During the mid-1800s, New Zealand attracted many single male immigrants wanting to make their fortunes on the goldfields and other like ventures. By 1900 there were numerous elderly men who had not married and were without families. This posed a problem as during this time as traditionally, elderly people who became ill or were unable to work relied on family for support. Where could elderly people go to get the care they needed?
Hospitals and Lunatic Asylums.
The Inspector-General of Hospitals and Lunatic Asylums, Dr G. W. Grabham wrote in his first report that the greatest obstacle to the hospitals’ usefulness was that they were made the homes of aged, infirm and chronic cases ‘corresponding very closely to the permanent pauper inhabitants of an English union workhouse’. Dr Duncan MacGregor, Grabham’s successor as Inspector-General, attributed overcrowding in the lunatic asylums to the accumulation of old people within. Old people who were ‘merely friendless’, but who soon became a permanent and expensive charge on central government. MacGregor pointed to the ‘disproportionate numbers of our population who at this stage of our history have grown old without contracting family ties’, and urged that the newly constituted hospital and charitable aid boards build local refuges to cater for this class. These refuges would be the beginning of aged care facilities in New Zealand.
The residential care of the aged in the period 1880—1920 was overwhelmingly the concern of public charity, as represented by the hospital and charitable aid boards. Those who could no longer work or live independently often became residents of benevolent institutions, set up by provincial charitable aid boards from the 1860s. Benevolent institutions were grim, uncomfortable places. They had infirmaries and cancer wards, but inmates suffering from dementia were sent to mental institutions.
After the First World War, life for elderly people in benevolent institutions became more strictly regulated. Inmates were required to surrender all belongings, abstain from alcohol, refrain from using obscene language and spitting on the floor, and bathe at least once a week. Despite all these rules, elderly men in particular often found ways of obtaining liquor – one of the few comforts left to them.
Physical conditions in the homes had improved by 1920, reports of scandal and disorder were less frequent, the gap between staff and inmates had widened, and discipline was exercised more subtly than in the past. But there was still a feeling that the inmates’ condition would be far worse outside the institutions and that they should be grateful for any assistance beyond total neglect.
Changes in the sector.
More church-run and private homes emerged after the Second World War, when women began to outnumber men in older age groups. Soon many elderly people lived out the remainder of their lives in rest homes. Also, after the Second World War, consumer organisations of disabled and elderly people and their families emerged. Their lobbying brought about significant changes, including the introduction of ‘community care’ – integrating previously institutionalised people into their local communities. There was also increased support for elderly people to stay in their own homes as long as possible, rather than entering a rest home – a policy called ‘ageing in place’. Although a range of support services were provided, much of the responsibility for this care fell on family members.
By the mid-1970s New Zealand had one of the highest rates of rest-home residency in the Western world.
Community groups and private providers.
Gradually ideas about older people remaining connected with family and community gained wider acceptance. From the 1980s older people were encouraged to continue living in their own homes, with support services such as Meals on Wheels, mobility aids and household help provided by district health boards. Private providers of home-care services also emerged.
Some who could afford it chose to live in retirement villages in small units or flats, with a range of optional support services. This allowed many older people to be independent for longer. Despite the policy of ‘ageing in place’, those who became unable to care for themselves often needed to move to a rest home eventually.
In 2010 the provision of rest homes was a deregulated and growing industry. While some rest homes were run by churches and charitable trusts, around 75% of the country’s 870 rest homes were owned by overseas companies, which worked to make profits for their shareholders.
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