Navigating the Aged Care System in New Zealand
The First Steps: Needs Assessment
The aged care journey in New Zealand begins with a Needs Assessment and Service Coordination (NASC) assessment. This is a crucial step that determines the level and type of care an older person requires. The assessment is carried out by a trained professional from a NASC agency, typically at the senior's own home. During this process, the assessor will evaluate the individual's health, daily living capabilities, and social support network. The assessor's role is to determine if the senior can be safely and effectively supported in their own community or if long-term residential care is necessary.
The outcome of the NASC assessment is a care plan tailored to the individual's specific needs. It may recommend various services, from community support like Meals on Wheels or home help, to more intensive options. For those assessed as having high or very high needs that are indefinite, the NASC may recommend residential care, such as a rest home or hospital. Having a needs assessment is a prerequisite for receiving any government funding for long-term care.
Types of Aged Care Services
New Zealand's aged care system offers a range of services designed to meet different levels of need. These are broadly categorised into in-home support and residential care.
In-home support
- Home Help: Assistance with household tasks like cleaning, laundry, and meal preparation.
- Personal Care: Support with daily routines such as bathing, dressing, and medication management.
- Respite Care: Temporary care services to provide relief for family caregivers, which can be delivered in the senior's home or a residential facility.
- Short-Term Care: Tailored services for temporary needs, such as recovering from an illness or hospital stay.
Residential care
- Rest Home Care: For seniors who can no longer live independently but do not require complex medical care. Staff provide personal care and medical monitoring.
- Hospital-Level Care: For those with higher medical needs requiring 24/7 nursing supervision.
- Dementia Unit Care: A secure and specialised environment for people with dementia, focusing on safety and tailored activities.
- Psychogeriatric Care: A higher level of specialised care for older people with complex behavioural or mental health issues.
Funding and Financial Assessments
Funding for aged care in New Zealand can be complex and depends heavily on a person's financial situation. The government, through Work and Income and Health New Zealand (Te Whatu Ora), offers subsidies for those who qualify.
The Process:
- Needs Assessment: First, a NASC assessment determines that the senior requires long-term residential care. The NASC agency provides the necessary forms.
- Financial Means Assessment: The individual or their family completes a financial means assessment via Work and Income. This assesses the senior's assets and income against specific thresholds.
- Subsidy Eligibility: If assets and income are below the threshold, the individual may qualify for the Residential Care Subsidy. This covers the majority of the care costs, with the individual contributing a portion of their income.
- Residential Care Loan: For individuals who own a property but exceed the asset threshold, an interest-free Residential Care Loan is available. This helps pay for care and is repaid upon the sale of the property or after the person's death.
- Private Payment: If the individual's assets and income are above the threshold, they are responsible for paying for their care privately until their assets fall below the threshold.
What Government Funding Covers
Government funding for residential care, whether via a subsidy or loan, covers a 'maximum contribution' for the standard costs. This includes accommodation in a standard room, meals, laundry, personal care, medical and nursing care, and GP visits. It does not cover 'premium' services.
Comparison of Standard vs. Premium Room Costs
| Feature | Standard Room (Covered by Max. Contribution) | Premium Room (Extra Charge) |
|---|---|---|
| Accommodation | Standard room, appropriate for older people | Larger room, ensuite bathroom, or garden access |
| Services Included | Meals, laundry, personal & nursing care, GP visits, mobility equipment | Not applicable; standard services are still included |
| Extra Services | Basic recreational activities | Specialised recreational activities, personal phones, internet access, premium Sky TV |
| Personal Items | Basic medical supplies, continence products | Personal clothing, toiletries, hairdresser services |
Choosing a Care Provider
Selecting the right aged care provider is a significant decision. The NASC assessment will provide a list of contracted providers in the area, but families are encouraged to research and visit several options. Key considerations include the facility's atmosphere, the quality of care, staffing levels, and any 'premium' accommodation charges that are not covered by the subsidy. Eldernet is a useful resource for finding and comparing providers in New Zealand.
The Importance of Advance Planning
Planning ahead is vital when it comes to aged care. This includes discussing future care preferences with family and considering an Enduring Power of Attorney (EPA). An EPA authorises a trusted person to make decisions about a senior's personal care, welfare, and property if they lose the capacity to do so themselves. It is often a requirement for admission to residential care and provides peace of mind that a person's wishes will be respected. For more information on this crucial aspect, you can consult a reputable legal resource such as The Citizens Advice Bureau website.
Conclusion
In New Zealand, aged care is a structured system focused on individual needs, with robust assessment processes and financial support mechanisms. By understanding the roles of the NASC, the different types of care available, and the financial assessment process, seniors and their families can navigate this system with greater clarity and confidence. Planning and communication are key to ensuring that older New Zealanders receive the support and quality of life they deserve as they age.
