Ageing in place a future direction of services for older people in new zealand
Download
1 / 21

ageing in place: a future direction of services for older people in new zealand - PowerPoint PPT Presentation


  • 361 Views
  • Uploaded on

Ageing in Place: A future direction of services for older people in New Zealand. Deb Kerry Acting Manager, Health Of Older Person Team, The Ministry of Health. Dr Matthew Parsons Senior Lecturer in Gerontology The University of Auckland. What is ageing in place?

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'ageing in place: a future direction of services for older people in new zealand' - Jims


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Ageing in place a future direction of services for older people in new zealand l.jpg

Ageing in Place: A future direction of services for older people in New Zealand

Deb Kerry

Acting Manager, Health Of Older Person Team,

The Ministry of Health

Dr Matthew Parsons

Senior Lecturer in Gerontology

The University of Auckland


Slide2 l.jpg


Ageing in place what is it l.jpg
Ageing in place: what is it?

  • 1994 OECD - people should be able to continue living in their own place of residence in their later years.

  • New Zealand- ageing-in-place is about government supporting people to make choices about where they live

  • The ability of older people to remain dwelling in the community, including within retirement villages (MSD, 2006)


Why in the community or at home l.jpg
Why in the community or at home…

  • Person centred

  • Familiarity with the home, neighbours, surroundings etc

  • A place with memories - especially of a dead spouse/partner

  • A focus for privacy

  • A place (in most cases) for security

  • A way to stay independent

  • Maximising the potential for social integration


Some assumptions l.jpg
Some assumptions

Older people prefer to live at home

Government strategy is to encourage older people to live at home

It may not save money, but we don’t think its more expensive for older people to live at home


Slide6 l.jpg


Slide7 l.jpg

Background to study

  • Development of Health of Older Person Strategy

    • Ageing in Place

    • Demographic shifts / costs

  • Risk of ad-hoc development of AIP services

  • Drive for evidence base

  • MoH desire for standardised assessment and evaluation.


Methods l.jpg
Methods

  • Prospective meta-analysis of randomised controlled trials (met-RCTs) to evaluate the effectiveness of ageing in place initiatives.

  • Population: 569 older people assessed with ‘high’ or ‘very high needs’

  • Assessments at: baseline, 3-months, 6-months and every 6-months for up to two years (average 12 months)


Methods9 l.jpg
Methods

  • Commenced November 2003, recruitment finished in November 2004 and final data collection completed in November 2005.

  • Sub-study: OPERA

  • Report with MoH


Outcome measures l.jpg
Outcome Measures

Primary end-points

  • Survival

  • Permanent institutionalisation into residential care


Outcome measures11 l.jpg
Outcome Measures

Secondary end-points

  • Disability

  • Number of Acute Hospitalisations

  • Number of Falls

  • Social Support Network

  • Health-related Quality of life

  • Experience of the primary informal caregiver

    Tertiary end-points

  • Costs- direct/ indirect


Research questions l.jpg
Research Questions

  • To what extent do the three initiatives (COSE, Masonic PIP and Community FIRST) collectively (a) delay or prevent entry of older people to residential care and (b) reduce mortality?

  • What is the impact of COSE, PIP and Community FIRST on an older person’s independence, quality of life and social support systems


Research questions13 l.jpg
Research Questions

  • Are there differences in quality between the three initiatives and conventional care?

  • What are the differences in quality of life of caregivers of older people within conventional services compared to the ageing-in-place initiatives?

  • How cost-effective are the ageing-in-place initiatives to the client, family, providers and funding agency in relation to conventional services?


Research questions14 l.jpg
Research Questions

  • Will ASPIRE be able to assess the sustainability of AIPI to improve outcomes and cost changes over a two year period?

  • Will ASPIRE be able to identify key elements of the AIPI healthcare models of community-based service delivery that lead to beneficial outcomes?


Predicted outputs l.jpg
Predicted outputs

  • Relative success of:

    • COSE,

    • Promoting Independence Programme

    • Community FIRST

  • Risk factors for admission to residential care

  • Role of NASC

  • Costs associated with ageing in place

  • Key elements of ageing in place


The role of nasc l.jpg
The role of NASC

  • NASC – a very significant role in assessing needs and brokering services

  • COSE an evolution of NASC

    • Linked to GPs

    • Enhanced coordination

    • Geographically based and therefore aware of local community resources and services (both formal and informal)

    • One point of contact for health professionals (GPs), older person and family / whanau


Intermediate care l.jpg
Intermediate care

  • Masonic PIP and Community FIRST both use residential care in the form of slow stream rehabilitation / transitional care

  • Change in the use of residential care – Respite, dementia care, end of life care

  • Key aspects of successful intermediate care



Restorative home support l.jpg
Restorative home support

  • Community FIRST is an example of restorative home support for older people with high and complex needs

  • Restorative home support key components:

    • Goal setting

    • Repetitive functional exercises incorporated into every day activities

    • Comprehensive assessment and care management

    • Community reintegration


Where to from here l.jpg
Where to from here?

  • Ageing in place – a key government direction

  • ASPIRE will provide the NZ context



ad