If I want to stay in my own home, what support will I need? This is the question we need to ask ourselves as we move towards the later stages of life.
With one of the highest rates of older people going from hospital settings into aged residential care in the country, Southern DHB launched ‘Home as my First Choice’ in April – an initiative focused on raising awareness of support options when an older person wants to either stay at home, or return home from hospital.
Andrew Metcalfe, Southern DHB Director Allied Health; Strategy, Primary, Community, says it’s about encouraging everyone to have conversations around the subject – from people working in health to older people and their family/whānau. “Many older people are telling us that for them, being in their own home is their first choice. Sometimes they encounter health services – after a fall, for example – and the wheels are set in motion to move them into residential care. Sometimes that’s the right option, but at other times it may not be the right move. If all of us can ask, how can we support you to stay at home? It’s amazing what solutions can be found.”
Andrew says after reviewing patient notes at Dunedin Hospital, they found most ‘what comes next’ conversations were overwhelmingly around aged residential care. “And this was even before they had been seen by one of our clinical needs assessors. There are supports available to help keep older people in their own homes for longer – if that’s what they want to do. Often, older people and their families just may not know what these options are – so, we want more conversations around this and an attitude of, how can we make this happen?”
Going home or remaining at home won’t be possible in all situations, but the aim is to explore every option of support to make it happen. “Vital partners in this campaign are primary care, home support, clinical needs assessors and other health professionals,” says Andrew. “This wider team can support a restorative approach that helps people to be independent, care for themselves and participate within their community, family and whānau for as long as possible.”
Andrew says the voice of older people is the most important part of the initiative. “Let’s listen to what they’re saying. We often think that we know better, but for many people, home is the best and the right place to be – so why not make sure that all other options have been well and truly checked out? Being lonely, feeling that you are not coping so well, that your memory is letting you down, losing confidence, feeling like a burden to others…all of these are big concerns for our older people, but they are not good reasons for going into care.
“We want to keep working with others in our community to make sure that these needs are addressed and that older people can spend as much of the rest of their lives as possible in their own homes, if that’s where they want to be. This includes formal care packages, through to what other supports can be connected with – and that includes existing family and friends, as well as other ones that they may not know about.”
Information and resources including leaflets and posters are available to encourage hospital patients and their families/whānau, and staff, to talk more about the option of staying or returning home with support. The ‘Home as my First Choice’ campaign ties in with other initiatives to support older people to return home, and stay well at home including the ‘Sit up, Get Dressed, Keep Moving,’ initiative and the Live Stronger for Longer programme. A website is currently being worked on which will include links to community resources and patients stories such as Daphne’s experience of being supported to live in her own home.