronchitis, and hypertrophy of the prostate. I’ve also been on teams that failed to find a drug for Alzheimer’s disease.  So anything that helps delay the ageing process is of both scientific and deep personal interest to me.

As part of my campaign to improve my personal longer healthy living, exercise is the top player, almost an Elixir of life so powerful is its positive impact. There are two forms of exercise to consider: aerobic exercise where you run and jump, get your heart pounding and your lungs struggling for breath. Multiple studies around the world have confirmed 20 minutes a day, or 150 minutes a week of serious exercise can reduce your risk of premature death by up to 30%, and particularly benefit risks of stroke, and heart attacks. But also cognition, a measure of mental function, is improved, and recent information suggests that the risks of dementia may be reduced. The other form of exercise engages your fading muscles, to improve their strength, and improve your balance, to reduce the risk of falls, which are far more common as we age, with serious consequences such as breaking of hips, and serious brain injury.

For the long-term health benefit, at any age, a proper exercise program is like a godfather deal, and you win anyway.

I have a personal trainer, a fine 60 year old, slight woman, who combines empathy with tough persuasion to follow a plan. Phrases like you’re rolling your eyes indicate a serious disdain for any lack of my commitment. My stability was wobbly, so getting me to walk backwards downstairs as part of my mobility re-education was a terrifying prospect for an old fellow. I’ll catch you she says confidently. I glanced nervously at her slight build. Don’t worry I’ve been a sheep shearer. Now I’m the ageing Merino ram being tugged on to the shearing floor for the final time. When I succeed in going up a stage in some task performance she says kindly good boy, like I’m the sheepdog. Wuff, wuff.

Recently I’ve extended my interaction by joining a group of fit, bouncy 60 and 70-year-olds who leap about like new born lambs to the sound of music, a transplanted 1980s Jane Fonda class. I began to leap and clap my hands above my head, try hopscotch, and running through a zigzag as if I was in a sheepdog trial and toss basket balls at pace. Very fit women in leotards sometimes call at me, get a move on man, with no consideration I’m 82 years. But surprise, I’m beginning to enjoy it, and feel much better after.

The gym gives me motivation, guidance, and periods of guilt when I don’t attend. But as I read the scientific literature it is clear. Avoiding exercise, now termed the sitting disease, carries higher risks of heart attacks, diabetes, stroke, obesity, and dementia. As I look at that list I want to push them all into the distance. Get away, it’s not time yet. So the gym becomes more than a place to exercise, and more and more my physical, mental, and social partner on the positive journey over the next few years.

It’s never too late, and the words better late than never carries serious implications as we age. Put down the remote, get exercising, find a trainer, but not mine as she’s busy.

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Challenges for the hospice movement

The overall challenge that faces the movement, in New Zealand and elsewhere is to maintain the vision that led to the founding of modern hospices – the holistic care of the dying – which was outlined in my previous blog. This is despite growing administrative demands and funding pressures[1].

  • The widespread assisted dying debate has profound implications for the hospice movement and has forced palliative care into a defensive position. Proponents of assisted dying support their case by maintaining that hospice cannot provide effective pain relief and adequate symptom control. The End of Life Choice Bill passed its third reading in the New Zealand Parliament, seeks to give people with a terminal illness the option of requesting assisted dying.
  • Palliative care in New Zealand is currently substantially under-resourced. The Government recognised the need in its 2000 New Zealand Palliative Care Strategy Document. Full implementation of this strategy requires continuing advocacy to ensure that it retains priority among other healthcare needs, especially when obtaining funding for the medical and technical aspects of end of life care may be seen as a high priority.

The Government provides, on average, around 50% of hospice core functions (some hospices receive just 38% of their total budget while others receive up to 75% – Mary Potter 45%). The remaining amount is funded by public donations and bequests, grants, and fundraising, including charity shops. Mary Potter Hospice has 8 shops, which provide 15% of its income – around $2 million a year. Interesting innovations in this area include an agreement with SKY TV, whereby shops in Thorndon and Porirua are drop-off points for SKY decoders, remotes and cables. This additional revenue stream is worth around $30,000 a year. The Hospice has a TradeMe page and shop volunteers keep a lookout for unusual, rare or popular items that might appeal to online shoppers. Recently a grandfather clock was sold for $521 and a Japanese katana sword for $178. Ceramics, vintage glass, and other collectable items have added to hospice income.

A logistics operation is essential for the pickup and delivery of goods. Hospice trucks are on the road seven days a week, providing work for four drivers. All this is in addition to the Mary Potter Hospice Strawberry Festival in November and pop-up shops at festivals and at Christmas.

In 2018 Work on the Mary Potter Apartments site began. These units, adjacent to the Wellington site will be rented out for additional income. 

  • Much of the hospice activity depends on volunteers, for fund-raising but also general activities for in-patients and in the community, so recruitment may also be a challenge as demand grows. The Mary Potter Inpatient Unit offers a family room with kitchen facilities, which is maintained by volunteers.

The Mary Potter 2018 annual report records 676 volunteers, providing 60,132 free hours of work. All the board members are volunteers. In 2018 a Companion Volunteer Programme was started for patients at home and support to their carers. This is likely to expand as more people receive palliative care services at home, but there will be competition for volunteers from other befriending services such as Age Concern’s AVS. Patients have a parade of medical, nursing and support staff coming into their homes, but non-medical social contact is also beneficial.

  • A key goal of the hospice movement is education and training in palliative care for the medical and nursing professions and wider community.

Mary Potter Hospice offers an extensive palliative care education programme to health professionals and the community, as well as to staff and volunteers. This provides specialist workshops, seminars and symposia. Hospice staff are encouraged to engage in postgraduate study and to present their research and case studies at conferences and seminars.

At the community level a series of workshops to provide practical help for carers and patients is being launched. Topics include home alone, managing money, cooking for one, calming the mind and socialising, funeral and advance care planning, time off for carers, holiday season resilience.

  • The recognition of cultural diversity is now an essential part of service planning and delivery. In 2007first Māori Liaison position at Mary Potter was established and in 2016 Pasifika Liaison. Te Pou Tautoko, the Māori support and advice group, helps the hospice to implement the Māori Service Plan. It ensures that services meet the needs of Māori communities and that a Māori voice is maintained through all levels of operation – Board, Executive, patients, whānau, volunteers and in the community. Each of the Mary Potter bases has Māori and Pasifika liaison staff, administrators and volunteers.
  • The multi-disciplinary and holistic approach of hospice calls for a wide range of skills among staff, and recruitment may pose a challenge, as well as issues arising from working together. As well as nursing care and symptom management, services may include (as at Mary Potter) emotional and spiritual support, regardless of religion or beliefs.  Other professionals needed may include social workers, occupational therapists, counsellors, physiotherapist, massage therapists, oral history recorders and music therapists. Some hospices encourage animal visits.
  • Liaison needs to be developed and maintained with other health professionals and therapists. These include workers in Aged Residential Care, regional hospitals and hospital palliative care teams, GP practice teams, district nurses, ambulance services, oncology and other specialist nurses, iwi health services and home support, assistive technology and social care agencies (some in the private sector). Medical students, student nurses and massage students are offered placements in the in-patient and community teams at Mary Potter.

 

[1] http://www.nathaniel.org.nz/bioethics-politics-and-slovenly-language-lessons-from-history/16-bioethical-issues/bioethics-at-the-end-of-life/114-the-hospice-movement-in-new-zealand-25-years-on
Also: https://www.mariecurie.org.uk/blog/what-is-the-hospice-movement/208684

 

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