Wairoa has been without any residential or respite aged-care facility, or hospital-level aged-care, since Cyclone Gabrielle flooding swept through Heritage Lifecare Glengarry last year. Ann Revington reports on a community fighting to look after its elders.
When Heritage Lifecare Glengarry closed in Wairoa, residents went to aged-care homes or hospitals in the wider Hawke’s Bay region or beyond.
Only a small number of those in its roughly 10 residential beds stayed with whānau in Wairoa. That community departure, and the challenges for those who stayed, is something that caught the eye of post-settlement entity Tātau Tātau o Te Wairoa.
Its housing development Te Rauā, between Kitchener and Black streets, will eventually include a communal living facility for kaumātua called Tokotoko.
But building this place for 12 live-in residents has been deferred because of escalating costs until 2025-26, subject to further funding.
The priority is now for 30 family whare, three to four bedroom homes, and 13 one to two bedroom homes for kaumātua ready by mid-2025.
Tātau Tātau chief executive Lewis Ratapu, who has experience with Abbeyfield-style residential care for kaumātua, said the model for Tokotoko would have helped address poor nutrition and isolation by improving diets, social interaction, while reducing loneliness and depression.
Part of the funding for ongoing care would come from the resident’s superannuation which would go to the provider and residents would have a weekly allowance of about $85.
“When you have 12 residents, the accommodation supplement would cover caregivers, and a live-on-site housekeeper.
“Residents would have a continental breakfast, lunch and a hot evening meal.
“Their normal state-funded home care would continue.”
Tokotoko would have a common kitchen and lounge space. Ratapu said he was involved in developing the model in Flaxmere and had spoken to the operators of the first Abbeyfield in Nelson as part of developing the concept for Wairoa.
“The ones that are successful have community involvement, like groups donating vegetables and meat.”
He said residents in the Abbeyfield models tend to live in them longer, delaying the time when hospital-level care is needed.
“It is better living in the community but because it is not a rest home, it is not funded by the Ministry of Health and it is seen as community housing.”
Acquiring another capital partner might offer an alternative way to complete the supported kaumātua care facility but there was still a serious need for hospital-level care in Wairoa.
“You can run the risk of having kaumātua progressing on to needing hospital-level care such as medication management and bariatric care [for care and support given to extremely obese people].
“So we need a hospital-level care facility otherwise they’ll stay in these community-living complexes or stay at home where there are inadequate facilities like a wet-area shower.
“This can mean at least three people are caring for them in their home which then affects people’s availability to work.”
A Wairoa general practice spokesperson said about 50 people at any time were living with family who needed hospital-level care and there was a long waiting list to get into rest homes outside of Wairoa.
Loneliness was another issue, if people were working and they were left on their own during the day, they said.
Ratapu said building family homes was a priority because of the impact of flooding on a pre-existing housing shortage, worsened by further flooding in June.
He was keen to see the operating model for rest homes reviewed. One of the things that made it unaffordable for Wairoa was the requirement for a registered nurse around the clock, he said.
“They either have to increase the bed-rate, and they have not done that, or attract more nurses and they are not prepared to pay more.
“Maybe you do not need a [registered nurse] overnight for the 10pm to 6am shift and instead have a level five health care assistant with support available from the hospital [nurse], ambulance, and telelink.
“That would require a change in rules for rest home and hospital care.”
Associate Health Minister Casey Costello said that Wairoa had been hit hard over the last couple of years and the Government was working across a number of areas – including flood protection – to respond and help the community.
“In the aged-care area, which is my responsibility, I’m aware that the town has lost its only facility and that this puts real pressure on families who need to find alternative care or try and provide it themselves.
“There are two longer-term pieces of work occurring that will help.
“As you know, Health NZ has a draft infrastructure plan that is looking at options for overall investment, including in health services for Wairoa. They are also finalising a review of the structure and funding for all of our aged care services – from home care and support through to aged residential care and dementia and psycho-geriatric services.
“There are some great models of care working in New Zealand, but some parts of the country have fewer available beds and a pressure on other services.
“Wairoa is like a number of smaller communities where solutions for aged care are urgently needed.
“I have asked health officials what we can do in the short-term to address the issues in your community and plan to get to Wairoa to discuss possible solutions.”
Wairoa Age Concern patron and soon to be manager Jan Little said the lack of care facilities was placing a “huge burden” on families and whānau who were caring for their loved ones.
“They are not geared up to care for the elderly and some patients who have been to hospital are discharged with little support, still requiring several weeks of care and bedrest and little advice on how to manage this.
“The government intervention is about helping respite care return to Wairoa.
“We need proactive care, not reactive when it is often too late and people have to leave Wairoa for residential care or hospital.
“There is a welfare downside too where families or partners have to decide between the cost of petrol to visit loved ones in Gisborne or Hawke’s Bay for example or paying their power bills or groceries.
“They should not have to be put in that position.
“If they are elderly, the drive there and back in one day can be very demanding and we no longer have a daily bus service and it is quickly booked out.
“Family have to weigh all this up and then add the isolation they feel, if their partners are now in other centres living in residential care there.”
Wairoa Taiwhenua chairman Nigel How said Heritage Lifecare had indicated to him that it would not be reinstating the Glengarry rest home operation.
“Cyclone Gabrielle was the catalyst for this decision, but it was getting close to that point already.
“The reasons are complex, but the two major ones were the lack of registered nurses plus an inequitable funding model.
“Rural aged care facilities have extra needs and expenses and the funding was not enough to operate their business model long-term in Wairoa.
“Solutions have been talked about, including a community-run, aged care facility [non-profit] and relocation to Hospital Hill [a new build].
“There is no plan yet about how to get this moving, with local efforts spread thin dealing with daily life and the recovery from two flooding events.”
Peter Nijmeijer, acting chief executive officer of Heritage Lifecare says the ownership of Glengarry in Wairoa has not changed.
“We are still working with our insurance company and landlord to reach an outcome. Regrettably until that process is finalised, we are not able to provide any clarity on the future of Glengarry.
“Adding to this is the fact that the land has recently been reclassified as 2C in the region’s flood-risk zoning.
“This means that interventions may be required at either a community or a property-specific level in order for the area to be safe to live.
“Unfortunately, it may still take some time to resolve these issues.”
The weather is heating up on the east coast as summer approaches.