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Residential Care

Many service providers and a small number of other agreed parties enter and update their own information about their service. Eldernet is therefore a vehicle for their information and is not responsible for their content. These persons have been advised that by entering data onto the Eldernet site Eldernet Ltd understand that they agree to comply with relevant New Zealand standards, ethics and legislation eg Fair Trading Act 1986 and Privacy Act 1993 etc.

Eldernet Ltd make a conscientious effort to ensure that the information on this site is accurate and up to date, however we, or our agents, cannot accept liability for any omissions, errors or action taken on the basis of information contained on the site.

The material on this site is intended for general information purposes only. It is not intended to replace information given to you by a health or other professional. Nothing on this site constitutes financial or other advice.  Eldernet does not recommend any financial product on a site which a link is provided to. Any recommendation or opinion expressed in relation to a particular product is solely the view of the relevant contributor. No articles or linked sites are financial advice for the purposes of the Financial Advisers Act 2008 and should not be relied upon in making an investment decision. Eldernet Ltd encourage you at all times, when seeking specific advice, to consult a professional in that field.

Eldernet also contains a large number of links to third party sites that in the opinion of Eldernet may provide information of interest to our users. However such information cannot be guaranteed to be accurate or up to date. We have very limited knowledge about the content of these sites, cannot give you any assurances about their information and take no responsibility for it. We ask you to exercise your judgment.

 

As Eldernet is an independent information provider that does not own or have an ‘interest’ in any service listed on the site nor does it provide any other role for listed services (e.g. a professional association with a defined membership), we are free to provide the most comprehensive listing of services for older people in New Zealand (i.e. those over 65 years of age or those who have an age related condition). To our knowledge there is no other website that lists:

  • ALL Home Support Services
  • ALL Retirement Villages (also available on www.retirementvillages.co.nz)
  • ALL care homes (i.e. residential care facilities)
  • Care home vacancies - Eldernet provides a daily bed availability report to most District Health Board regions. It's available for you to see.

 

Other benefits include:

  • Extensive information about many services - Each facility or service that has listed with Eldernet has provided us with standardised information. From this information a database has been designed that enables people to select localities, features, facilities and services that are important to them. This has the potential to link the person to the facility or service that is most appropriate to their needs.
  • The ability to ‘view’ a large range of care homes - Many people have told us that they would like to personally visit every facility in their locality, but realise that practically speaking, this is not possible. This site is the next best thing to visiting each facility personally.
  • The ability to view available retirement village properties as they 'come to sale'. If you're in the market to buy, this function saves you time and gives you specific information about each property. You can go directly to this section via retirementvillages.co.nz 
  • The ability for others to be involved in decision making - Often family members/significant others, are invited to and wish to be involved in the decision-making process. It has previously been very difficult and expensive for people who live elsewhere, especially those overseas, to be involved to any great extent. The Eldernet service now means that they can be more included. 

 

Updated: 2020-04-23

There are a variety of reasons for this; the most common being that the person has experienced deterioration in health and is having difficulty with managing at home. (Please note: an assessment by an authorised service is required prior to entry to residential care.) The following are five typical pre-entry situations:

  • Mr T has had some time to anticipate the move into residential care but has some reluctance to do anything about it. (A recent assessment shows he is eligible for residential care.) He has been finding it hard to manage at home even with formal home support services. His friends have either died or moved away. Other social supports have fallen away too and he has become quite isolated. He has numerous falls. His children who live in other parts of the country worry about him. He won’t go and live with any of them. Things are coming to a ‘head’.
  • Miss D is typical of those who experience a sudden change in their circumstances or health. She had previously been very active and fit prior to her sudden severe and disabling stroke. She had never entertained the idea of residential care. She has no family.
  • Mrs G who has a major disability, relied upon the significant support and care provided by her husband and formal support services. He died suddenly leaving her few options other than going into residential care.
  • For a long time Mrs K has thought about and planned for life in a residential care facility. She has gathered quite a lot of information about residential care over the years and having used ‘short stay’ options in the past knows what to expect. She is eligible for residential care and now thinks the time has come to make the move. She’s looking forward to the companionship and support offered in a rest home and the freedom from the worry of maintaining her house in the suburbs.
  • Mr B has dementia. His family can no longer care for him at home. His behaviour has become more difficult to manage. He wanders away from home and quickly gets ‘lost’ and becomes aggressive whenever any one tries to guide or help him. Family members are ‘stressed’. His assessment has established that he requires more specialised care than is possible in his community.  Note: If someone has dementia it doesn’t automatically mean that they require residential care. If they are eligible for residential care this will be established following a specialised assessment. The assessment will also indicate whether secure dementia care is needed (as opposed to general rest home care).

Very occasionally some people require care for security and loss reasons. These people may, for example have suffered a trauma e.g. home invasion and feel unable to continue living alone.

Updated 2020-03-30

Studies show that only a small percentage of those aged over 65 years in New Zealand live in a care home (approximately 5-6% - with some variation between cultures and ethnic groups). These figures also vary according to the age group in question i.e. the percentage of those in their 60s living in residential care is far less than those in their 90s. This means that as we age the possibility of needing this type of care increases.

For a number of years, the government has been developing policies and strategies to support people to live in their homes for longer. This has had the effect of delaying entry into a care home (especially ‘rest home level of care’) so that now it is more common for people to enter a care home at 'hospital level' of care where more complex care can be provided.

Another factor to remember is that over 50% of us might spend a short time in a care home (not strictly as long-term residents; (perhaps to give a carer a break or for palliative care), so the role of care homes is evolving over time.

Some people who are under 65 years of age may also live in residential care (i.e. rest homes or private hospitals).  This generally means they have a disability and require intensive or specialised nursing care.

It is clear however that the greatest percentage of those aged over 65 live in their own homes or elsewhere, such as in a retirement village or with family etc.

Reviewed: 2020-03-30

Entry is managed by a process known as Needs Assessment.

  • To begin this process you either need to talk to your doctor about the issues that are leading you to take this step or you can contact the agency responsible for managing assessments (most commonly known as NASC) yourself.
  • Undergo an assessment. The type of assessment used in New Zealand is interRAI. An assessment is not something you pass or fail: it is a way of finding out what your needs are and how they might best be met and whether you qualify for publicly funded support.
  • Those with unlimited ability to pay privately may contact the provider directly and negotiate the cost of care. An interRAI assessment is still advised.
  • Those who are not New Zealand residents are advised to contact the provider directly and negotiate the cost of care.

 

After the assessment has been done the findings will be discussed with you. Possible outcomes of the assessment may include:

  • A recommendation for increased support services at home
  • A recommendation for entry to a care home (the criteria for entry is quite high);
  • If you do not meet the criteria, other options may be recommended e.g. increased family/whanau, community and/or private home support services.

 

The following applies to those who have decided to go into residential care and are taking the next steps:

  1. The person responsible for co-ordinating your services will give you your Assessment Certificate and if relevant, the ‘Residential Care Subsidy - Application for Financial Means Assessment’ form’. Make sure you know what type/level of care you require e.g. rest home, dementia, hospital, specialist hospital.
  2. Discuss your options with those closest to you and seek any clarification from the person responsible for coordinating your services.
  3. When the decision is made to go into a care home check the Eldernet Residential Care Vacancy status report. A click from the home page shows all care homes in New Zealand and, in most regions shows where vacancies are. Alternatively you can ask for a printed copy. 
  4. Shortlist possible homes/hospitals that provide your level of care. It is your responsibility to select your home. (See checklist).
  5. Visit the facilities on your shortlist. You may be offered a range of care options including standard care accommodation/rooms, premium accommodation/rooms (where an additional fee is charged for additional features) to care apartments. Care apartments are a type of accommodation where you pay an upfront amount (it may be of a similar amount paid for a house). Care apartment arrangements are governed by what is known as an ORA (Occupation Right Agreement – see the sections on retirement villages).
  6. Ask for a copy of each facility’s Admission Agreement. Make sure you ask about any additional charges and that you have written information about any of these. Go away and read these documents (so that you have time to make an informed choice).
  7. If you want a ‘trial’ of care home (it’s often a good way to find out how well you and the facility ‘fit’) organise this. You must pay for a trial yourself; it is not subsidised.
  8. Decide on your preferred home.
  9. Talk with the admissions person, negotiate any issues and sign the Admission Agreement.
  10. You are responsible for paying for or contributing towards your care. Make arrangements for this. Apply for a Residential Care Subsidy or Loan if appropriate (More about the Residential Care Subsidy or Loan).

 

Updated: 2020-03-30

District Health Boards (DHBs) are responsible for the funding and arrangement of health services in their regions. There are 20 DHB regions in New Zealand. They may be seen on this Ministry of Health website link.

Updated: 2020-03-30

An assessment identifies any health issues you have, your wider needs, and whether you qualify for publicly funded support. The type of assessment done in this situation is interRAI, an internationally recognised computer-based assessment programme.  It is done by a trained interRAI health professional who is skilled in the area of older people’s health. interRAI assessors may be based at your local DHB hospital, in community and home support agencies and at residential care homes, so you may undergo an assessment in any of those settings. Most commonly however, it’s done in your own home.

Information will be gathered about any medical conditions you have; you will be asked about a wide range of issues such as your ability to do things, your mental wellbeing and social situation.

The assessment is confidential to you, your healthcare professionals and those to whom you give approval to view. The resulting data, which will be discussed with you, ensures that you and others involved in your care have the best information on which to base decisions.

It will give recommendations about what needs to be done to improve your health and wellbeing. You may or may not require formal support services, some of which may be subsidised (see page x. As important decisions may be made at this time it is helpful to include those closest to you e.g. your family/whanau, in this process.

Types of assessments

There are many types of interRAI assessments (including reassessments), and the one most suited to you is determined by the type of needs you have.

If a short assessment or reassessment is indicated it may be done by an assessor, usually based in the community.

If your needs are complex, then more information will be needed to ensure you get the most appropriate support. This assessment is often completed by a clinical needs assessor from the DHB. A comprehensive interRAI assessment like this is thorough and can take up to two hours.

Sometimes a basic assessment or review can be done over the phone. These calls are only made if it is thought that the situation can be properly addressed in this way. If you have problems discussing such things over the phone e.g. you can’t hear well, feel uncomfortable, want someone with you or can’t explain things properly, then ask for a ‘face to face’ meeting.

The outcome of the assessment will be discussed with you, and with your permission your family/whanau. If you require treatment a referral to the appropriate service will be made. If you require services then you will be advised and these arranged. This process is known as service coordination.

 

Updated: 2020-03-30

After you have had an assessment you may be referred to someone known as a service or care coordinator (usually based here). They will discuss the recommendations with you and help organise any services that have been recommended following the assessment and that you agree to. Amongst other options this may involve arranging home support services, carer support for any carer, or talking through your options with you if going into a care home has been recommended. They will also give you the information you need and set up the process for entry to care if this is decided. 

Some services may be subsidised for those who are eligible (financial eligibility may also apply). You may need to pay or part pay for other services.(See: Will I have to pay for my care?)

Updated: 2020-03-30

You can ask for a review or reassessment. Contact your local older persons service.

Updated 2020-03-30

There are four levels of residential care.

  • Rest Home Care – People who require this level of care usually have some ability to get about on their own or with someone helping them. They require some assistance with personal care and general day to day activities. Many have a degree of memory loss. Some people who have dementia may be able to be safely and appropriately supported in a rest home.
  • Hospital – Hospital care is provided for those who have a significant disability and medical concerns. Most require the assistance of two people to move about.
  • Dementia Care – Dementia care homes provide a secure home for those with a dementia and for whom there are safety concerns and possible behaviour issues.
  • Specialist Hospital/Psychogeriatric Care - This type of care is designed for people with a mental health or dementia disorder who require a high level of nursing care and management of challenging behaviour. They therefore require a secure environment and the skills of staff trained in psychogeriatric care.

 

Reviewed: 2020-03-30

Eldernet does not accept any responsibility for people taking action based on this information alone. Please therefore ensure that you seek the appropriate advice from Work and Income or your solicitor.

In the first place you are responsible for paying for your own care.

There is a maximum amount that you will have to pay (as long as provider meets certain requirements which all providers listed in the residential care section of Eldernet do).  This is known as the Maximum Contribution (MC). It is aligned to the DHB contract price for Rest Home Care paid to providers.

The reality is that many cannot afford to fully pay for their care or they run out of their own funds and need to apply for a subsidy or a loan.

In brief

A Residential Care Subsidy (RCS) may be available if:

  • you have been assessed as requiring long-term rest home or hospital care indefinitely, and;
  • you are eligible for public funded health and disability services, and;     
  • your chosen residential facility has a contract with a DHB, and;
  • you are aged 65 or over and your assets are within certain limits (determined by the means assessment), or;
  • you are aged 50 to 64, single, with no dependent children.

In order to make a judgement about whether you are eligible for a RCS Work and Income conduct a financial means assessment. There are two parts to this:

  • Means assessment of assets
  • Means assessment of income and the residents contribution

This subject is complex and individual circumstances vary widely. Please make sure you get full, up to date details from Work and Income.  Helpful information and brochures are published by the Ministry of Health (MOH) and Work and Income (WINZ).  Further information can be obtained from your regional Work and Income office or your older persons’ service.

You can also phone: 

  • The Residential Care Subsidy Unit freephone 0800 999 727
  • Seniorline a joint DHBs funded service which helps people find their way the system - freephone 0800 725 463

 

Points to note:

  • If applying for the Residential Care Subsidy you need to return the signed application form to Work and Income within 90 days of the date you want the Residential Care Subsidy to start.
  • You will retain a weekly allowance for your personal use and an annual clothing allowance.
  • Application for a Special Needs Grant for essential items, such as dentures or hearing aids, may be made to Work and Income.
  • Further financial assistance may be available from Work and Income.
  • If you are eligible for a RCS and have a partner living at home, the partner retains the use of the home and car. (They may be included in the asset test calculation.)
  • If you are eligible for a RCS and have a partner at home who is receiving NZ Superannuation or other specific benefits, they may be eligible to get a weekly Special Disability Allowance for visiting purposes of and may be eligible to receive the NZ Superannuation at the Living Alone rate. Work and Income will advise regarding other entitlements.
  • In the case of an elderly victim of crime, the funding agency must pay the full cost of contracted care services provided to the person.
  • Persons who do not have New Zealand residency are advised to contact their preferred care provider directly to negotiate the cost of care.
  • Private payers may be eligible for Work and Income assistance, e.g. Disability Allowance, if they meet financial and other criteria. Subsidised residents are not eligible for a Disability Allowance as this is factored into the RCS.
  • You can ask for a review of your means assessment (e.g. your circumstances may have changed) or for a financial means assessment at any time.             
  • If you are not eligible for a RCS and you have limited other assets and you do not wish to sell your house you can apply to Work and Income for a loan to pay for your care.

 

Updated 2020-04-23

 

As can be expected these feelings are as varied as the circumstances and the people involved.

Moving to a new house, even in the best of times is well recognised as being a stressful event. A large proportion of people however find themselves in the position of making a decision when they are feeling quite fragile e.g. following the death of a spouse who had been their caregiver or a decline in their own health. Previous reports of isolated incidents of poor care and even abuse also shapes our thinking about the desirability of this type of care. Our own experience of visiting ‘rest homes’ in the past can have been less than positive. It is not surprising then, that many of the feelings people experience about residential care are perceived as being negative. Often too, this response is the normal ‘outworking’ of grief associated with these losses. (However, as for many losses, it needs to be remembered that after a period most people feel more positive.) The following are typical of the initial range of feelings.

  • bewilderment/confusion, a sense of being overwhelmed e.g. by the process leading up to the event
  • powerlessness
  • resignation
  • grief associated with multiple losses e.g. home, neighbours, pets, loss of control over their lives, the death of a spouse
  • nervousness about leaving the familiar and facing the unfamiliar
  • worry about a potential loss of privacy
  • anger e.g. about the financial situation, particularly the inability in some instances to pass on the ‘fruit of their hard work’ to their children
  • relief, particularly if the move has been anticipated
  • anticipation e.g. making new friends/trying new things
  • reassurance, confidence, and an increase in a sense of personal security

Occasionally people are so overwhelmed by the situation that they want others to make decisions for them. This can become a problem later as the person can feel resentful that they did not make the decision themselves and may blame others if they are unhappy with the placement. Increasingly the person’s health condition makes it almost impossible for them to have much input into the decision. Care therefore, needs to be taken to ensure that the person is as involved as possible in the decision making process and that decisions that are made, are consistent with what it is understood the person would have made for themselves, had they been able.

Depression may also complicate things and although depression is often thought of as a younger person’s problem, it is a common complaint of older people and often goes unrecognised. It is important to seek help from a health professional if depression is suspected or if ‘low mood’ continues.

Updated 2020-04-23

There are two aspects that need to be considered in this response. Generally this question is asked out of a concern that those things that that are familiar and comfortable and that give pleasure and a meaning in life could be lost. On the other hand the question could mean; are things going to improve for me?

An important and helpful principle to bear in mind is that if a careful selection of facility is made, by matching the person with the place that best suits them and their need, then the more successful the residency is likely to be. There should be fewer adjustments to make and greater potential to take advantage of new opportunities.

Some people may welcome a change of lifestyle, for example they may have had problems with mobility and found it difficult maintaining the social contacts they would have liked. With increased assistance, their mobility and lifestyle could be improved.

A new community

When someone moves into a residential care situation they are not just moving into a new neighbourhood, they are moving into an interactive community. It is this issue that often makes the selection of a residential facility so difficult. For some people this factor is more important than the physical environment such as the location, buildings, decoration, gardens etc. As people usually relate best to a community where values, beliefs and ways of doing things are similar to their own, it makes sense to remember this when the selection is made.

Increased personal interaction

One of the greatest changes in a residential care lifestyle often has to do with the increased interaction with, and dependency on others. The closer living arrangements of residential care can be more like living in a flatting, boarding, or hotel situation than any other type of accommodation. Some men say the closeness of the residential care situation reminds them of army days. This of course may have positive or negative connotations. For others, however, it has been a long time (if ever) that they have had to live at such close proximity to ‘strangers’.

You will, of necessity, have to get to know many new people; your fellow residents and staff. Some facilities are busier, livelier, bustling places than others. Choose a place that suits your personality. For example: Some people find it harder than others to ‘mix’, or they may be the sort of person who enjoys spending a large part of the day on their own. It would be wise for this person to choose a residence that can cater for and support these lifelong preferences. A busy, interactive environment may just lead to stress or unhappiness.

Certainly, for those who are lonely, residential care can provide increased opportunities for interaction and new friendships are often formed. Remember the degree of interaction varies from home to home; it’s your choice.

Privacy

Maintaining privacy is also something that a lot of people moving into residential care are concerned about – personal, health and financial privacy are all important.  Discuss any concerns you have with staff and/or management and when viewing a facility observe carefully how resident’s privacy is respected before making your choose of facility.

New Activities and Interests

The facility will provide activities for residents throughout the week. This can be an opportunity for you to try some new activities and possibly introduce others to your own hobbies and interests.  Prior to selecting a facility talk to the activities coordinator about your interests and hobbies and see if these can be accommodated and incorporated into the activity schedule.  There is also usually the opportunity to go on outings or visits to local community groups which can provide you with a way to keep up your community contacts or make some new contacts.

Many facilities are also making computers available for residents to use.  This can be a great opportunity to learn something new if you are not familiar with computers.  Alternatively, staff will often be able to help you simply reap the benefits of the technology to keep in contact with friends and family. 

Routine

Imposed routine and order in the day, and the ability to come and go as one pleases are significant factors to bear in mind, when making a choice of residence. Some residences have a more formally structured environment than others. Discussion with staff and other residents enables people to determine the formality or otherwise of a particular residence.

Make your surroundings your own

Personalise your room with your own furniture, incorporating things of sentimental value and other items that you enjoy having close by. You may not feel like doing this in the first instance however it will make your room feel more like home and you'll find others respond positively to it too. A personalised room creates a more private feel which helps others respect your space. This in turn has a positive effect on you too.

Increased Quality of Life

Ideally a move into residential care should bring about an increased quality of life for the new resident.  Provision of regular well balanced meals, monitoring of health conditions and medication and medical advice when required should assist in maintaining the best health possible. 

Many facilities have programs with a rehabilitative content which aims to maintain or, if possible, restore some of your physical skills or capabilities. If this is important to you, ensure the  facility you choose, provides such a program.

Living within a facility may also provide a greater sense of security for those who were previously living alone in the community. 

Finally

Hold onto the things that are important to you; try to maintain your own style, your way of dressing, your culture and customs etc. It’s what makes you you! On the whole staff want to be helpful and make your transition and life at your new home as enjoyable as possible. Help them to help you by letting them know about these things. They are less likely to offend you that way.

Updated 2020-04-23

For most people, looking for a residential facility is a new experience and they do not always know what they should be looking for. The following guide gives ideas about how you can go about the task.

Eldernet shows you information about every residential care provider in New Zealand

While the amount of information shown can vary, most show quite comprehensive information.  In many DHB regions around the country daily bed availability reports are also available. Each facility supplies their own information on the Eldernet website in which they usually describe their home and services in their own words. By carefully reading this you can begin to see where one home might differ to another. Gaps in information can mean several things i.e. that the data has not been completely filled out or that that particular service is not provided etc. If a particular aspect of the service is important to you and you cannot see information about it, ask questions.

Many providers offer additional services, premium rooms and possibly a Care Apartment, all of which come at additional cost. You need to understand these different offerings and the implications of each. They are explained more fully HERE but briefly they are:

  • Additional charges relate to services that can easily be stopped e.g. own phone line, SKY TV, special outings etc.
  • Premium rooms are those with superior fixed elements e.g. French doors onto an outside space, bigger room, ensuite etc.
  • Care Apartments are those where you pay a capital contribution, much as you would for a retirement village unit.

Use appropriate professionals and significant others to help you

Discuss your options with those who know your needs and wishes e.g. a social worker, service co-ordinator, family, friends etc. Remember the final decision is yours.

Identify the things that are important to you

Excellent care should be a top priority. Remember, this is the reason why you require this service.

  • How close is it to your loved ones/family? If you move away from your home area to be closer to family will they be able to visit more frequently? Be realistic.
  • How close is it to your place of worship? Can you continue to practice your faith at the home?
  • How close is it to well-known friends and places?
  • How possible would it be to still do the things that are important to you, such as keeping in touch with clubs and groups?
  • Is the property and/or interior visually appealing to you? Does it matter?
  • How big is the facility? Does size matter?
  • What other on-site services are there? If you have a progressive condition are there appropriate services for you to move to e.g. hospital care?
  • What are staffing levels like? How do the various facilities you are considering compare?
  • What are dynamics like within the home? Do people seem to get on well?
  • Are resident satisfaction surveys done? If so, are they available for everyone to see?
  • How close is it to other services, shops, bank, cafe etc?
  • What sort of room choice do you have?
  • Do you know anyone who can give you a fair assessment of what a home might be like e.g. someone who lives there or a family member? Ask them about the things they like and don’t like.
  • Read the Ministry of Health’s audit report for the home. All facilities must have this done routinely. There is a link to this audit at the bottom of each facility’s page. An excellent audit report will give the facility four years before another full audit is required. During the period covered by the audit another spot audit is undertaken. This is to ensure standards have not slipped or that progress is being made towards improvement of standards etc. A provisional audit is given when a home changes ownership and a partial provisional audit when new additions and reconfiguration of services are made. (Both the provisional and partial provisional audits cover a shorter time period.)

Evaluate and prioritise these factors

It may even be helpful to number the factors according to important they are.

Use the search function on Eldernet to narrow your search for the most suitable home according to the priorities that you have identified.

Use the Eldernet CHECKLIST

Find your new home

The information from Eldernet will give you basic, standardised information on all listed facilities and more extensive information from those who have provided it. Select the facilities that best match your requirements. As with most decisions it is advisable to have at least two or more options.

  • Visit the facilities. Make an appointment to view each facility in the first instance. That way you can be assured of being given focused attention. It is advisable to set aside at least one hour for the first visit. There is only a limited amount of new information one can absorb at any one time, so a revisit often helps to answer any outstanding questions. Visit during mealtimes, at evenings or weekends too; people often visit a house more than once before purchasing! This is no different. Be observant; take notice of your intuition. Do you like the feeling of the place? Watch and listen to people interacting; would you feel at home there? Take advantage of any offers of hospitality e.g. cup of tea or meal offer. It is at times like this that people talk more freely. As you will often be seated in a semi-public area it gives you the opportunity to closely observe and to get a more accurate impression of the facility. If time permits it may be preferable to visit different facilities on different days.
  • Ask questions. You have a right to good and appropriate care, so you need to ask questions to determine the suitability of each service for you. Ask questions of the staff, residents, and some visitors. This will give you a good overall impression of how the service operates.
  • Make an unannounced visit. Are you treated differently? Do you observe anything that causes you concern?
  • Read the Admission Agreement and get all the necessary information about the cost. Take this away and read this carefully as it will set out all terms and conditions and itemise costs including any additional payments you agree to. Additional charges will vary from facility to facility, so it is important to ask questions such as: Do you have rooms that attract additional charges? What services will I have to pay for? It is recommended that you check your admission agreement carefully and seek independent advice.
  • If you feel you have made your choice you may want to have a trial period. Managers will often offer you a trial period and you are entitled to ask for this. A useful period is usually about one month and during this time you can get some idea about how well you may ‘fit in' with the place. Usual fees apply although you may be offered a trial period at a ‘special rate’. You are of course under no obligation at any time to remain in the facility. If you are clear from the beginning that this is ‘a trial’ then by being more explicit you will feel less obligated to stay.

Make yourself at home 

Once you have moved in begin to make your new place your home. Be easy on yourself: it takes time to adjust, to orientate yourself to your new surroundings, to feel comfortable and begin to make new friends.

You do not have to stay if you feel you have made the wrong choice. It may be that for a variety of reasons the residential facility is just ‘not you’, and you wish to move on. 

 

We suggest you consider the following questions when comparing residential care facilities. Make sure that the facilities you consider meet your assessed care level needs. This list is provided to give you ideas. Use it to form your own questions.

Facility Atmosphere

  • How do the residents relate one to another and to staff?
  • How does the manager relate to staff, residents and all visitors including tradespeople?
  • Do relationships seem natural and easy?
  • How do staff members speak to you? (Do they give you their full attention or do they tend to talk to those accompanying you?)
  • How engaged in the life of the place do people seem to be? (Are residents sitting around the edge of a lounge where it is difficult to connect with others or do the seating arrangements on the lounge areas encourage interaction?)
  • Do the residents appear happy and well cared for? (If a resident is calling out for attention are they assisted promptly?)
  •  How well does individual differences (e.g. appearance, need etc) seem to be catered for?

Care

  •  Are buzzers answered promptly?
  •  How well is resident privacy managed? (This may be especially important if the rooms don’t have ensuites.)
  •  Do staff members knock and wait to be invited in before entering rooms? (Staff should await permission before entering someone’s private space.)
  •  What does it smell like? (An all over pervasive 'fishy' smell may mean a high number of urinary tract infections. What is being done to treat and prevent these?)
  •  Do residents look comfortable? Can they move about in their beds and chairs easily? If not, are they regularly checked and repositioned comfortably?
  •  Are residents cleanly and tidily dressed?
  • Watch staff responses to those who need help e.g. at meal time; are they helpful? Are there enough staff members available to help all those that need it at busier times?
  • What is the carer to resident ratio?  How is this different at night and weekends?
  • When are the registered nurses on duty?
  • How stable is the staffing? (Are you able to regularly have the same caregiver assist you or is there no set assignment of caregivers to residents).
  • Who fills in for staff when they are absent? (You may like to ask how the caregivers that “fill in” are sufficiently orientated and familarised with the facility and residents and whether security checks have been done on relieving staff.)
  • What is the policy regarding the use of Bureau nurses and caregivers? (Bureau personnel may be engaged from time to time to cover staff leave/ sickness etc. Constant use may indicate difficulty obtaining/retaining staff.) 
  • Does the facility management perform police/background checks on potential new staff members?
  • What system do staff have for updating each other between shifts?
  • What does the facility do to ensure safe medicine management?
  • Do many people keep their own doctor? (Residents are entitled to retain their own General Practitioner [GP], however if the residence is a considerable distance from the medical practice it is often practical to change doctors. You will probably have to pay additional costs to be attended by your own GP as the 'house GP' is usually more 'cost effective'.)
  • Is there a GP on call at all times?
  • What qualifications do the caregivers have? (You may like to ask about ongoing staff training and what tasks various people in the facility perform e.g. caregiver, household staff, enrolled nurse, registered nurse etc. You may find this varies from facility to facility.
  • What is the policy if people do not sleep well or become a little confused and disturb others during the night etc?

Rooms/Facility Layout

  • Are the rooms spacious enough for you, sunny or well lit, with an outside window?
  • If you are considering a particular room is there space for your own furniture and other personal items?
  • Are all furnishings supplied or do you have a choice of own furnishing/furniture? (You should be encouraged to bring items that will help make your room feel like your home.)
  • Can you bring your own bed? (If you require hospital level of care then this is generally not an option. Hospitals have beds that can be adjusted and are designed to ensure your comfort.)
  • Are there pleasant areas you can go to, inside and outside? Are these easily accessible for you or would you require assistance to access them?
  • Are the bedroom sizes and facilities appropriate for you? Are these standard rooms or do they attract extra costs (premium rooms - see also further questions below))?
  • Is there easy access between areas, e.g. no tricky stairs?  Are hallways wide enough if you require assistance or for a wheelchair?
  • Can you control the heating in your own room?
  • If the rooms don’t have ensuites are the toilets close by and easily accessible? (Ensuites are not essential for those who require assistance with bathing/showering/toileting.)
  • If there are shared rooms, is there a choice of room-mate?
  • What are the lounges like? Are there areas where you could comfortably entertain guests? Do all the lounges have TVs or are there some quieter areas?
  • Are all living areas comfortably warm?
  • Can you manage to find your way around the home? (You may need to orientate yourself so give yourself time to do this.)

Safety

  • Are call bells within easy reach in bedrooms and located sufficiently throughout the rest of the facility? Take note when call bells are rung – are they are answered promptly.
  • Are accidents or spills attended to promptly?
  • Does the facility display a current license, building 'Warrant of Fitness' and evacuation procedures?
  • Are the building/s and grounds secured at night?
  • How often are emergency drills held?
  • Does the facility have an emergency plan and adequate emergency supplies for each resident?  (At least three days supply of food, water and essential medical supplies for each resident should be on hand if required). Are they prepared for power or communication outages? Are residents next of kin’s contact detail easily available in a non digital form?
  • How are accidents recorded?  What review procedures are in place to ensure similar accidents are prevented? How are these documented and are family members informed?

Meals

  • Ask about meal times (rotational meal times may apply) menu range and choice? Is the weekly menu prominently displayed?
  • Do residents who need help with their meals dine in another area? How do you feel about this?
  • How are individual preferences catered for?
  • What access do residents have to tea/coffee making facilities? Can you help yourself to snacks or fruit at any-time?
  • Can a friend/relative join you for morning/afternoon tea or main meals occasionally; if so, is there a cost?
  • What do current residents say about the meals?
  • What do the meals look like? (It's a good idea to make your visit at a time when you can see these.)
  • What does the dining room look like? Are the tables and chairs clean? Is any table linen fresh and clean?
  • What is the policy about having meals in your room? 

Routines and Activities

  • Is there an activities programme displayed? Who decides what goes into it?
  • What is offered in arranged activities? How frequently are these? Are individualised activities arranged and if so can they cater to your hobbies/interests? (A well constructed programme should not be patronising.)
  • What qualifications does the person who arranges the activities hold? Many now hold a Diversional Therapist qualification.
  • How frequent are the outings? Who chooses where to go? Can everyone be included? Are there any associated costs? Does the facility have a bus or minivan onsite?
  • What opportunities for community involvement are there? (Many facilities have regular visits from the RSA or Age Concern Accredited Visitors or arrange outings to these community groups.)
  • Does the person arranging the activities program also assist residents to keep in touch with friends and family e.g. letter writing, email, Skype, regular phone calls or visits. 

Dignity/Privacy and Independence

  • When you visit do you feel comfortable about the way in which residents are addressed and their privacy and dignity respected? Would you be happy to be treated in such a manner?
  • Is independence encouraged? How is this done?
  • How are individual preferences catered for e.g. are bed times flexible, who chooses what you wear, how often can you shower etc.?
  • Do the residents have a collective voice, i.e. is there a residents' committee? If there is, who chairs the meetings? (A staff member can inhibit discussion.)
  • Is there a policy about money management?  (People should be able to continue to manage their own financial affairs if they wish or unless it has been determined that they do not have the capacity to manage this.)  How is the security of your money and personal belongs managed? *you are responsible for the insurance of your own personal items.)
  • If you don’t have your own phone in your room can you use the facility phone?  Is this located in a private place? 
  • If there is a computer with internet access onsite can this be used privately also?
  • What other house rules are there, e.g. how long can visitors stay, how do you inform people of your intention to go out for the day etc.?
  • How are residents’ ethnic, cultural and spiritual values and beliefs respected and upheld?

General

  • How are complaints dealt with? Do residents and their visitors feel that it is easy to make a compliant? (The procedure for making a complaint should be displayed in a public place.)
  • Is there an orientation programme for new residents?
  • How are disputes/disagreements between residents dealt with?
  • What arrangement is there for washing your personal clothing? How do staff members ensure that clothes aren’t returned to the wrong resident?
  • How much does it cost per day/month? What is included or not included in that cost? What are possible additional expenses?
  • Are there any additional costs? (If so make sure these are itemised on your Agreement and included in your budget.)
  • Are any additional charges separable (able to be stopped without affecting which room you have e.g. a private phone line, SKY TV etc.) or are there wider implications (e.g. move to another room)?
  • How are any complaints dealt with? Ask residents and their relatives about their experiences. (Residents have the right to make a complaint.)
  • In what circumstances would you have to surrender your room e.g. long hospitalisation, etc.?
  • Do you have to give up your studio unit/serviced apartment if you receive a Residential Care subsidy? (See also - ' I live in a small unit in a village and I pay regular service fees. I now need rest home care. Will I have to move out of my unit?'
  • Can you go on holiday? If so, for how long?
  • Is there a contract with the Health funders? (If you require a Residential Care Subsidy you must choose a home where the facility has a contract with the District Health Board [DHB].)
  • Has the facility ever been subject to a formal complaint ie Health and Disability Commissioner? If so what was the outcome?

Specialised Dementia and Specialised Hospital Care

Mental health services for older people undertake specialised psychogeriatric assessments before determining the need to move into secure dementia or specialised hospital care and will also provide support to families. Staff in these facilities should be trained in this specialised area of care. If you are looking for a secure facility you need to consider all the previous questions and to ask what is provided for the special needs of these residents.

  • Are key relatives/former carers involved in making or revising care plans?
  • How is the resident's dignity maintained? (While a variety of behaviours can be observed at any time, staff should always be sensitive and caring to residents and their unique needs. Where possible, they should also make sure that things that have been important to the person in the past are not neglected e.g. applying make-up, shaving etc.)
  • How are behaviours that challenge managed? (Such behaviour often indicates the person is distressed about something. Skilled care and management can often determine what this is and alleviate it.)
  • Are residents engaged in meaningful activities? How do staff oversee these?
  • How is respectfulness shown to residents?
  • How is restraint monitored? (There should be a written policy on restraint.)
  • Do staff regularly interact in a warm and caring way with residents?
  • How accessible are staff? What is registered nursing staff cover like?
  • How is the resident’s dignity maintained?
  • How will the service manage the person’s changing needs over time?
  • Does the facility operate a specific type of dementia care programme? (Several international models operate in New Zealand facilities e.g. Spark of Life, Eden.

Make enquiries

How long is the facility certified for? This link to the Ministry of Health website Rest Home Certification and Audits gives you the answer. Certification may be granted for up to four years. (A shorter period usually indicates that the auditors require additional work to be done in order to meet full compliance. The issue may not be major. Do not be afraid to ask.) 

Trial period

You may try out a home before making a commitment. If you do, you will have to pay for this yourself. Most people say a month gives them enough time to assess the facility. Although it’s not long enough to really feel ‘at home’, it’s long engh to see: how the home operates, what staff are like and whether you like it sufficiently. Going to the home ‘for a trial’ may make you feel more comfortable about moving if it’s not right for you. You are purchasing a service and have the right to expect reasonable needs to be met. Once the decision has been made, inform the management so that the next step in the process can be completed.

The Ministry of Health website's Rest home certification and audits section shows which facilities are certified.  The longest period given is four years. (A shorter period usually indicates that the auditors require additional work to be done in order to meet full compliance. The issue may not be major. Do not be afraid to ask.) Certification Audit reports are available on the Ministry of Health website.  These can be viewed via this link: Certification Audit Reports.

Reviewed: 2020-05-08

 

All residential facilities should have a complaints procedure and many of them give a copy of this to prospective residents. The complaints form should also be freely available for you to pick up from a designated area in the facility e.g. by the office, front door or lounge entrance.

It is not easy to make a complaint, especially if you feel in a less powerful position than those whom you wish to complain about. Sometimes it feels easier just to ‘let things be’ and do nothing about it. Unsatisfactory situations are more likely to be addressed, however, if appropriate people know about them.

The correct process is to make a complaint through the channels shown in the complaint form:

  • In the first instance this is generally to the Manager of the service and most commonly the issue can be resolved at this level.
  • If this has not been successful, or if the concern is about management, or if you think it would be better addressed elsewhere you could ‘talk it over’ and get further advice from your service coordinator/NASC, social worker or Age Concern.
  • Support is available from the Nationwide Health & Disability Advocacy Service.  The Health and Disability Advocacy Service is a consumer advocacy service for all users of health and disability services.  Independent health and disability advocates are located all over New Zealand.  Their role is to :
        • inform consumers about their rights when using health and disability services
        • assist consumers who have concerns and want to make a complaint
        • offer education and training about consumer rights and provider duties to the providers of health and disability services.
        • The service is free, independent and confidential.  Free phone 0800 555 050 or email advocacy@hdc.org.nz.  Alternatively contact your local office.
  • If a formal complaint needs to be made it is usually channelled through to the Health and Disability Commissioner, where complaints are reviewed to determine the most appropriate course of action.  This may include a referral to another body (eg. MOH), use of advocacy, investigation or no action.  Reports of investigation findings may be published on the Health and Disability Commissioner’s website.
  • Other options are to contact the funder of the service, e.g. DHB, ACC, etc., if you know who this is, or the provider associations that the service may belong to i.e. New Zealand Aged Care Association (residential care - membership usually shown on the providers Eldernet page), Care Association New Zealand (residential care - membership usually shown on the providers Eldernet page), Home & Community Health Association (Home Support services - membership often shown on the providers Eldernet page)

 

Updated: 2020-05-08

 

Those who receive services that are related to their health or a disability (e.g. a need for residential care) have their rights protected by:

THE CODE OF HEALTH AND DISABILITY SERVICES CONSUMER’S RIGHTS

  1. Respect
  2. Fair Treatment
  3. Dignity and Independence
  4. Proper Standards
  5. Communication
  6. Information
  7. It is your decision
  8. Support
  9. Teaching and Research
  10. Complaints

 

You should always be treated with respect. This includes respect for your culture, values and beliefs, as well as your personal privacy.

No one should discriminate against you, pressure you into something you do not want or take advantage of you in any way.

Services should support you to live a dignified independent life.

You have the right to be treated with care and skill, and to receive services that reflect your needs. All those involved in your care should work together for you.

You have the right to be listened to and understood, and receive information in whatever way that you need. When it is necessary and practicable, an interpreter should be available.

You have the right to have your condition explained and be told what your choices are. This includes how long you may have to wait, an estimate of any costs, who will be involved and likely benefits and side effects. You can ask questions to help you be fully informed.

It is up to you to decide. You can say no or change your mind at any time.

You have the right to have someone with you to give you support in most circumstances.

All these rights also apply when you are taking part in teaching and research.

It is OK to complain – your complaints help improve service. It must be easy for you to make a complaint, and should not have any effect on the way you are treated.

This is an outline of the rights guaranteed by the law know as the ‘Health and Disability Services Consumers’ Code of Rights.’ They apply to all health and disability services, whether you pay for them or not.

A full copy of the Code of Rights is available from your service provider. Local independent advocacy services are available and the Health and Disability Commissioner can be reached toll free on 0800 112233.

Reviewed 2020-05-08

 

Understanding the importance for your caregiver to ‘have a break’ from the caregiving role is a big part of making care at home ‘workable’. Initially you may only need assistance with little things, however over time, your needs may increase. It’s important to recognise the changing circumstances in the household and to make time to discuss and take stock of the situation. Successfully negotiating the changing relationships and roles in the household involves managing the care well and balancing everyone’s different needs. If this can be done successfully it can be a rewarding time for all concerned and make any potentially difficult times easier for everyone.

Family/whānau 

The ability of family/whānau  members and friends to provide support will vary according to their circumstances e.g. they may live far away, have other demands, lack confidence, need to be in paid work. While it is often the fact that one family member becomes the main carer, (it initially seems easier and less complicated), it’s helpful for others to be involved too. Family dynamics (which we all have) can often ‘play out’ at this time, however, if people are aware of them, they can be managed.

Assessment

An assessment will be required if you want to access any formal or subsidised supports e.g. home help, Respite Care and Carer Support. Any such supports need to work in tandem with the support provided by your carer/s. It is important that everyone involved in your care understands the level of confidence, skills, strengths and abilities of your carer/s and for them to be recognised as an important part of your team.

Using the allocated amount of formal subsidised services such as, Day Programmes, Respite Care and Carer Support (see below for more information) is a good choice as regular and routine support is best. There may be financial implications as subsidies may not cover the full cost of everything you want and there may be additional charges for these services. Discuss any concerns about this with your service coordinator. Make sure you are also receiving any other financial support you may be eligible for (see: Ministry of Social Development ).

Education

Research shows that providing education for carers is beneficial. It reduces stress as it: improves the carer’s knowledge about relevant medical conditions; often gives practical training e.g. about safety issues, how to lift correctly, manage personal care needs etc.; explains how the system works (e.g. assessments, what financial and other assistance might be available); answers their questions and generally prepares them for future. A number of support organisations offer these services. They are usually free. If you cannot access a service near you, use the internet to find out or seek out relevant printed material (enquire at Age Concern).

Resources

Consider what practical resources you already have and what might be needed. If you have never been in this situation before, you may not know what could be useful. You can learn a lot by visiting a disability equipment shop; look at the products and ask about how they might benefit you. You don’t have to buy. Obviously if you want things like equipment now, and you can afford it, you can buy it. For those with limited financial resources however, it is important to be linked in with your GP and health services as soon as possible as it is not always easy to get subsidised services and other things, such as equipment, quickly.

‘Time out’

It is easy to get tied up in the day to day practicalities and this can become isolating. Try to make life as ‘normal’ as possible for you both; go to social events, day programmes, use the Total Mobility scheme if eligible and take people up on their offers of help. Caring relationships are usually based on love and all parties need to feel loved. At the very least, your carer needs regular ‘time out’ to ‘recharge their physical and mental batteries’. A caring role is often stressful and no matter how strong and capable you think your carer is, the relationship can become strained. ‘Time out’ for you both is important.

Day programmes or clubs

These are often held at small home like community facilities or sometimes in areas of residential care facilities set aside for this purpose. People often attend several times a week. Various activities are offered and morning and afternoon teas and a midday meal provided. Transport may also be offered, for which there is usually a cost. Group numbers are limited and kept quite small. Some programmes are DHB funded. A subsidy may be available if you have been assessed by your local older persons service as being eligible.

Carer Support Subsidy

This subsidy is designed to look after your carer*. It allows them to pay someone (other than those who live with you) to care for you while they get a break. ‘Carer Support’ days are allocated depending on the need identified in an assessment. It is reviewed each year. The rate varies slightly depending on where you live. You local older persons service can advise you of the rate for your area.(* A person may be considered to be a carer even if they don't live with you. A determining factor for some funding decisions is whether this person provides more than four hours unpaid care per day.) 

For payment your carer needs to: ensure the assessment is undertaken and allocation approved, keep track of days used, make the bookings and arrange for payment of the relief caregiver. Carer Support claims must be sent to the Payment Centre within 90 days or they may not be paid. Some relief caregivers or service providers may want an ‘upfront payment’ first. If so, a receipt needs to be obtained and reimbursement claimed from the Payments Centre. If Carer Support is taken at a care home a ‘top-up’ payment will probably be required. You or your carer should ask about additional costs when booking.

See the Ministry of Health website for more information and for reimbursement forms or contact the MOH’s Carer Support Line on 0800 855 066 (select option 2)

Respite care

This type of care is, in most instances, provided in a residential care home. It can only be accessed via an assessment approved by your older persons service. Usually, you are allocated a set number of days for a short stay, the number of which varies from situation to situation. You cannot use it for convalescent care, or when you are unwell. You may be able to arrange a booking in advance of your intended stay. Payment is arranged via your older persons service however there may be additional charges you will be asked to pay. 

For further information see Carers NZ or freephone Carers NZ on 0800 777 797 for the free booklet ‘A Guide for Carers’  

Finally, issues will arise along the way that need to be addressed. You and your carer/s need to continue having honest discussions with those involved in your care. Review your plans routinely and as circumstances change.

Updated: 2020-05-14

 

People who have been assessed as requiring dementia care* have experienced significant memory loss and personality changes that mean they require specialised nursing care, support, and supervision. In order for their needs to be met it is now advised that they are cared for in a secure facility.

(*The term dementia which although still commonly used, is being replaced by the term ‘cognitive impairment’ which has much broader definitions. In this instance however the term dementia covers a range of illnesses, including Alzheimer’s disease, which lead to a progressive and irreversible loss of the person’s ability to think, reason, and remember.)

As you are the carer it is likely you will have been aware of the changes for your relative over time. While the assessment will show that their needs are now greater than can be realistically managed at home you may be feeling a range of mixed and perhaps conflicted thoughts and emotions about this. It is very natural to feel this way. Your relative will also have emotional issues to deal with. Helpful information for you both can be found on the Dementia NZ and Alzheimers New Zealand websites. (These organisations can be found throughout New Zealand and are supportive places for the person with a dementia, their family/whanau and friends. Contacting them as early in the condition as possible maximises the benefits for you all.)

Now that the time has come for more formalised care the following is required:

  • A suitable care home needs to be found.
  • Legal and financial aspects need to be attended to.


Legal and financial aspects

It is important that the person going to a dementia care home has an Enduring Power of Attorney (EPOA) in place and that this is activated at the appropriate time. This allows the nominated persons/s to act on behalf of the person with a dementia (e.g. pay bills and help make decisions etc) and will streamline the process for all concerned. (These links give more information about EPOA and associated issues such as importance of having a current Will.)

Finding a suitable care home

There are many different philosophies about dementia care which means that how one home operates can be significantly different to the next so if you are assisting your relative to find a dementia care home look around, observe carefully and ask lots of questions such as:

  • What is your philosophy about dementia care?
  • What do you think are some of the most important things for those with dementia?

You might be surprised at the range of responses.  

Dementia can lead to the person exhibiting some behaviours that are difficult for others to cope with. Often these behaviours are due to some distress the person is experiencing.  Skilled staff will work to understand what these are and determine the best way to address them. It is important to ask about the home’s policy for managing and understanding these behaviours. Restraining residents through either physical restraint or medication is only permitted under certain conditions i.e. with doctor’s orders and for a limited period.

It is particularly important to choose a home where staff are well trained, empathetic and caring.  Ideally this would be a home where:

  • the resident’s dignity is upheld
  • the staff have a genuine concern for the residents and commitment to ongoing training for this specialised work
  • there is a high staff to patient ratio
  • there is a comprehensive programme of motivational/diversional therapy
  • you are also supported

This CHECKLIST should also help in your decision making. 

Finally try to find a care home that your relative might choose for themselves if they were fully able, rather than one that would suit you. Get their input as much as possible.

Updated 2020-05-14

 

Visiting can be a stressful time especially if you do not understand the condition so it is useful to find out more before visiting. Dementia NZ and Alzheimers New Zealand are the main support organisations in New Zealand. Useful resources can be found at both.

A supportive dementia care facility will give you some helpful ideas about how you can make visits easier for you and your loved one. For example:

  • keep the visits short
  • use photographs or other mementos to remember special times
  • play favourite music
  • choose a time of day to visit when the person is more settled (staff can often advise you)
  • avoid questions (silence is ok)

If communication is difficult remember that you can also use your body language especially facial expressions and gestures and the tone and pitch of your voice.  Use eye contact and try to keep sentences short, simple and specific.  Touch can be a powerful way to express the bond you have with your relative.  Test it out gently at first to make sure it's something your relative enjoys.

Although visiting a relative with dementia may be stressful at times, in doing so you are providing support for your relative, the extended family and carers in the facility. Don't underestimate the value of your visit. 

If taking children along you may find it useful to discuss the effects of the dementia on your relative with them before visiting.

Updated 2020-05-14

Making a decision about residential care often requires the consideration of complex and difficult issues. Should the older person stay at home or should they go into residential care? In some cases the older person makes the decision themselves but often, as in this situation, the family is involved. Each family member will have his or her own thoughts on the matter.

It is important not to lose sight of the fact that the older person is central to this decision. Their best interests and what they want to happen should be a high priority. This consideration can get ‘buried’ by other things, particularly if there are many competing concerns such as family members feeling ‘stressed’. Competing demands and stress, especially if they are not spoken about or acknowledged, are an invitation to misunderstanding and conflict. Careful and sensitive consideration of all the issues will help all concerned work their way through the situation.

The following questions are useful in helping people think through the issues:

1. How can we sensitively discuss this?

2. What are the older person’s rights?

3. What expectations does the older person have?

4. What obstacles are there to these expectations?

5. What happens if we can’t agree?

6. If the older person is going to go into residential care who decides where?

1. How can we sensitively discuss this?

These tips may be helpful:

  • Constructive discussion needs your goodwill.
  • Make plenty of time for the discussion.
  • Listen for longer than you talk.
  • Listen without judging.
  • Let everyone have his or her say.
  • Do not interrupt. Unfinished sentences can easily lead to misunderstandings.
  • Have a positive attitude.
  • Be prepared to compromise. Sometimes the best solutions are those no-one had thought of beforehand.

2. What are the older person’s rights?

This is a good question to ask because the answer is often quite enlightening for families. Knowledge of the older person’s rights creates an environment where decisions can be made with greater sensitivity and awareness.

The Health and Disabilities Commissioner (Code of Health and Disability Services Consumers’ Rights) Regulations 1996 (SR 1996/78) (as at 03 September 2007) clearly lays out these rights in Right 7. The following sub clauses state:

“1. Services may be provided to a consumer only if that consumer makes an informed choice and gives informed consent, except where any enactment, or the common law, or any other provision of this Code provides otherwise.

2. Every consumer must be presumed competent to make an informed choice and give informed consent, unless there are reasonable grounds for believing that the consumer is not competent.

7. Every consumer has the right to refuse services and to withdraw consent to services.”

(Note: The test of competency is high. “A person can be competent even if they are under the Mental Health (Compulsory Assessment and Treatment) Act 1992 (MH Act). Compulsory treatment does not make people legally incompetent." The law is very clear about the issue of competency and if there is serious reason to doubt a person’s competency this should be discussed with a doctor.)

Sub clause 1 (above) requires that the older person gives “informed consent”. Informed consent under the Health and Disability Code is a process that requires effective communication between all parties (Right 5) and the provision of all necessary information to the consumer, including information about options, risks and benefits (Right 6).

The important areas for consideration are therefore the older person’s freedom of choice and informed consent, the presumption that they are competent to make their own decisions and the weighing up of family concerns.

Families sometimes find it difficult observing their older relative living in what they believe is an unsatisfactory or unsafe situation. The choice that some older people make to remain at home despite the acknowledged risks may well put them ‘at odds’ with their family. The reality is however, the majority of older people want to preserve family harmony and they often ‘go along’ with what the family (or a family member) want and will subvert their own desires in order to achieve this. Families need to be aware of these dynamics and mindful of the ‘shift of power’ that occurs in such events. Where there are difficult issues to work through, strongly diverging opinions or concerns about safety a health professional such as a social worker should be involved.

3. What expectation does the older person have?

Expectations are as varied as the people involved or the social groups in which they live. For example, some older people have an expectation that they will be supported/cared for by family members. Harmony is maintained if this expectation is matched by a similar understanding of the family.

Then again the older person may have few expectations of their family. They may clearly see their future as being theirs alone to control. For example, recent evidence shows that older people are increasingly more likely to see their retirement savings or assets as being ‘their own’ to be used to meet their own needs and not for the ‘inheritance’ of their families. Many families are understanding and supportive of this rationale and don’t expect to receive an ‘inheritance’.

Sometimes however there is a mismatch between expectations of the older person and their family. A common mismatch is where the older person would like their family to care for them but the family is unable to do so. Sometimes the older person has asked the family to promise not to ever “send them to one of those places”. If support is not forthcoming it is sometimes seen as ‘rejection’ or a ‘lack of family commitment’. It’s easy to explain this as just a further ‘break down’ in modern society but there are a number of factors that need to be more carefully considered and understood.

4. What obstacles are there to these expectations?

Pressures on families today are quite different to those experienced by the previous generation. These significant differences often impact on families’ ability to provide care and support. They include:

  • the long distances separating many families
  • the increase in sole parenting
  • remarriage and associated reconstituted family pressures and commitments
  • casualisation of work and irregular working hours
  • the need for both partners to find paid work in order to provide an adequate income
  • the need for those in the paid work force to work towards their own retirement savings
  • an often longer working life in ‘paid employment’
  • middle aged children helping care for and support their own younger family members, eg raising grandchildren

No two circumstances are the same. There will be issues unique to your own situation. Older people and their families therefore need to be very clear about:

  • what they do and do not expect
  • what the obstacles are to having their expectations met
  • what they can and cannot realistically do to meet the expectations

Expectations that are ‘out in the open’ are much easier to deal with than those that are hidden.

5. What happens if we can’t agree?

By following the above process the family should have a better understanding of each person’s perspective and the obstacles they collectively face as a family. Compromise by family members will be necessary where agreement can’t be reached. Assuming that goodwill is present, the amount of compromise may need to be proportional to the amount of help that the individual can give i.e. if you can’t give much support should your expectations have the highest priority?

Consider the following situation: A 91 year old man who requires significant formal and family support may need to consider residential care. He would prefer to stay at home if possible. His daughter who lives nearby provides the most ‘hands on’ care but, despite having had many breaks, is exhausted. The daughter who lives in another city thinks her father should be able to stay at home. His son who is very busy with ‘on call’ work and less available to help, reluctantly thinks his father should 'go into care'. All formal support services have been utilised in the past. The solution is not easy.

  • Are any of the children willing/able to change their own situation e.g. live closer to their father, have their father come to live with them, change their job?
  • Is there a possibility of engaging further help at home e.g. private care?
  • What can each member realistically do?
  • How can family avoid pressurising individual members?
  • Can individuals agree to differ and yet support the final decision?

Hopefully a better understanding of the issues and other people's perspectives will make the acceptance of the final decision easier.

If you can’t work this issue through ask for a referral to a social worker. They are located in all areas of the country. An independent person can help you work though the issues more easily and arrive at a decision that everyone is more understanding of and satisfied with.

6. If the older person is going to go into residential care who decides where?

Ideally the older person should make the decision themselves, however if a person’s ability to make a selection of residential facility is affected in any way e.g. by poor health, they will understandably be more dependent on others to help them make a choice. This is a big responsibility for those who assist. To make things more difficult there is often only a short time in which to make a choice. How you make the decision is just as important as who makes it.

A sense of powerlessness results when people feel that they have no input into decision making. Involve the older person in the decision making process as much as possible.

When it comes to choosing a residence it is important to avoid choosing a place that the helper would like ‘for themselves’ or one that they think would be ‘good for’ the other person. The most helpful way someone can assist is to try to choose a place that the person themselves might choose. One way that this can be done is to identify the things that are important to the older person, prioritise these; then find a facility that is most suited. (The Eldernet search function may be useful for this. Similarly you could email the facilities you are considering with your prioritised list and see what response you get.) A social worker or service coordinator has skill in this area. They can help you identify the things that you need to consider and that are specific to your situation.

A good idea is for family members to check out as many facilities as is possible/necessary, narrow this down to 2-3 ‘finalists’ and if possible encourage the older person to make their choice from this list. This way the final choice is still theirs.

Remember too that if residential care is decided upon and if the first choice of facility is not what you had expected (bearing in mind that it takes a reasonable time to settle in and assess this) then a change can be made. Your service co-ordinator must be notified so that they can make the necessary procedural arrangements.

Finally, once a decision has been made keep the channels of communication open by reviewing things on a regular basis.

 

 

Moving into an aged care facility requires a lot of major lifestyle adjustments.  (See FAQ  9.) While everyone deals with change differently family members may be able to utilise the suggestions below to assist with this adjustment process.

  • Encourage your mother to take personal belongings with her that enables her to view and treat this new place as her own home. Some people like to take a large number of personal items, furniture and/or a pet with them. Talk with the facility manager about what is appropriate and manageable for the room size, the way she likes to live etc. Other people initially want to discard most of their belongings (this may be a reflection of how they are feeling about the move). If possible encourage them to allow important and/or sentimental items to be stored and review this decision in the future. Often, once the person begins settling in, items of significance can be reintroduced.
  • Be available to talk. It’s natural that when becoming a member of a residential care community that there will be a number of things your mother will want to talk about; people who do things differently to how she does, routines that on first impression may seem to be overly prescriptive etc. She may not be looking for solutions to any issues she raises but may simply feel better for having expressed her feelings knowing she has been listened to. If there are any issues that your mother wants addressed, help her to do this. Sometimes this is harder to do than trying to convince her that everything is fine. This doesn’t necessarily mean that you agree with her concerns but it does mean that she knows you are supporting her.
  • Where possible assist your mother to keep up her previous contacts in the community. This can be done via phone calls, emails or Skype.  If she was a member of a community group prior to the move encourage her to continue with this afterwards.  Ask the manager how this can most easily and best be achieved.  Mobility vouchers may be available to assist with transport.
  • Continuing with previous interests can also assist someone to settle in.  If appropriate, talk to the activities coordinator about your mother’s previous interests and activities and see if any of these can be continued in some way.
  • Encourage your mother to exercise. Physical actively has positive psychological effects too.  Perhaps family members can take her out for a walk. If the facility offers an exercise programme there may be opportunities to link into these or build on them during your times together. Ask the Occupational/Diversional therapist or Activitities Coordinator for ideas.  
  • If you mother is struggling to settle in she may find (if she is able) that writing down her concerns or feelings about the move helps her to clarify and deal with her thoughts regarding  this new life. Nobody needs to see this; just the act of writing things out can be therapeutic in itself.
  • Another option, if settling in is proving to be difficult, is to encourage your mother to talk to a social worker (e.g. from the service that was involved in the move) about specific concerns. The facility may also have a visiting pastoral worker or spiritual advisor who may be available to talk to and assist. These people are more impartial than family members and they have the skills to help people work through issues they are finding difficult.
  • A move into residential care requires many changes and adjustments.  Therefore it is understandable that this adjustment process will take a considerable period of time. Be aware of this and be patient.

If you feel that your mother is not coping well with the move after trying these suggestions let someone know e.g. the manager (if appropriate), her doctor or the service coordinator or social worker who was involved in the placement. There could be various reasons as to why she has not settled in e.g. unresolved issues with people at the facility, suffering from depression which could be relieved or managed with the right medical advice or it could be that the facility is not the most suitable for her. Keep an open mind about what the solution/s may be.

 

There are two issues here. Firstly there is the dilemma of where to live. Families often have the best of intentions in these sorts of situations but the best solution for you may not be moving to the city. Smaller communities are often very supportive of people who have been members of the district for some time. It is not uncommon for people in residential care in a small town or rural area to say, “I’ve got no family here now but I know everyone and they know me.” Conversely people often like to have family nearby especially if they get on well. The reality however can be that modern families are very busy and if you move to the city you may find that family visits are not as frequent as either you or your daughter hope. This could leave you spending most of the time with people you don’t know very well. It’s a delicate situation. Rather than doing what you think your daughter wants you to do talk the issues through with her. Being open and honest about the situation may free her of any sense of obligation she has and allow the best solution to emerge.

Secondly it is very important that any transfer between services, whether within your District Health Board (DHB) region or outside it, is done in consultation with your local service/care co-ordination service. If your needs have changed since your last assessment you will be reassessed to determine the level of care you require. If the transfer is to another DHB region your co-ordinator will contact the corresponding team in the region you intend to move to. An acceptance needs to be received before you move. This process also allows time for funding details to be sorted out.

Updated 2015-07-14

If you are privately paying your admission agreement should cover these circumstances and the costs should be identified there. It may allow for a lesser payment over this time.

If you are a subsidised resident the two circumstances are treated differently.

  • If you are in hospital you can be absent for 21 days per financial year (1 July - 30 June). During this time the subsidy will continue to be paid. This period may be extended following a recommendation by NASC.
  • If you are on holiday you can take up to two weeks at a time up to a maximum of 28 days per financial year (1 July - 30 June). During this time the subsidy will continue to be paid.

 

 

Your rest home should be constantly monitoring your needs so any changes should be picked up during that process.

If however, you feel your needs have changed and these have not been picked up on you can ask for a reassessment.  

It is important to receive the appropriate care as each level of care requires caregivers and other staff to have different types of skills and issues such as health monitoring and oversight also differ significantly e.g. more registered nursing input is required for hospital level of care as opposed to rest home.

If you are reassessed as requiring a level of care which is not offered by your current care provider you will need to move to a facility which can provide the level of care you require.

 

The quick answer is; not necessarily. The reality is; we are all sexual beings and many people wish to continue an active sex life into their older age. It may be that you currently have a partner and you are facing separation due to the need for residential care, perhaps your partner is with you in care; then again you could be contemplating a new intimate relationship with a resident; whatever your situation, enjoying an active sexual life in a residential care setting can be somewhat of a challenge.

The majority of the obstacles sadly stem from other people's misconceptions, prejudices, disapproval and lack of knowledge. This combined with the possible logistics and the fact that the home is a place shared with others makes the ability to engage in an intimate relationship even more difficult.

Other people

In the residential care setting you are obliged to live at close proximity with others. The human dynamics around you will impact on you much more than they would have in the wider community. Possible things you may have to contend with range from the lack of knowledge around this subject by staff (and others), the 'sensibilities' of your own family/families, through to the issue of dementia.

Many people find it difficult to talk about the sexuality of older people. They are often shocked at the thought of older people having a sexual relationship; others may feel awkward or express a judgmental attitude. You may even remember feeling that way yourself. It is not uncommon either for a staff member to discourage a blossoming relationship because they lack the skill to know how to handle it properly. Poor management of such situations can be demoralizing for residents. Older people like to be 'fancied' too. "When allowed to engage in relationships with others, these positive experiences enable (d) them to feel joyful, special, loved and attractive again ." (Promoting awareness of sexuality of older people in residential care. Lisa Low et al)

Managers of residential care facilities are now more aware of these issues. In fact resident's rights to intimacy are a component of staff training. While staff are trained to be mindful of their own values, culture and customs and not to impose those on residents, the reality is that some people struggle with this.

Family sensibilities can be another issue. It's one thing if mum and dad want to have sex at the rest home but it seems to be another thing if the person 'in care' forms a new relationship and wants to have sex with someone else. The reaction is not always positive. Families can feel rejected, threatened, distressed and in some instances concerned about remarriage and inheritance issues. Over time, particularly if their parent is single, most families are generally very supportive and pleased. They find it comforting that there is someone else nearby who is important in their parent's life.

Dementia brings its own set of issues when it comes to sexuality. Staff in dementia care facilities are generally used to residents forming relationships; often platonic but sometimes more intimate. Occasionally the person with dementia will form a relationship with another resident, to the initial consternation of their partner (if they have one). There are a number of reasons why this occurs but most commonly it is due to mistaken identity, seeking physical closeness or needing relief from sexual tension. Staff should be understanding about this situation and in many instances will have the skill to be able to work this through with the individuals or family concerned. If they don't we suggest you contact Alzheimers New Zealand, an excellent source for support and somewhere you can safely debrief.

It goes without saying that staff/resident relationships are not permitted. A professional distance should be maintained at all times between staff and residents.

If you want to engage the services of a sex worker you have the right to do so. If you need assistance procuring these services speak to someone who you know will treat this in a professional, confidential way.

Privacy

It is not always easy to ensure the degree of privacy that one would wish for in a residential care facility. You probably require assistance by staff for your activities of daily living and this means that, by necessity they will come and go from your room frequently. They also need to have easy access to your room in the event of an accident, emergency etc.

There are a number of things that can be done to increase the sense of privacy. Staff know that they should knock and wait to be invited into your room before entering. Ask them to do this and insist (in as nice a way as possible) that all staff adhere to this at all times. Senior staff can help by reinforcing this and talking quietly with their colleagues. A 'Please do not disturb' sign on the door is another possibility. Put this up whenever you want a quiet time. Everyone therefore gets used to the idea that you want uninterrupted time for a variety of reasons. Discuss other options with senior staff.

Occasionally other residents may inadvertently come into your room. If there are residents who bother you in this way talk quietly to management about possible solutions.

Double beds

Of course while a double bed isn't essential for the enjoyment of intimacy for some couples it is quite important. Occasionally facilities are able to accommodate the request to bring in a double bed. The room needs to be big enough to provide sufficient free space around the bed for staff to carry out their tasks in safety. It is also needs to be said that it is more difficulty for the staff to provide nursing care to someone in a double bed.

Consent

A loving relationship is enjoyable to both parties and it is usually evident to others in body language and a multitude of other ways. The distress of one party is also usually quite evident. Staff will intervene in any situation if they suspect it is not consensual or is causing distress to one of the parties.

If you as a resident are beginning a new intimate relationship it is vital to ensure that the other person involved is agreeable to this. If your partner is in a dementia care facility, recognizes you as the partner, is able to say no to you if they want to, and is enjoying physical intimacy with you then it is not likely to cause concern to health professionals or staff. Consent can be a tricky issue particularly where dementia is concerned. If you have doubts yourself check it out with your doctor.

As there are vulnerable people in residential care anyone considered to have knowingly taken advantage of another person will face the consequences of their actions just as they would in the wider community.

Sexual Health

Older people are not immune to sexually transmitted infections. Usual precautions should be taken.

Viagra has played a part by raising the profile of the sexuality of older people. If you have concerns about sexual performance or other issues pertaining to sexual health please see your doctor.

Finally

The point to remember is if you live in a residential care facility it is your home and despite the restrictions imposed by your own health and the shared living environment, you need to be able to continue your lifestyle as freely as possible (as long as it does not infringe on the rights of others). Choose a home that will respect this and help you achieve your goals.

See also:

Coming out coming in. How do dominant discourses around aged care facilities take into account the identity and needs of ageing lesbians?

A Resource Guide from the American Psychology Association  

http://www.gayline.org.nz/ This site has several very helpful videos where the learnings can be applied to any intimate relationship.

 

 

Yes; there are a minimum number of staff required for each duty and this is detailed in the Age Related Residential Care between the DHB and residential care providers.

There is a requirement for the residential care facility to provide sufficient staff to meet the health and personal care needs of all subsidised residents at all times and if the Registered Nurse or Manager at any time considers that additional staff are required these must be provided.

For example at any given time a rest home could have a number of residents who are quite mobile and require limited assistance getting about. When this changes, so too should the staffing situation. 

 

The Age Related Residential Care (ARRC) contract sets out the standard services providers must deliver to those who have been needs assessed and are eligible for care. These must meet the person’s assessed needs as detailed in their ‘Care Plan’ and include:

  • accommodation;
  • laundry;
  • nursing and care services;
  • food services;
  • continence products;
  • ‘house GP’ visits;
  • health care that is ordered by the GP;
  • prescriptions and transport for health related needs.

 

 

Briefly, this is because many facilities now offer services over and above the subsidised or standard service and they charge extra for it.

On 1st July 2014 changes to the Age Related Residential Care (ARRC) contract relating to ‘premium rooms’ and ‘extra’ charges came into force. These changes came about for a number of reasons including: funding issues, an increasing number of facilities offering a wider range of services and features including ‘premium only’ facilities, the raised expectations of residents and their families, uncertainty, lack of clarity and inconsistency. 

Residential Care facilities operate under contract to their local DHB. The ARRC contract sets out the standard services providers must deliver to all needs assessed people eligible for care. These must meet the person’s assessed needs as detailed in their Care Plan and include: accommodation, laundry, nursing and care services, food services, continence products, ‘house GP’ visits, health care that is ordered by the GP, prescriptions and transport for health related needs. All residents are means tested to see how much they can afford to pay toward the cost of their care. The Maximum Contribution defines the maximum payment for ARRC contracted services. The Residential Care Subsidy (RCS) covers these costs.

Residents may also purchase additional/‘extra’ services. These fall into two categories:

    • those that are able to be stopped quickly e.g. own phone  line, SKY TV etc.;
    • those that relate to superior fixed elements in the room (often known as ‘premium rooms’) e.g. ensuite, additional space, tea/coffee making area etc..

In many situations residents are prepared to pay an extra charge for additional services and features. Sometimes however, the resident does not want to, or cannot pay an extra fee. 

If you agree to pay extra fees make sure you have these noted in your agreement.

For further information about this subject contact Seniorline 0800 725 463

 

Eldernet does not accept any responsibility for people taking action based on this information alone. Please therefore ensure that you seek the appropriate advice from Work and Income or your solicitor.

There are a number of aspects to this question:

  • The Maximum Contribution
  • Additional services
  • Those receiving a subsidy
  • ‘Top up’

The ‘Maximum Contribution’

Those who have had their needs assessed and been found to be eligible for residential care and who reside or will reside in a DHB contracted facility need pay no more than the ‘Maximum Contribution’. The ‘Maximum Contribution’ is the maximum amount that any resident should have to pay for their ‘basic’ care.

The amount varies between ‘local body’ regions and is adjusted annually. Further information and the weekly rate per region can be found via the Ministry of Health website section ‘Maximum Contribution’.

Fully subsidised residents costs are covered by the residential care subsidy.

Where confusion seems to creep in is around ‘Additional services’.

Additional Services

Additional Services are those services over and above the ‘basic’ District Health Board contracted services. You will have to pay for any additional services yourself. Additional services may be purchased by any resident whether privately paying or subsidised and can range from a personal copy of the daily newspaper through to items such as a personal phone line, Sky TV or luxury, premium accommodation.

Additional services and associated charges fall into two categories:

  • those that are able to be stopped quickly e.g. own phone  line, SKY TV etc.;
  • those that relate to superior fixed elements in the room (often known as ‘premium rooms’) e.g. ensuite, additional space, tea/coffee making area etc..

All residents should be given an admission agreement to consider and sign before taking up residency. Amongst other things the admission agreement should tell you what you will and will not have to pay for. It is wise to take it away before signing so that you can look at it more carefully at your own pace and in your own time. You may also like to get a legal opinion. Always ensure that any additional services you agree to are itemised on this agreement.

Note: If you are at the stage of deciding on your choice of facility and you are facing costs over and above the ‘basic’ service that you are not willing or able to pay for then you need to be aware that if the service does not have another option for you, you will probably have to go elsewhere.

Those receiving a subsidy

If you receive a Residential Care Subsidy and are residing in a District Health Board contracted facility all your essential ‘basic’ costs must be provided for.

In general the subsidy covers: food services, laundry, nursing and care services, continence products, GP visits, health care that is ordered by the GP, prescriptions and transport to health services.

Examples of what the subsidy does not cover include: specialist visits, hairdresser and personal toiletries, transport and recreational activities beyond the usual day to day activities incorporated into the programme, private phone, satellite TV, personal reading material, spectacles, hearing aids and dental care. Further information and examples can be seen on the Ministry of Health website in the section ‘Questions and Answers on Residential Care’

As a subsidised resident you may also be offered additional services which you can either agree to or decline. If you do agree to additional services make sure these are itemised on your agreement and that you include these in your budget.

‘Top up’

If you do not meet the asset threshold (i.e. privately paying) and you require care that in reality costs more than the Maximum Contribution e.g. dementia or hospital care, then the DHB pay a ‘top up’ price (up to the DHB contract price). You will not be asked to pay this amount.

For other information relevant to this subject see the Seniorline website section 'Moving into Care'.

 

If you are in the situation where the only vacancies that are available are in rooms that attract extra charges, and you do not want to pay these, then the following new guidelines apply:

  • If there is a vacancy for a standard room at another facility within a 10km radius of the home of choice then you may have to go there.
  • If the home of choice has occupancy over 90% and there is a vacancy for a standard room at another facility within 10km and you do not want to take it, then extra fees may be charged. When a standard room becomes available you may have to move into that (having been given 3 days’ notice).
  • If the home of your choice has occupancy over 90% and there is no other vacancy within 10km then the provider must accept you and not charge extra fees. When a standard room becomes available the provider may ask you to move into that room (giving you 3 days’ notice).
  • If the home of your choice has occupancy of less than 90% then the provider should accept you and not charge extra fees. When a standard room becomes available you may have to move into it (giving you 3 days’ notice).

Check the Eldernet website Residential Care Vacancies section. You will see a column that shows those whether facilities have additional room costs. 

 

A care apartment offers the same type of care as a care home and, like a care home, can only provide the levels of care it’s certified for. The providers must have an ARRC agreement with the DHB. Also, the type and standard of care must meet the criteria defined in this agreement.

  • ‘certified’ serviced apartment/unit in a retirement village AND
  • this village has a DHB contract to deliver the level of residential care you require AND
  • you have been assessed as requiring long-term residential care

Importantly, a care apartment also operates under retirement village legislation and is ‘purchased’ by the occupier. One advantage of this is the capital you retain. Your apartment is an asset that will be onsold when you no longer need it.

If you choose a care apartment you will usually have to pay an upfront capital amount as these are a type of retirement village offering. You also need to inquire about the levels of care that may be provided.

Specific rules apply to this arrangement. This is to ensure the resident and the DHB don’t end up paying for the same thing.   If you are privately paying for your care and receiving DHB contracted care you will only pay for the personal care and associated services, such as meals, linen and laundry.

Accommodation should not be charged for or should be reimbursed to you – a formula of 18 percent of the maximum rest home price applies. You will still pay maintenance and property type fees.

Additional or ‘premium’ fees related to fixed elements in your care apartment cannot be charged as you already ‘own’ these.

If you get an RCS and are receiving DHB care under an ARRC agreement, any fees you pay cannot include charges such as meals, cleaning, laundry and room service that are cov­ered in the ARRC agreement and payment arrangements.

Your eligibility is established firstly by your needs assessment and secondly via a financial means assessment. (See also the residential care Frequent Question ‘Will I have to pay for my care’.)

One of the difficulties with understanding this service is working out who pays for what when a subsidy is involved. Specific rules apply in such situations.

Whether you are privately paying or receiving a RCS it is likely that the Retirement Village will also assess the situation to decide whether they can in fact safely deliver the level of care to you in your apartment that you require.

You will need to pay property-related charges such as rates, insurance and maintenance fees as detailed in your ORA.

As with all village contracts you must get specialised legal advice before committing yourself to these agreements as they can be complex. It is also wise to talk this over with those closest to you.

Residents can choose to leave their unit/apartment as per their Occupation Right Agreement (ORA) when moving into a residential care home becomes an option.  It is very important to seek specialised legal advice.

 

Generally, Retirement Village operators have designed serviced apartments (and other similar services) so that increasing (or decreasing) ‘packages’ of support can be offered as residents’ needs change. However, rather than making assumptions about your increasing need for support (and running the risk that you over look something that might be able to be addressed/treated) it is recommended that a ‘needs assessment’ is obtained from the experts at the older persons service in your area. (See also question ‘What is Needs Assessment)

An assessment will establish what your real needs are and whether these are able to be addressed (e.g. rehabilitation may be offered, or medical conditions treated etc.). You will then be in a better position to know exactly what is required. If it is clear that you need more support a recommendation will be made outlining the nature of this support.

You may be able to purchase the necessary support from the Retirement Village. Your contract with the Retirement Village should state just what services are available for purchase and the extent of these (e.g. rest home level of care, hospital level of care etc.). It should also indicate what will happen if you run out of your own funds.

In some situations and in some villages parts of the Retirement Village (e.g. care apartments, serviced apartments, studio units, etc.) may also be ‘certified’ by the government certifying agency and ‘contracted’ to your local District Health Board (DHB) to:

  • enable residents in these rooms to receive the same types of services that residents in the care facility receive and
  • to access a Residential Care Subsidy (RCS) should they run out of their own funds.

Your eligibility is established firstly by your needs assessment and secondly via a financial means assessment. (See also the residential care Frequent Question ‘Will I have to pay for my care’.)

One of the difficulties with understanding this new service is working out who pays for what when a subsidy is involved. Specific rules apply in such situations.

Whether you are privately paying or receiving a RCS it is likely that the Retirement Village will also assess the situation to decide whether they can in fact safely deliver the level of care to you in your apartment that you require.

 

Care Apartments are a new type of service that have arisen over recent years. What you are being offered is this new service.

They effectively combine elements of residential care with a retirement village option. From a ‘technical’ perspective these suites/units are more like living in your own home than in a residential care facility. Although they are certified for residential care, the prospective resident usually ‘buys/purchases’ the Care Apartment before taking up residency. ‘Purchase’ costs vary widely.

This type of ‘purchase is usually a capital contribution and you do not generally ‘own’ the suite/unit The operation of these suites/units is generally governed by the Retirement Villages Act 2003 and, in some instances (e.g. where a subsidy is involved), the Age Related  Residential Care contract (ARRC) between the operators and the DHB.

Before you sign a contract it is very important that you get independent legal advice and that you understand what the future will be like for you and your money. If you are going to be paying privately for your care do you know what happens if you run out of money? Does the facility contract allow you to stay in your suite/unit if you require a subsidy? The contract should be comprehensive and cover scenarios like this.

Note: Usual needs assessment criteria apply for anyone applying for a subsidy.

 

Yes – the Residential Care Subsidy payment covers both care and accommodation.  As you are already paying for some accommodation costs some compensation should be paid (so the provider is not being paid twice for the same thing; once by you under the Occupational Right Agreement and again through the payment of the residential care subsidy by the DHB). A new formula has been applied as of 1 July 2013:

For residents in this situation and who are assessed as requiring long-term residential care, the following regime applies (as of 1 July 2013):

  • Rebate/refund arrangements in place prior to 1 July 2013 can be grand-parented, provided they are fair to the resident;
  • The basis for the calculation to determine the accommodation refund/rebate is 18% of the maximum price for rest home services (ask for the current amount);
  • Retirement village compliance costs not included in the ARRC payment can be recovered from the resident, but the maximum amount is the weekly fee charged to independent residents in the village. Examples of such charges are: rates, insurance, exterior maintenance etc. These fees can be significant.

Residents can choose to leave their unit/apartment as per their ORA (when moving into a residential care home becomes an option).

 

Any transfer between services, whether within your District Health Board (DHB) region or outside it, is done in consultation with your local service/care co-ordination service. If your needs have changed since your last assessment you will be reassessed to determine the level of care you require.  An acceptance needs to be received before you move. This process also allows time for funding details to be sorted out.

If the transfer is to another DHB region your co-ordinator will contact the corresponding team in the region you intend to move to. 

Updated: 2015-07-14

Essentially the asset threshold will be increased by the consumer price index each year on 1 July instead of by a flat $10,000 as previously. The Ministry of Health website gives further information about this.

 

The Ministry of Health website provides information about residential care. Select 'Publications' from the left side menu for up to date brochures.

 

Your local NASC/Care coordination services are able to give you this information.

You can also visit the Ministry of Health website and obtain links to the different DHB web sites.

Seniorline, a nationwide service, helps you navigate your way around services for older people. It operates Monday to Friday 8am to 4pm. Call free on 0800 725 463 or visit ww.adhb.govt.nz/seniorline

"Where From Here" (published by Eldernet) is a region specific book.  These contain essential information for older people that is region specific.  These are updated every year and can be ordered via the website www.carepublications.co.nz or by phoning 0800 162 706.  There may be a small cost for postage. Alternatively they are also available free from selected community agencies.

 

This agreement and its accompanying documentation define the service agreements with and expectations the DHB has of its providers. In 2002 the Ministry of Health introduced a National Contract for Aged Residential Care Services. Responsibility for it was devolved to the regional District Health Boards (DHBs) on 1 October 2003. Information about the current agreement can be seen on the TAS/DHB Shared Services website.

Updated 2020-04-08

Enduring Powers of Attorney, known as an EPA or EPOA, are legal doc­uments that allow you to appoint someone you trust to make decisions for you if you are no longer able to do so yourself. The original meaning of the word attorney is a person acting for another as an agent. You can appoint one person to do this; however, as the tasks are quite diverse, you may want to choose more than one.

Those you appoint do not need to be family members. You can set up an EPA/EPOA through a lawyer or a trustee company. Ask what the fee is likely to be. You should also appoint successor attorneys. These can step in if the original attorneys are unable or unwilling to act for you.

If you lose mental capacity and you have not appointed an EPA/EPOA, your family or others concerned with your wellbeing must make an appli­cation to the Family Court for the appointment of a person or persons to act for you. This process comes with an emotional and financial cost, is complicated, must be repeated at prescribed intervals, and there is no guarantee that the person appointed will be the one you may have preferred as your attorney.

There are two different kinds of EPA/EPOA: one for personal care and welfare matters; and one for finan­cial and property matters. They do not need to be the same person.

For your personal care and welfare, you can appoint only one person/attorney at any time. You cannot appoint an organisation to act in this role. An EPA/EPOA in relation to your personal care and welfare can be activated only if you lose the mental capacity to make your own decisions. The law says you are presumed to be competent, or mentally capable to make your own decisions, unless an assessment by your GP or another qualified health practitioner shows otherwise.

For financial and property matters, you can appoint one or more attorneys and you can specify how and when they will act. If you want someone independent, you can engage the services of a specialist such as a lawyer, accountant or trustee company. A finance and property EPA/EPOA can be set up to be used by your attorneys while you still have mental capacity or to come into effect only if you lose that.

The legislation includes many safe­guards, and the rules about how your attorneys can operate are well defined:

  • Attorneys can be restricted as to what property and personal matters they can and cannot act on.
  • Your attorneys can materially benefit from their role only if you have made provision for that.
  • Your attorney must consult with any other attorneys you have appointed. This gives more oversight and is a good reason to appoint more than one.
  • You can revoke your attorney, unless you have lost mental capacity.
  • The attorneys must provide information to others if they request it, if they have a right to see it (your accoun­tant or doctor, for example) and if you have made provision for that.

Once the EPA/EPOA is in place, give your attorneys, successor attorneys, doctor, accountant, bank and family copies of the relevant documents.

If you move into residential care or a retirement village you will be asked for these documents. The EPA/EPOA needs to be activated for those going into dementia or psychogeriatric care.

SETTING UP AN EPA/EPOA

  • This can be done only with a special EPA/EPOA form. Those who are advising you can supply the form, or it is available online from the Super Seniors’ website (www.superseniors.msd.govt.nz).
  • Reading through the form before any meetings should make you better prepared and save time and money.
  • Your signature on the form must be witnessed by an authorised witness. They need to certify that you understand what you are signing and what the risks are, and that you are not being pressured.
  • This article is an overview and is not personal advice. Discuss further with your lawyer or a trustee company.

 

The first of these is Joint Tenancy.  A majority of married people, people in a civil union or people in long term de facto relationships, own their properties as joint tenants.  The significant feature of this form of ownership is that on the death of the first partner, the property automatically passes to the survivor by way of a rule of law known as Survivorship.  It does not matter what is in the first partner’s Will or, for that matter, whether the first partner even has a Will.  The surviving partner will take the entire property in his or her own name.  The property is not administered under the Will of the partner who has died.

The second common form of legal ownership where two (or more) people own property together is Tenancy in common.  Simply, this form of ownership allows for property to be owned in distinct shares.  The most common form is tenancy in common in equal shares, but, by creating a tenancy in common, ownership can be in unequal shares.  Significantly, the rule of survivorship does not apply and, as a consequence, what happens to a person’s share of the property on his or her death depends entirely on what is stated in that person’s Will.  Under a Will, a person holding shares in property as tenant in common’ can leave their share to anyone they choose or may even divide their share between two or more others thereby creating more owners of the same property.  This is one reason why, for example, some Maori land can have a large number of owners, all of whom retain a legal interest in the property.

Rest home subsidies

Where property is owned by joint tenants the whole property passes to the survivor on the death of the other partner.  If the surviving partner then requires either long stay hospital care or rest home care, they will have to meet Work and Income New Zealand (WINZ) criteria before qualifying for any Government-subsidised care.

Any person requiring long-term care is, under present rules, means tested in relation to his or her assets and (effectively) in relation to his or her income.  Trusts are often used to remove assets from personal ownership and/or to tailor income to personal circumstances but legal advice must be sought as this is a complex area and mistakes can be costly.  Simply, if the assets of a person who has been assessed as requiring long-term care are less than a certain amount they will be entitled to receive subsidised long-term care.  Again, simply, certain income received may be repatriated by WINZ to refund the subsidy.

A person requiring long-term care who does not qualify for subsidised care, and who does not sell their home to pay for their care, may have their care paid by WINZ subject to WINZ taking a charge (similar to a mortgage) over the home.  Any funds paid for care will typically be secured against the home and will be repaid to WINZ as a priority payment when the home is sold or passed to a new owner under the terms of a Will.

The right to receive, or the possibility of being denied, subsidised long-term care is a concern to a lot of people as they age and their needs change.  Specialist advice should be sought at an early stage in order for people legally to protect their assets and income.

Some people choose tenancy in common as their preferred form of ownership in property.  See 'What is a Life Interest Will?' below for more detail on the reasons why this is so.

Updated 1 July 2015 by Peter Orpin of Lane Neave Lawyers - www.laneneave.co.nz

DISCLAIMER

The information provided in this list of Questions and Answers (Q&A) is of a general nature.  It is not intended as a substitute for specific professional advice on any matter and should not be relied upon for that purpose.  The Q&A is not an alternative to legal advice and does not replace any requirements under any relevant Act, Regulations, Code of Practice, Rule, Standards or Orders.  While Eldernet and Lane Neave Lawyers have endeavoured to ensure this information is accurate and as useful as possible, to the fullest extent permitted by law neither organisation accepts any loss, liability or responsibility (whether in contract, tort (including negligence) or otherwise) resulting directly or indirectly from any action taken or reliance made by any person on the information or advice (or the use of such information or advice) which is provided in this Q&A or incorporated into it by reference.

The Property (Relationships) Act 1976 outlines the law in relation to the division of relationship property, whether on separation and/or on the death of one of a couple.

The Act applies to anyone who is married, in a civil union, or who lives in a de facto relationship (which may include a same sex couple).  The law came into effect on the 1st of February 2002 with the passing of the re named Property (Relationships) Act 1976, formerly known as the Matrimonial Property Act 1976.  Since the 1st of August 2001 married couples, civil union partners and de facto couples have been able to enter into an agreement to contract out of the provisions of the Act.

Prior to the passing of the amendment legislation in 2001 there was no clearly defined legal definition of what constituted a civil union partnership or a de facto relationship, and no statutory basis existed for the division of relationship property on the breakdown of a civil union partnership or a de facto relationship.  The Act now defines a marriage, a civil union, and a de facto relationship.  To assist in determining whether a couple is deemed to be living together, the Act provides a check list of factors to be taken into consideration, including:-

  • the duration of the relationship;
  • whether the couple live together in one house;
  • whether a sexual relationship exists;
  • the degree of financial dependence or interdependence;
  • the ownership, use and acquisition of property;
  • the degree of mutual commitment to a shared life;
  • the care and support of children;
  • the performance of household duties; and
  • the reputation and public aspects of the relationship.

The Court may be called on to decide, as a question of fact, whether a relationship is a de facto relationship in terms of the Act and, if so, the date on which the relationship began.  The start date can be difficult to ascertain and although a couple might maintain separate residences, the Court may still find the existence of a de facto relationship for other reasons, such as the way they hold themselves out to the public as a couple, the degree of financial interdependence which exists between them or the presence of children.

A marriage, civil union or de facto relationship of short duration is deemed by the Act to be one in which the partners have lived together as husband and wife, civil union partners or de facto partners for less than three years.  Establishing the date that a de facto relationship began could therefore have significant financial implications.  It should also be noted that under the Act, where a couple live together as de facto partners and then marry or enter into a civil union, the Court will typically include the time prior to the marriage or civil union in calculating the total duration of the marriage or civil union.

Where division of relationship property is required, the Act makes a presumption of equal sharing unless the marriage, civil union or de facto relationship is one of short duration, if there are extraordinary circumstances which make equal sharing repugnant to justice, or where there is economic disparity.  Relationship property will include the family home and chattels, all property acquired after the relationship began, property acquired in contemplation of the relationship or intended for the common use or benefit of the parties.

In cases where there is significant economic disparity between the parties following separation, there is provision either for a departure from the equal sharing presumption or for the postponing of property sharing in order to prevent undue hardship on either spouse or partner.

It is still possible for one spouse or partner to retain separate property under the Act, common examples of which might include inheritances or gifts.  It is important to maintain such property as being clearly separate because any degree of intermingling with other relationship property could lead to the separate property becoming relationship property.  The special nature of separate property can be lost where, for example, an inheritance is used to pay off or reduce a joint mortgage on the family home, or where an inherited house is lived in by the couple.  In either of these circumstances, what was separate property will almost certainly become relationship property.

Significantly, the Act also affects the division of property on the death of a spouse, civil union partner or de facto partner.  A surviving partner now has an option of whether to:

A)     accept an inheritance under the Will of the deceased partner; or

B)      make a claim under the Act for their share of the relationship property.

Any such claim must be lodged within six months of death or the date of grant of administration of the estate, whichever is the later.

On its face, the Act favours the surviving partner as it is presumed that all property of the deceased partner at the time of death is relationship property and, furthermore, that all property acquired by the estate of the deceased partner is also relationship property.  Once a surviving partner elects to exercise option B and lodge a claim against the estate, every gift to that person under the Will of the deceased is revoked unless it is clearly intended from the Will that the survivor receive those gifts regardless of the outcome of any claim.

Where property is transferred to a trust during the course of a marriage, civil union or de facto relationship, and this has the effect of defeating the sharing of relationship property, the Court can order compensation to be paid either in the form of money, by property being transferred to the partner or spouse, or by an order that trust income be paid to a partner or spouse for a specified period.

The legislation has potentially far reaching consequences for all couples (married, civil union or de facto) on the separation or death of a spouse or partner.

Updated 1 July 2015 by Peter Orpin of Lane Neave Lawyers - www.laneneave.co.nz

DISCLAIMER

The information provided in this list of Questions and Answers (Q&A) is of a general nature.  It is not intended as a substitute for specific professional advice on any matter and should not be relied upon for that purpose.  The Q&A is not an alternative to legal advice and does not replace any requirements under any relevant Act, Regulations, Code of Practice, Rule, Standards or Orders.  While Eldernet and Lane Neave Lawyers have endeavoured to ensure this information is accurate and as useful as possible, to the fullest extent permitted by law neither organisation accepts any loss, liability or responsibility (whether in contract, tort (including negligence) or otherwise) resulting directly or indirectly from any action taken or reliance made by any person on the information or advice (or the use of such information or advice) which is provided in this Q&A or incorporated into it by reference.

If property is owned by two or more persons as tenants in common, they are free to leave their share of the property in such manner as they choose in their Will.

Where, say as a husband and wife, a family home is owned as tenants in common in equal shares, either spouse may leave a life interest in their Will to the surviving spouse.  On the death of the first spouse, his or her estate will be administered by the executor(s) appointed in the Will who will then typically take on the role of trustee(s) to administer the right of the surviving spouse to live in the property for the remainder of his or her lifetime.  Upon the ultimate death of the surviving spouse, the share of the property that is still owned by the first spouse will be passed to the final or residuary beneficiaries named in the first spouse’s Will.

Under this scenario the surviving spouse, as a tenant in common, only owns their share of the property in his or her own name.  The other share is recorded on the Certificate of Title as being in the name of the trustee(s) and to be dealt with as specified in the first spouse’s Will.  Should the surviving spouse at any time require long-term care, they may be more likely to qualify for subsidised care as, in making any declaration to WINZ about the extent of their assets, they need only declare ownership of the other part of the property that they own as he or she enjoy only a life interest in the other part of the property.

Even if the family home is sold (or at least charged by WINZ) to pay for long-term care, only the sale proceeds from the part of the property owned by the surviving spouse/partner (subject to the allowable asset limits) need be used to pay for long-term care.  As subsidised long-term care is (effectively) income tested, if the house were sold and the proceeds from the sale of the late spouse’s/partner’s share invested, the income from that would typically also need to be used to pay toward the cost of long-term care.  Significantly though, the capital is preserved and upon the death of the surviving spouse/partner, the capital would go to the final or residuary beneficiaries named in the Will.  If no-one is named as such in the Will, the property may need to be distributed under the terms of the Administration Act 1969.

There are anti-avoidance provisions in the Social Security Act 1964 and it is important to seek professional advice before taking any action.  The Chief Executive of the Ministry of Social Development has wide powers to set aside any disposition of property which is considered to have been entered into to ensure that a person qualifies for a benefit or subsidy to which they might not otherwise be entitled.  Timing is important, as is good legal advice.  Generally, gifts made within a five year period of application for subsidised long-term care are clawed back and there is discretion for the Chief Executive to look back further, as they see fit.

A lawyer’s cost to transfer ownership of a home from joint tenancy to a tenancy in common, including completion of Wills with appropriate life interests, may be in the order of $1,500 provided there is no mortgage involved although this is cheaper than the more complicated and expensive option of transferring a home into a discretionary trust.  Although a trust can protect the whole property, along with any other assets transferred into the trust, a life interest situation will usually ensure that at least one half of the property is protected and preserved for children or other beneficiaries.  Legal advice should always be sought before any of these types of decision are made.

Updated 1 July 2015 by Peter Orpin of Lane Neave Lawyers  - www.laneneave.co.nz

DISCLAIMER

The information provided in this list of Questions and Answers (Q&A) is of a general nature.  It is not intended as a substitute for specific professional advice on any matter and should not be relied upon for that purpose.  The Q&A is not an alternative to legal advice and does not replace any requirements under any relevant Act, Regulations, Code of Practice, Rule, Standards or Orders.  While Eldernet and Lane Neave Lawyers have endeavoured to ensure this information is accurate and as useful as possible, to the fullest extent permitted by law neither organisation accepts any loss, liability or responsibility (whether in contract, tort (including negligence) or otherwise) resulting directly or indirectly from any action taken or reliance made by any person on the information or advice (or the use of such information or advice) which is provided in this Q&A or incorporated into it by reference.

Many people put off making a Will, almost as if to do so is acknowledgement of one’s own mortality.  Consider, though, what might happen if a person dies without a current or valid Will.

If a person dies without a current or valid Will he or she is said to have died ‘intestate’ and their estate will be settled according to the provisions of the Administration Act 1969. There are consequences to having property dealt with under that Act.

If a person dies intestate their estate is divided in strict accordance with the Act, initially amongst a surviving spouse, civil union or de facto partner, children and/or immediate family.  If there are young children, any part of an intestate estate to which they might be entitled must be held in trust for them until they are 18 years old.  If a person dies without a spouse or children, his or her property is distributed between their parents, brothers and sisters and perhaps even nieces and nephews.  If the Administrator finds that there are no entitled beneficiaries (as that term is defined in the Act), the Crown takes the entire estate.

Almost inevitably the result is that a deceased’s estate is divided in a manner other than what he or she might have otherwise wished.  In addition, dying intestate will invariably mean that the process of administering an estate will be more drawn out and almost inevitably more expensive.  The Court will appoint an Administrator who is entitled to cover their costs from the estate.

If a person dies with a valid Will, he or she will have the comfort of knowing that their affairs will be administered in the manner they wished.  Once a person has a valid Will it is important that it is reviewed regularly (to make sure it is up to date) and that someone close to you knows where the original signed copy of the Will is kept.

Updated 1 July 2015 by Peter Orpin of Lane Neave Lawyers – www.laneneave.co.nz

DISCLAIMER

The information provided in this list of Questions and Answers (Q&A) is of a general nature.  It is not intended as a substitute for specific professional advice on any matter and should not be relied upon for that purpose.  The Q&A is not an alternative to legal advice and does not replace any requirements under any relevant Act, Regulations, Code of Practice, Rule, Standards or Orders.  While Eldernet and Lane Neave Lawyers have endeavoured to ensure this information is accurate and as useful as possible, to the fullest extent permitted by law neither organisation accepts any loss, liability or responsibility (whether in contract, tort (including negligence) or otherwise) resulting directly or indirectly from any action taken or reliance made by any person on the information or advice (or the use of such information or advice) which is provided in this Q&A or incorporated into it by reference.

Basically, anything provided it is legal.

As well as dealing with a person’s property, a Will can also be used to give directions about burial or cremation and the type of funeral service.  If there are young children, a guardian should be appointed in a Will to represent and protect the children’s interests, at least until they are 18 years of age.

Family arguments can be minimised by stating clearly which possessions are to go to which person.  As well as leaving specific bequests of personal belongings, many people will choose to leave monetary amounts to family or friends and, in some circumstances, to a specified organisation or charity.

If there is a child with special needs, and it would be inappropriate for him or her to receive a cash gift from an estate, it is possible to set up a testamentary trust in a Will to ensure that the child’s needs are met during their lifetime and then upon their death, the remainder of the capital and interest of the trust can be divided in accordance with the wishes stated in the Will.

People may choose to leave their surviving spouse/partner a life interest only in their share of a house property or other investments, so that they enjoy the use of the asset (or the income from it) during the remainder of their lifetime, but on the death of the surviving spouse/partner, the capital is passed in accordance with the wishes stated in the Will.

If at the time of death a person is owed money by family members or by the trustees of a trust formed by the deceased person during their lifetime, it is possible for the deceased person to forgive that debt in their Will.  Similarly, a Will can appoint new trustees of a trust that had been set up by the deceased person during their lifetime and can nominate someone to have the power of appointment of future trustees or beneficiaries of the trust.  A Will is a flexible document which, if properly structured, can relieve financial strain on a family and limit arguments between those close to the deceased person.  But, to be really useful, a Will must be reviewed regularly and, if necessary, either updated or replaced with a new Will.

Updated 1 July 2015 by Peter Orpin of Lane Neave Lawyers - www.laneneave.co.nz

DISCLAIMER

The information provided in this list of Questions and Answers (Q&A) is of a general nature.  It is not intended as a substitute for specific professional advice on any matter and should not be relied upon for that purpose.  The Q&A is not an alternative to legal advice and does not replace any requirements under any relevant Act, Regulations, Code of Practice, Rule, Standards or Orders.  While Eldernet and Lane Neave Lawyers have endeavoured to ensure this information is accurate and as useful as possible, to the fullest extent permitted by law neither organisation accepts any loss, liability or responsibility (whether in contract, tort (including negligence) or otherwise) resulting directly or indirectly from any action taken or reliance made by any person on the information or advice (or the use of such information or advice) which is provided in this Q&A or incorporated into it by reference.

A Will is a document that needs to be reviewed regularly as personal circumstances change. 

There are, however, certain events which make it absolutely essential to update a Will.  For example, a Will is automatically revoked if a person marries or enters into a civil union unless the Will was made in contemplation of that marriage or civil union.  Likewise, if a marriage or civil union is dissolved, if there are dependent children, or if property interests increase significantly (by way of an inheritance, for example), a Will should be reviewed.

Updated 1 July 2015 by Peter Orpin of Lane Neave Lawyers - www.laneneave.co.nz

DISCLAIMER

The information provided in this list of Questions and Answers (Q&A) is of a general nature.  It is not intended as a substitute for specific professional advice on any matter and should not be relied upon for that purpose.  The Q&A is not an alternative to legal advice and does not replace any requirements under any relevant Act, Regulations, Code of Practice, Rule, Standards or Orders.  While Eldernet and Lane Neave Lawyers have endeavoured to ensure this information is accurate and as useful as possible, to the fullest extent permitted by law neither organisation accepts any loss, liability or responsibility (whether in contract, tort (including negligence) or otherwise) resulting directly or indirectly from any action taken or reliance made by any person on the information or advice (or the use of such information or advice) which is provided in this Q&A or incorporated into it by reference.

Different options exist for a person to set aside funds for their funeral that will not be considered as an asset for such things as asset testing by WINZ for a benefit or eligibility for subsidised long-term care.

Many people choose to enter into a prepaid funeral arrangement with a funeral director of their choice.  Generally speaking, this will be for a set amount sufficient to cover the costs of a funeral at an agreed rate.  Those funds are then invested in a funeral trust by the funeral director and if, after the funeral has been paid for, there are funds left over, those funds could remain the property of the funeral director.  Advice should be sought before signing any such contract.

At the present time WINZ permits an amount of up to $10,000 to be set aside in a prepaid funeral trust, and for that sum not to be included as an asset of the person to whose credit the money is held.  This is a declaration of trust where an amount of up to $10,000 is placed in the name of the trustee(s), to hold the same for the express purpose of paying for a named person’s funeral.  These funds may be invested in an investment chosen by the trustee(s).  Under new income testing rules for residential care subsidies the income from the funeral trust is counted as income available to pay for long-term care.  Following death and a funeral, the funds are used to pay the funeral account.  Any balance will form part of the deceased person’s estate and will be distributed according to the terms of the person’s Will.

In determining eligibility for subsidised long-term care the amount set aside in a Funeral Trust will not be included in a person’s assets provided the amount does not exceed $10,000.

Updated 1 July 2015 by Peter Orpin of Lane Neave Lawyers - www.laneneave.co.nz

DISCLAIMER

The information provided in this list of Questions and Answers (Q&A) is of a general nature.  It is not intended as a substitute for specific professional advice on any matter and should not be relied upon for that purpose.  The Q&A is not an alternative to legal advice and does not replace any requirements under any relevant Act, Regulations, Code of Practice, Rule, Standards or Orders.  While Eldernet and Lane Neave Lawyers have endeavoured to ensure this information is accurate and as useful as possible, to the fullest extent permitted by law neither organisation accepts any loss, liability or responsibility (whether in contract, tort (including negligence) or otherwise) resulting directly or indirectly from any action taken or reliance made by any person on the information or advice (or the use of such information or advice) which is provided in this Q&A or incorporated into it by reference.

The Trusts Act 2019 makes significant changes to previous trust law. See Ministry of Justice information

The Trusts Act 2019 makes significant changes to previous trust law. See Ministry of Justice information

Any assets, which are transferred to a Trust, must be sold at market value, otherwise the Inland Revenue Department can assess you for gift duty on the difference between the value you allocated at the time of sale and the actual market value at that time.

Gift duty is no longer payable in New Zealand, and the need to progressively gift the value of assets to a Trust over a number of years has gone.  However, a notional timetable for the progressive passing of the value of property to a Trust is in place with WINZ and may have a significant impact on a person’s eligibility for subsidised residential care. Professional advice should always be sought on this matter.

Updated 29 July 2014 by Peter Orpin of Lane Neave Lawyers - www.laneneave.co.nz

The Sorted web site HERE has information about Equity Release.  They also provide booklets HERE.

Updated 29 July 2014