Residential care

If you're considering moving into residential care (rest home or hospital), our checklist and public audit information can help you to make a successful move.

For a small number of older people (currently around 34,000), living at home may cease to be a feasible option, and new living options are needed:

• Rest homes provide residential care for people who need assistance with their daily lives.
• Long-term hospital care provides 24‑hour care, supervised by nurses, for those with a significant level of physical or mental disability.

A decision to move to a rest home, or to be admitted to a long-stay hospital, can be difficult for both you and your family.

It can be an opportunity for positive change, giving you freedom from responsibilities such as home maintenance. You can get the support you need and gain new friends and social activities. But it can bring a reduction in activity and may represent considerable loss of autonomy, with less scope to make your own decisions.

The circumstances surrounding your decision to move and the rest home environment and management are also important.

Rest home information

As with many aspects of successful ageing, advance planning is beneficial.  We recommend you plan ahead, and look around at rest homes in advance of your needing this kind of care.   Moves often need to be made quickly, after sudden ill-health or other crises, so it pays to have information in advance.

The Ministry of Health's unit HealthCert has lists of certified rest homes, and summaries of their audit reports are becoming available as homes are re-certified.

Rest home audit summaries include:

• a factual summary prepared by the Designated Audit Agency that undertook the audit
• a table showing the rest home’s achievement against the Health and Disability Sector Standards using a four-point scale
• additional info on the provider (e.g.special audits).

These resources are listed below.

Choosing a rest home

When you're looking at rest homes, or asking others to choose for you, have a look at the audit report summary if it is available.  When you visit the rest home, talk to the Manager, and get copies of any written information.  If there was anything of concern in the audit report summary, ask the Manager what has been done to fix it.  Ask if you can stay for a while when the tour is over – talk to the residents and find out what they think of the home.  Ask:

About the environment:

• does the size and management (small and locally-owned or large and corporate) suit me?
• is the location suitable for family and friends to visit and when can they visit?
• what opportunities are there for privacy and time alone?
• are the external doors locked? Can you go outside whenever you want?
• how much can you bring with you, such as pets, possessions, paintings or favourite pieces of furniture?

About your care:

• can the amount of assistance you need be provided, and what happens if the level of support you need changes?
• what's the ratio of staff to residents, what are their qualifications, do they get regular training and what's the staff turnover?
• is there a registered nurse on site at all times?
• are there any additional costs you are expected to pay?
  • Some rest homes charge extra for additional services, including for example, rooms with en-suite bathrooms.
• how involved can family and friends be in care and decision-making?
• can you keep your own family doctor?
• will your cultural needs be met, personally and socially?

About day-to-day life:

• how are decisions made between staff and residents?
• is there a choice of food, and when and where it can be eaten?
• what recreational activities are available?
• is transport to shops, activities and recreation available?
• how many newspapers, TVs, phones and internet-linked computers are available for residents?
• is there opportunity to cook, garden, do maintenance or housework?
• how are spiritual needs met?

When you’ve made a shortlist of homes you like, go back and visit without an appointment (perhaps choosing a meal time) and see if your first impressions still hold true.

Resources

For more information on residential care:

> VISIT Seniorline, an Auckland District Health Board site with excellent 'how to' information on accomodation options

> VISIT SeniorLink for their interactive list of New Zealand resthomes, retirement villages and aged care facilities

> VISIT Alzheimer's New Zealand for people who have dementia, their Choosing Residential Care information will help.

> DOWNLOAD Consumer's free Resthome Checklist PDF file

Certified Providers

> VISIT  HealthCert, a unit of the Ministry of Health, which manages Certification of healthcare services.

> VISIT Certified providers of hospital and rest home services The MoH's listing of certified providers of residential care services, and audits of them as they become available.

> PHONE  People with complaints should call MoH HealthCert compliance on 0800 113 813 or your local District Health Board's Funding and Planning Manager (see your phone book).

Media

> READ Consumer's August 2009 article "Rest home roulette"

> READ Consumer's October 2009 update "Failing to care"

> VISIT our Media Watch – The Nelson Mail