As there have been a number of changes to the Health System over recent years, many older people are no longer clear in their understanding of the scope and function of the various health agencies.

The main point  is:

• The Ministry of Health is the Government Agency which provides funding for all of the Health Services. For over 65 year olds this funding comes from The Ministry of Health through local District Health Boards.
  

Funding

People can become quite confused about health services coming into the home. It is quite helpful to know that services can be funded from different "buckets of money".

Older people will often be receiving services from the "age related" area which in turn fits under Disability Support Services. This will pay for Home Support, Personal Assistance (showering etc) etc.

On the other hand the District Nursing service is funded from the "personal health" bucket.

A person could easily receive services from both areas,but these would be co-ordinated.

In some circumstances ACC funded is also involved if the person has had a fall or accident.

As the title implies, these services are comprehensive, multi disciplinary services which make thorough assessments of older people, treat them and rehabilitate either back into the community or into a residential facility (e.g. rest home or long stay hospital).

Specialists such as Geriatrics and Psychogeriatricians, Speech Language Therapists etc. run clinics. Generally Doctors and Health Professionals will arrange appointments for people to ensure comprehensive assessment and treatment.

Various services are provided on an inpatient or outpatient basis. Individuals are also assessed on a day patient basis or in the community (e.g. in their homes, residential homes etc.).

A comprehensive range of services is provided, these may include Medical and Nursing staff, Psychotherapists, Occupational Therapists and Social Workers. The team  may also include a Clinical Psychologist, Speech Language Therapist, Dietitian or Pharmacist. One or two may visit and this could result in further assessment at your closest or regional hospital.
In general both inpatient and outpatient services are provided for older people who may have multiple and complicated age related health and support needs.

Referrals

REFERRALS can be made from many sources e.g. GP's, Health Professionals, acute wards or the person themselves.

Those referred will generally have some of the following conditions:

• Frail elderly with multiple medical problems.
• Those unable to complete their normal activities of daily living.
• People who are unsafe to go home but who would improve with more input from the Rehabilitation team.
• Those who are medically unstable.
• Patients who require complex home assessments or whose family members require skills and confidence to care for them.
• People with poor mobility or low exercise tolerance.
• Elderly people who require referrals to rest homes or long term care.
• Any elderly patient that would benefit from advice from specialist elder care professionals.

Outpatient Clinics

As older people can have multiple and complex age related needs, specific outpatient clinics are generally run at most regional hospitals.

Costs

There are no costs for any of these Care of the Elderly Services.

Inpatient Services

In addition to medical and nursing staff, the following health professionals provide specialised assistance:

• Physiotherapists - to access mobility, provide aids if necessary.
• Occupational Therapists - to access and assist in the safe return to a person's environment. Issues may include dressing,showering, kitchen assessments and provision of specialised equipment.
• Social Workers - to access needs and arrange appropriate support services such as Needs Assessment and Service co-ordination.
• Clinical Psychologist- to assist with any stress problems, emotional issues and other difficulties hindering recovery.
• Speech Language Therapist - to assess swallowing difficulties and recommend appropriate foods and fluids, and provide assistance with communication problems.
• Dietitian - to discuss diets, especially specialised diets e.g. diabetic diets, diets to increase weight, high protein diets etc.
• Pharmacist - advice on taking medicines at home, help with fully stocking trays and discussion on changes to medication.

Following thorough assessments, sometimes meetings are held with family, caregivers and patients to plan for a person's placement. Assessment of a person's functioning is often carried out not only in the hospital but often in their home setting.

Adapting the Home

If the home can be made suitable with appropriate equipment or modifications, staying in the existing home can have many advantages.
Occupational Therapists provide advice on ways of managing with day to day tasks. They can also make recommendations on funding for essential modifications for the home. If anyone is experiencing any difficulty at all in managing within their own home, they are advised to contact their GP for a referral to a Community Occupational Therapist, or alternatively contact a private Occupational Therapist

For your local Occupational Therapists see

• Tauranga/Mount Maunganui/Papamoa Occupational Therapists
• Katikati Occupational Therapists
  
• Te Puke Occupational Therapists
  
• Taranaki Occupational Therapists
  
• Horowhenua Occupational Therapists
  
  

The numerous changes that can be made (and funded) by the Ministry of Health are:

• Improving outside access by installing ramps, railings, grips, wheelchair access and in very special cases, even driveways.
• Ensuring bathrooms are safe by making modifications to showers, baths, etc. and providing safety equipment.
• Eliminating potential hazards, e.g. loose mats, protruding sharp edges etc.

In many cases equipment can be loaned or hired, and it is always advisable to talk with a qualified Physiotherapist or Occupational Therapist  to discuss individual needs first. For Ministry of Health assistance see more information here.

Personal Care

(Bathing/showering/dressing etc)

If people are experiencing problems with bathing, showering or dressing, it is possible they may qualify for assistance with these tasks. The local needs assessor should be contacted. Anyone can refer as long as the person has given consent.

There are however a number of products available that can help, these range from long range brushes and sponges for showering, to specialised aids for dressing.

Occupational Therapists's are available to give advice on the best practise and the best product for individual needs. the most common aids are:

• Specialised, wide grip toothbrushes for dental care.
• Extensions applied to everyday devices to allow for reach, e.g. for combs and hairbrushes. 

View helpful equipment stockists:

• Tauranga/Mount Maunganui/Papamoa Mobility Aids and Equipment
• Katikati Mobility Aids and Equipment
  
• Te PukeMobility Aids and Equipment
  
• Taranaki Mobility Aids and Equipment
• Horowhenua Mobility Aids and Equipment
  

Financial help for Travel and Accommodation can be provided by the Ministry of Health in special circumstances.

if you are referred to a hospital specialist or specialist centre some distance away, you may be eligible to recieve travel assistance. The National Travel Assistance Scheme takes some fincancial pressure off patients who need to travel to other regional health services for treatment.

Applicants must meet criteria on the distacne travelled and accomodation but in some cases the scheme can pay up to 100 per cent of claims.

To find out more go to www.moh.govt.nz /travelassistance  

As there are a number of "exclusions" to this scheme, enquiries should be made to the Ministry of Health to check on eligibility.

Check also under "Transport & Travel" sections for Transport options in local areas see below.

• Tauranga/Mount Maunganui/Papamoa
• Katikati
• Te Puke
• Taranaki
• Horowhenua