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Gerontology Matters
October 2013

The New Zealand Association of Gerontology

In this issue:

President's Welcome

I recently attended a seminar facilitated by Associate Professor Victoria Traynor from The University of Wollogong, Australia on person-centred care (PCC). Consequently my message for this newsletter relates to this topic. However, rather than regurgitate the contents of the seminar verbatim, my intention is to problematise the concept. Hopefully my thoughts might spark some reaction and consequent dialogue of which naturally I would be keen for you all to participate in.
For many of us familiar with PCC we think of Tom Kitwood’s work and his influential text “Dementia reconsidered: The person comes first”. Since Kitwood, a multitude of authors have written on, and espouse PCC as being integral to the provision of health and social services to older people. Recently I asked a group of postgraduate students to define PCC. A typical response went along the lines of “The older person, as well as their family, are positioned in the centre, so their needs are central to the provision of care. Care providers respond in a culturally appropriate and responsive manner”.
Other words associated with PCC included “therapeutic relationships”, “responsive”, “promoting self determination”, “commitment” and “holism”. Sounds pretty good don’t you think? The issue I have is that theoretically PCC is all well and good and I support the concept fully, however there are significant barriers to operationalising PCC. These barriers are multifactorial and may be financially, organisationally or personally driven. On a pragmatic level organisations need to be fiscally responsible while still meeting their contractual and professional obligations to providing a quality care service to older adults. This is a significant tension, on the one hand being committed to providing PCC as evidenced in many organisational charter documents, while on the other hand the need to provide a ‘healthy’ financial return to investors. As a health professional I can only begin to provide PCC if I am aware of and understand the socio-cultural backgrounds of older people I serve, and the current professional, contractual, financial constraints in providing PCC.
As members of NZAG, what do you think of PCC and what do you see as the issues? Email us and let us know your thoughts.
Stephen Neville

The International Association of Geriatrics and Gerontology (IAGG)

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Information relevant to NZAG members

NZAG - should it respond to policy proposals?

By NZAG Executive Member - Judith A. Davey

There has been discussion over the years about the scope and breadth of NZAG interests. Our constitution gives us a very wide brief to study all aspects of ageing, but, in effect, there has been heavy concentration on health and on later life, on service provision and professional practice. This reflects to some extent the interests of the membership. Could, or should, we be looking at other aspects? What is our role in policy debates related to ageing?
One of my roles in NZAG is to look at policies, including central government policies related to, or which have implications for, ageing. Which initiatives should we respond to? How should we respond, and should we take steps to ensure that any NZAG statements reflect the views of the membership?
An opportunity to respond arises with the publication of the Commission for Financial Literacy and Retirement Income’s discussion paper, “Focusing on the Future”, which is part of the 2013 review of Retirement Income Policy. This is the precursor of a report to government due by the end of the year and calls for comments by early November.
I think the document is relevant to anyone in New Zealand who expects to grow old here and is concerned about their income in retirement (not to mention anyone who has ever paid tax here). It is clear and readable and encourages discussion. As well as looking at the big picture – the global financial situation and international trends in retirement income policies – the report looks at how we currently support older people. This does not mean only NZ Superannuation, but also non-income measures, such as the Gold Card and welfare benefit supplements. It looks at how KiwiSaver is working and what its potential is for the future. Let’s not also forget the NZ Superannuation Fund. The paper includes sections on housing and employment and explains why these are relevant.
This is the background to a discussion of the future of retirement income policy. Is NZ Superannuation sustainable? Should the age of eligibility be raised? Are we saving enough to fund comfortable living standards in retirement? What should we do with KiwiSaver lump sums when our schemes mature? It is hard to underestimate the importance of these to all of us as we grow older.
I found myself in agreement with most of the report’s recommendations and was moved to send in comments, under my own name. Could I have done this on behalf of NZAG? It is just an example, but it raises important issues for the association. Should we respond to calls for comment on policy proposal? If so, which, who should do this and what process of internal consultation is appropriate? Does the executive have the mandate to respond for NZAG? Do the executive members with the policy portfolio? If the membership is to be involved, how should this happen (and can this be done in a timely way, when the times given for comment are often short)? I welcome your reactions.

Judith A. Davey

Aging and Eldercare Expert Joy Loverde Offers Tips for Successfully Aging

01 October 2013 - Santa Barbara Independent

At some point as we grow older, we all approach a fork in the road, says Joy Loverde, author of “The Complete Eldercare Planner: Where to Start, Which Questions to Ask, and How to Find Help.”
Whether we veer toward a thriving finish to life or toward a struggling end depends on how we plan, Loverde recently told an audience of approximately 50 during a presentation at The Samarkand, a Covenant Retirement Community in Santa Barbara.

New Roles and Scopes from Health Workforce New Zealand

Health Workforce New Zealand (HWNZ)

We have seen the following roles on HWNZ that may be of interest to you:
  • Gerontology Nurse Specialist in Primary Care
    In September 2010, HWNZ, together with Waitemata PHO, the University of Auckland, and Waitemata DHB, established the Gerontology Nurse Specialist (GNS) in Primary Care demonstration, a nurse-led initiative with a preventative and early intervention focus.
  • Nurse Practitioner role in Aged Care
    A new innovative model of care that sees the implementation of the Nurse Practitioner role in the aged care sector is increasing access and reducing healthcare inequalities for older people in the community. This innovation was developed to support three Levin aged residential care facilities in response to a GP shortage in the MidCentral region. Health Workforce New Zealand funded the evaluation, which was completed by the University of Auckland.

The Business of Ageing

Ministry of Social Development

Realising the Economic Potential of Older People in New Zealand: 2011 - 2051
The Business of Ageing Project highlights the contribution older people will make to New Zealand’s economic competitiveness over the next 40 years. It looks at the growing value of their labour market participation, income, tax, spending, and voluntary/ unpaid work.
Two project reports have been produced.
  • The Business of Ageing: Realising the Economic Potential of Older People in New Zealand: 2011 - 2051
  • The Business of Ageing: 2013 Update

NZ seventh in elderly wellbeing table

01 October 2013 - 3 News
The following is from 3 News:

New Zealand has ranked seventh in a global survey of the quality of life and wellbeing of older people.
The first Global AgeWatch Index looked at factors such as income, health, employment and education to rank countries by how well their ageing populations are faring.
Sweden topped the list, followed by Norway, Germany, the Netherlands and Canada. Australia was outside the top 10, ranked 14th.
At the bottom of the list were Pakistan, Tanzania and Afghanistan.
New Zealand performed well in employment, education and health status, but challenges remain when it comes to income security.
Global AgeWatch says that by 2030, there will be more people aged over 60 than there are aged under 10.

Call to stop elderly being ripped off 

21 October 2013 - Stuff

The following article is from 
Hundreds of elderly people are being swindled out of their savings each year, in some cases by members of their own family, aged-care groups say. 
Grey Power and the Aged Care Association say an Aged Care Commissioner is needed to stamp out financial abuse of the elderly, which often stems from family members using their enduring powers of attorney.
They are calling on the Government and other political parties to create the position and give it some teeth in the form of power to take legal action through the courts. 
Both organisations have made their case in a discussion document released today. 

Putting the focus on older New Zealanders

01 October 2013 - Health Improvement and Innovation Resource Centre (HIIRC)

The following is from the HIIRC:

The steps being taken to make sure our growing ageing population remains healthy and independent were today outlined by the Senior Citizens Minister Jo Goodhew.
Mrs Goodhew launched the Older New Zealanders: Healthy, Independent, Connected and Respected document to coincide with the International Day of Older Persons.
“This document outlines the services and support available to older people, and summarises in one place what is going on across government agencies to reaffirm this Government’s commitment to the Positive Ageing Strategy.
“It also looks at the opportunities our growing older population will bring, and how to recognise the skills and knowledge of older New Zealanders.

Rest home nursing trial gets top award 

19 October 2013 – Manawatu Standard via Stuff

The following is from the Manawatu Standard:
An innovative scheme to improve the lives of older people in the Horowhenua region has reigned supreme at this year's MidCentral District Health Board Health Awards. 
The black tie event, held at the Awapuni Racecourse in Palmerston North last night, recognised individuals and teams in the region for their commitment to healthcare. 
A ground-breaking trial, involving a nurse practitioner in three Horowhenua rest homes, was awarded the Supreme Award for Excellence in Innovation and Integration in Healthcare, worth $3000. 

Specialist geriatric medical assessment for patients discharged from hospital acute assessment units: Randomised controlled trial (UK)

10 October 2013 - HIIRC

The following is from the HIIRC:

This individual patient randomised-controlled trial evaluated the effect of specialist geriatric medical management on the outcomes of at risk older people discharged from acute medical assessment units, compared with usual care.
The study was set in 2 hospitals in Nottingham and Leicester, UK, and participants were 433 patients aged 70 or over who were discharged within 72 hours of attending an acute medical assessment unit and at risk of decline as indicated by a score of at least 2 on the Identification of Seniors At Risk tool.
The intervention was an assessment made on the acute medical assessment unit and further outpatient management by specialist physicians in geriatric medicine, including advice and support to primary care services.


Do the elderly have a voice? Advance care planning discussions with frail and older individuals: A systematic literature review and narrative synthesis

15 October 2013 - HIIRC

The following is from the HIIRC:

This systematic literature review and narrative synthesis  investigated the attitudes of public and healthcare professionals to advance care planning discussions with frail and older people, who have no main overriding diagnosis, and who are estimated to account for around 40% of deaths.
Articles that related to frail or older individuals and either advance care plans or discussions on end-of-life care were included. Studies of specific conditions or that focused on prognosis, capacity, or resuscitation decisions were excluded.

World Alzheimer Report 2013

Ageing and Dementia Care via Alzheimer's Society 

The Global Observatory for Ageing and Dementia Care (ADI), hosted at the Health Service and Population Research Department, King’s College London, was founded in 2013. Supported by Alzheimer’s Disease International, and King’s College London, the Observatory has a tripartite mission:
  1. To build upon ADI’s 10/66 Dementia Research Group program of population-based and intervention research in low and middle income countries, maximising the impact that research findings from our data can have upon policy and practice.
  2. To develop, evaluate, and promote primary care and community interventions for people with dementia.
  3. To synthesise global evidence for policymakers and public, in particular, continuing and developing our role in the preparation of high impact evidence-based reports for Alzheimer’s Disease International (World Alzheimer Reports 2009, 2010 and 2011), the World Health Organization (Dementia: a public health priority, 2012) and other relevant intergovernmental organisations.
The World Alzheimer Report 2013 was independently researched and authored by Prof Martin Prince, Dr Matthew Prina and Dr Maëlenn Guerchet on behalf of the Global Observatory for Ageing and Dementia Care. The evidence reported in Chapters 1-6, and the inferences drawn, are the responsibility of the authors alone. The key messages and recommendations were developed jointly by the Global Observatory and Alzheimer’s Disease International.


Building dementia-friendly communities: A priority for everyone

Alzheimer's Society (UK)

The following is a report is from the Alzheimer's Society:

This report provides evidence on dementia-friendly communities from the perspective of people affected by dementia and their carers. It explores the barriers that people face in their community, how they would like to be engaged with their local area and the support they need to do so.
It also collates existing evidence and describes projects that are already making a difference for people with dementia. This information is used both to provide a definition of a dementia-friendly community, and to lay out 10 areas of focus for communities working to become dementia friendly.

Conferences - New Zealand

Aged Care Service Delivery Conference

12-13 November 2013 - Auckland, NZ

Creating better service performance management
This is an event that creates a constructive platform that allows you to learn from industry experts and apply insider knowledge to your organisation. Don’t miss this unique opportunity to network with and get inspired by your peers, improve your understanding of how to enhance the quality of aged care, and learn about the key factors that drive elder satisfaction.
This conference is a great way to:
  • Deepen your understanding of how aged care is delivered via local DHBs and rest homes across the country
  • Hear about new residential living and care pathways which allow older people to age in place
  • Facilitate discussion on how to restructure the aged care workforce for maximum staff retention
  • Learn about how to build a culturally conducive model of aged care within your organisation
  • Gain insight into what makes the most difference to consumer experience and satisfaction as told by the customer
Immerse yourself in the full-day separately bookable workshop:
  • Building a culturally competent model of aged care
NZAG Members: Enter the promotional code MA6KV0 when registering online and receive a 10% discount. 
Register today and join us at the conference to share your ideas and passion for driving the aged care industry forward.

Sharing Evidence - Supporting Action, NDC Knowledge Exchange Forum 2013

21-22 November 2013 - Auckland, NZ

The National Dementia Cooperative’s (NDC) 2013 Knowledge Exchange Forum is an opportunity to push the current boundaries of what we do as caring professionals. This event will provide access to some of the latest New Zealand implementation and innovation stories and bring together creative and committed practitioners in the field.

Annual Elder Law for the Health Sector Conference & Managing the Deteriorating Patient Symposium

February 2014 - Auckland, NZ

This conference will focus on addressing the ethical and legal challenges within aged care and analysing the strategies needed to improve the continuum of care for patients at risk. 
So far we have a strong agenda with speakers from: 
Clinical Update NZ, Gillespie Young Watson,Buddle Findlay, Minter Ellison Rudd Watts, Buchanan Gray, Gaze Burt, Waitemata DHB, University of Otago, University of Auckland, Blackstone Chambers, Claro Law, Christchurch Hospital, Office of the Health & Disability Commissioner, Bay of Plenty DHB, Totara Hospice, Wellington Hospital, Auckland City Hospital, True Colours Children’s Health Trust, Arohanui Hospice, Mercy Hospice Auckland,

NZAG members are eligible for a 10% discount for this event, watch this space for registration details.

Conferences - Overseas

Global Disability, Ageing & Healthcare Conferences Online Guide 

See a more comprehensive listing of conferences at our web site 
For more information click here.
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