A New Zealand Perspective on Aged Care

29 Apr 2021

Carolyn Cooper is Bupa’s Managing Director for Bupa Villages & Aged Care New Zealand. She has experience in the public health system in New Zealand and Australia, as well as in the private health sector and for ACC in New Zealand. Our editorial team spoke to Carolyn to find out what is happening in the aged care sector from New Zealand’s perspective as well as the opportunities and challenges to overcome. Carolyn also shares her proudest achievements managing her teams since the start of COVID-19, which definitely hasn’t been an easy journey.

1. (Following a Royal Commission) Australia is reimagining the future of ageing well and aged care; particularly as the population grows, people live longer and their expectations of care are changing. What is happening in this space from a New Zealand perspective?

Like in Australia, New Zealanders are living much longer with our older population growing faster than our younger population. Lots of us will have long-term or chronic health conditions or disabilities in our later years. New Zealand pursues a policy of “ageing in place”, recognising that most older people wish to live in their own homes for as long as possible. Often aged residential care is seen as a last resort, and we are trying to change that perception. I support people living independently in a place of their choice, for as long as they wish, if they are safe and being supported. However, entering aged residential care can actually enhance the wellbeing of older people, as shown in research by the New Zealand Aged Care Association in 2018.  Across all key indicators of an older person’s health and wellbeing, health outcomes improved over a six-month period after entering a care home. My deep commitment is that we are balancing quality of care with quality of life – things like food, daily activities and a lovely homely environment are equally important to provide residents.

Across the board older Kiwis are looking for more choice in their older years and a “bridging of the gap” between independent living and aged care. This is particularly true for couples who may have vastly differing health needs and we’re seeing an increase in people entering our retirement villages (where they live independently) with a view to futureproofing – it’s reassuring for them to know there is care available when needed.  At the end of the day though, the key thing people are looking for remains the same – we all just want our mum/dad/wife/husband to be safe, happy and well looked after. So good quality care remains at the heart of aged care.

2. What are the major shifts or opportunities ahead then as you see it?

The care of older New Zealanders is becoming increasingly customer centric and demand driven. One of the opportunities I see is exploring how we support people wanting to bridge that gap between independent living – for example in a retirement village or at home – and aged care, providing increments of care. These are things like care suites and serviced apartments where care is delivered to your own suite or apartment. Other options include Refundable Accommodation Deposits, which are common in Australia but not so well known in New Zealand.

We are also seeing more diversity in aged care residents, which requires more flexibility and understanding of different cultures and their care requirements. And the physical design of our retirement villages and care facilities are changing to meet the needs and wants of future residents– things like sensory gardens for those living with dementia.

The sector also needs to be thinking sustainably – environmental sustainability is increasingly important, as it is critical to our own health and wellbeing. We build all our retirement villages to the Green Building Council’s Homestar rating. But the sustainability of the sector is also going through a shift.  It’s important to remember that the aged care sector’s almost 40,000 beds provide care for older and vulnerable New Zealanders at a fraction of the cost of keeping those residents in one of the 11,000 public hospital beds. But the aged care sector is not being funded adequately and this will put increasing pressure on the Health and Disability System if care home providers close their doors and residents end up in public hospitals.

Also, the recently announced Health and Disability Sector reforms will hopefully do away with undue complexity for us as a sector – no longer having to operationally deal with 20 different District Health Boards.

3. Conversely, what are the challenges that will need to be overcome?

As previously mentioned, one of the biggest ongoing challenges facing aged residential care sector is underfunding. The acuity of residents is also increasing, and their care needs are becoming more complex. We are at a critical point and we are currently underfunded by $425 million per year. It’s unsustainable but the 2019 review into aged residential care funding is a step in the right direction.

Workforce availability is a constant challenge.  Despite COVID-19, unemployment in New Zealand is still low, and even with the pay equity settlement, which saw hourly rates increase for care workers, the sector struggles to attract New Zealanders. We need 1,000 care workers each year over the next decade. It’s a mission of mine to shine a positive light on aged residential care and make it an attractive career option for nurses and caregivers.

With the borders closed due to COVID-19, we’ve also been dealing with ways to support our migrant workers, who make up a quarter to a third of our sector’s workforce.

4. Leading during a pandemic will not have been easy so what helped you maintain resiliency and a true north? What have you been most proud of over the past 18 months?

It was certainly a challenging time – working from home and being physically isolated from my teams and people working on the front line. I always try to lead with authenticity and I was having daily calls with over 140 leaders in our villages and care facilities, which helped my resilience enormously. I have been very proud of the entire Bupa team of more than 4,000 people throughout the country in our care homes and retirement villages. Our people really did step up and provide support and care to our residents when they needed it most. I was in awe of their resilience and their ‘person first’ approach, which is at the heart of our Bupa purpose and values.

I’m also fortunate to be surrounded by a more than capable leadership team to support me in leading through the pandemic. I’ve been very proud of the way our people have led through COVID-19.