Mother's transition from retirement village to aged care under spotlight

Transition from independent living in a retirement village to higher level care is expected to be part of a larger policy review.

Sue Brown's mother lived in a serviced apartment in a retirement village for six years before being told at very short notice she had to leave because of mobility issues, MPs heard yesterday.

The mother had been assessed as needing rest home-level care and her retirement village had initially agreed to provide that level of care in her serviced apartment.

But suddenly, according to Brown, the retirement village made a unilateral decision that she needed hospital-level care because of mobility issues.

It did not have a hospital room available at that time and did not have the staff to transfer the mother in and out of her wheelchair. It called an ambulance to take her to a public hospital, that day but the family refused.

The next day, the day before Christmas in 2016, the family felt they had no choice and this time the ambulance took her to a public hospital.

Her mother was so traumatised by her treatment that Brown started a petition in 2020 seeking a law change to require retirement villages to have capacity to accommodate residents when moving from one level of care to the next.

She came to Parliament yesterday to talk to the social services and community select committee about it.

"I wish I could put into words the raw emotion and distress that mum and the family were under following this eviction," Brown's submission said.

"Mum was 86 years old and homeless. She had lost control of all aspects of her life and felt completely abandoned.

Sue Brown appearing before the social services committee yesterday.

"She was in shock and could not communicate or function normally. The family was in shock as well. It was absolutely heartbreaking, watching mum come to the realisation that she would not go back to her home of six years."

Sue Brown did not want to publicise the name of her mother or the name of her retirement village. Brown wanted to keep her story largely anonymised because she believes it is representative and is not that unusual.

While attracting only 63 signatures, the petition was the subject of some high-level submissions this week to the Parliamentary Social Services and Community Select Committee.

Retirement Commissioner Jane Wrightson appeared, as well as the Retirement Villages Association and Brown herself.

It has highlighted problems many people face when they move from retirement villages to aged care and, as well, the fact that many couples are split up in separate rest homes, a strong part of Brown's submission.

Retirement Commissioner Jane Wrightson. Photo / Michael Craig

The interface between the various levels of care is likely to be subject to much greater focus in policy review of the retirement villages and the aged care sector, as recommended by the Retirement Commissioner earlier this year.

Brown said the family moved her mother back to a hospital room in the retirement village when one became available.

"But by this stage she was totally traumatised and consumed with anxiety. The eviction had a massive impact on mum. She was confused, disorientated and could not function or communicate normally for months."

She died five months later, in 2017.

Brown made a series of suggestions when she appeared before the committee yesterday including:

• Allowing residents to stay in their existing serviced apartment room and receive the next level of care in that room, using staff engaged by the operator. It could be on a temporary basis until a room at the next level of care became available in the resident's current facility. Residents could be well placed to contribute to these costs if the operator agrees to a deferred payment when their serviced apartment was sold.

• Allowing residents to engage external caregivers or family, to provide care in their existing room until a room at the higher level of care became available at their current facility.

• Building a "dual service" bed capacity in New Zealand, allowing residents to stay in their existing rest-home level of care room when they move to hospital level of care (except for acute medical conditions). The Government already subsidises both rest home-level of care and hospital level of care.

• Considering provisions of more respite care rooms with the retirement village/aged care sector.

"Having these four options available would take the urgency out of the transition when a resident receives an assessment that requires a higher level of care," she said.

Wrightson told the committee that it seemed Brown's case involved staffing as well as accommodation issues.

She questioned what was best practice for retirement villages when a care bed was not immediately available – "and I imagine this is relatively common".

"In my view it is unclear, and it varies across villages. Plain English communications of rights and obligations needs to be excellent.

"The whole area needs work. There are no sector-wide standards and the number of Government agencies in the aged-care space adds further complexity: MSD, Health, Health and Disability Commissioner, Winz, DHBs and presumably the upcoming Aged Care Commissioner."

She said it was difficult for laypeople to have a full understanding of the system and their rights and responsibilities.

"This is exacerbated as health and other issues develop at what can be emotional times. The system is legally and commercially focused and consumer rights are weaker than they could be. Care and respect need to be the drivers."

Retirement Villages Association chief executive John Collyns (right) with association board member David Bennett, appearing before the social services committee.

The Retirement Villages Association represents operators of 390 villages in New Zealand, with about 34,200 units housing about 46,000 seniors.

Executive director John Collyns said about 65 per cent of its members also provided aged care facilities.

He said the petitioner's call to have a care bed available at any time was not practical or economic without additional funding from the state.

He said the priority offer to care for village residents over a member of the public was an important consideration when choosing a village.

"Therefore operators offering this need to be confident that for the majority of residents, the offer holds true."

That was usually possible because a resident was able to plan their move with time to get the needs assessment and for the operator to have a room available when needed.

But an acute health event could mean the move was less seamless and could involve a short stay in a public hospital or a temporary move to another facility.

"These circumstances, sadly, are difficult to predict but the operator will work closely with the resident and their family to ensure the process is as smooth as possible."

Committee chairwoman Angie Warren-Clark told Sue Brown the committee would consider her petition with care.