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New model of support for older people needed

26 August 2006

New model of support for older people needed nationwide

Presbyterian Support Northern (PSN) General Manager Development John Baird says PSN is thrilled with the endorsement its innovative positive ageing service has received in a report released today, and is calling for the nationwide roll-out of its unique model of restorative home-based support for older people.

According to the ASPIRE (Assessment of Services Promoting Independence and Recovery in Elders) report, released today by the Ministry of Health, PSN’s CommunityFIRST service (which has since been renamed Enliven Positive Ageing Services) led to a 28% reduction in the risk of mortality and a 33% reduction in the risk of requiring residential care when compared to usual services for older people. The study also found PSN’s service appeared to lead to improved levels of functional independence and a reduction in depression amongst older people, when compared to usual care.

“From the results of a two-year pilot we did in Hamilton and subsequent experience there and in other locations with clients with varying types and levels of need we knew our unique home-based support services for older people were making a positive impact,” says Mr Baird. “To have our own findings backed up by the ASPIRE trial is excellent – and further supports our belief that our model of service needs to be made available to all older New Zealanders.”

Mr Baird says developing and introducing the new “ageing-in-place” service was a significant change process for PSN and the older people it works alongside.

“Enliven, which we now provide in Auckland, Manukau, Hamilton, Tauranga and Rotorua, is a leading-edge service based on a fundamental change in thinking about how to support older people and what is possible for them.

“At its heart it’s about enabling older New Zealanders to stay in their own homes and to remain in control of their own destiny. It’s about ensuring older people have a choice – that they don’t have to sacrifice independence for comfort and safety and that a hospital admission for example isn’t a one-way ticket. It’s about working in partnership with older people, providing them with the individually tailored support they need to achieve the goals they’ve set, based on what is important to them.”

Mr Baird says PSN would like to see restorative home based support for older people funded and implemented throughout the country for older people with the full spectrum of needs, not just for clients with “high and complex needs” such as those involved in the ASPIRE trial.

“It is no longer acceptable to provide home-based support services to older people that aren’t based on positive ageing. Also, as this study has proven, Enliven-type services can provide a safe option of supporting older people in their own homes instead of being admitted to residential care.”

The organisation also supports improved pay and employment conditions for support workers, including training and supervision, Mr Baird says, adding that something also has to be done to address the difficulties recruiting and retaining staff in the aged care sector.

“We look forward to more dialogue with the Ministry of Health and district health boards about all of these matters.” In concluding Mr Baird expressed his appreciation to all of the clients and families involved in the ASPIRE trial.

“I’d also like to thank all of our partners in this service and to all of our staff for their tireless efforts in developing and delivering this superb service to older people.”


Please note: The Ministry of Health’s release is available on the Ministry of Health website at http://www.moh.govt.nz/media About CommunityFIRST - now named Enliven Positive Ageing Services Essentially CommunityFIRST was the first example of restorative home support for older people with “high and complex needs” in New Zealand. It invariably involves the integration of physical activity into the day-to-day delivery of services. Developed in association with other Presbyterian Support regions, in particular Presbyterian Support Otago, it was first piloted in Hamilton for two years in partnership with the Ministry of Health, Waikato District Health Board and Disability Support Link.

Now available to older people in Auckland, Hamilton, Rotorua and Tauranga, Enliven Positive Ageing Services offer older people with the option of staying in their own homes and the support needed in order to achieve their own goals. The model relies on a multi-disciplinary team (primarily a registered nurse, physiotherapist and occupational therapist) providing an in-depth support plan, which is delivered by highly-trained support workers under the supervision of the multi-disciplinary team.

A key concept of the service is to base support programmes around the goals and aspirations of the older person, which are translated into support and exercise plans that ensure high levels of client engagement.

The Enliven philosophy: Some things make for a happier, healthier life no matter what your age… • A sense of community • Friends, family, whanau - people you love who love you back • Being able to give and to receive • A home of your own choosing • Being able to make good decisions for yourself • And, most of all, practical support...when, how and where you need it most.

PSN is currently the only provider delivering restorative home based support older people of all needs levels, under the name Enliven Positive Ageing Services.

Several other Presbyterian Support regions are also progressing with restorative home based support - Presbyterian Support Otago, Presbyterian Support South Canterbury, Presbyterian Support Central and Presbyterian Support East Coast.

At present PSN’s services for older people are funded by: Counties Manukau District Health Board, Auckland District Health Board, Waikato District Health Board, Bay of Plenty District Health Board and Lakes District Health Board. About the ASPIRE trial

The ASPIRE trial was conducted for the Ministry of Health by Auckland University. It’s key objectives were to assess the effectiveness of ageing-in-place initiatives as compared to usual care in: • Preventing (or delaying the time before) a community-based older people requires permanent residential care; and • Improving survival in community-based older people compared to usual care.

It involved assessing three “ageing-in-place” services: • Community FIRST (Enliven) flexible integrated restorative support in Hamilton - Presbyterian Support Northern • Promoting Independence Programme in Lower Hutt - Masonic • Coordinator of Services for the Elderly (COSE) case management initiative in Christchurch - formed as part of the Elder Care Canterbury Project).

In total 569 older people were involved in the ASPIRE trial. Of these 113 older people participated from the Hamilton region, of which 57 received usual care and 56 received CommunityFIRST. In Lower Hutt 105 people participated, of which 53 received usual care and 52 received PIP while in Christchurch 351 participated, with 182 receiving usual care and 169 receiving COSE.


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