Extended home help a long-term gain

Press, 8 May 1978, Page 17

Extended home help a long-term gain

The present free homehelp service provided for aged and disabled people

living in the community should be extended, according to a report published this week by the Management Services and Research Unit of the Department of Health. The report, prepared by Mr J. R. Hyslop and Mrs Slew Suan Dourado says home help should be provided to all people who are unable to maintain themselves in their own homes and for whom the only reasonable alternative would be imminent or accelerated admission to hospital or residential home.

It should also be provid* ed for people who by reason of short-term ill health or disability would otherwise have to enter hospital, stay in hospital

From the Department of Health

longer, or have a longer and less satisfactory convalescence.

Home-help services in New Zealand are provided by hospital boards, the Department of Social Welfare and voluntary organisations. The report recommends that hospital boards should take over those cases handled by the department; and says the requirement that boards should provide home help only where district nurses are also required to attend should be lifted. New Zealand has more

than 2000 home helps, usually mature women with homes of their own and a concern for the sick anB elderly. They do normal housework,’ preparation of meals and some shopping. However, an

equally important part of the job is on the social side.

their working hours or to ring up, just to say ‘hello’ or to make sure ‘old Mrs Smith is okay today.’ “Several home helps also mentioned taking an invalid or elderly person shopping or to the beach in their own time, as well as baking and bottling fruits.”

Most home helps are paid by the hour .some organisations giving a standard wage while others pay according to age and experience. The rate ranges from $1.50 to $2.50 an hour. The Women’s Division of Federated Farmers also employs housekeepers by the week, pay* ing from $26.75 to $65, depending on age and the nature of the engagement.

There are very clear financial and social bene-

“The element of companionship is very infport* ant,” says the report. “Officers of the Social Welfare District Office feel strongly that home helps serve in relieving loneliness and boredom and in keeping an eye on the solitary elderly or disabled, while some hospital board supervisors have even advised home helps to meet the recipient’s needs first when they are depressed and want company or consoling.” It adds that most home helps interviewed felt recipients regarded them as friends and many became genuinely concerned for and attached to individual clients. “It is not unknown for home helps to slip back into a household outside

fits in maintaining the aged and disabled in the community. The report quotes a hypthetical case of a patient requiring a district nurse twice a day, seven days a week; home help three hours a day, five days a week; and meals on wheels five days a week. This degree of home care would cost about $92 a week. In addition, the patient could very likely be receiving a Social Welfare Department benefit as well as other supporting services, which would entail a total expenditure of

over $lOO a week from public funds to maintain him in the community. Hospital care costs up to $5OO a week. The report points out that the hypothetical case quoted is an “uncommonly extreme” one, so the saving is very considerable. On the social side, where the recipient is the mother of a family, home help allows the normal routine to be maintained without interruption to children’s education or husband’s employment. For the elderly it allows them to remain in familiar

surroundings and among friends. The report quotes a couple in their 80s: “I thought we couldn’t cope and would have to go into old people’s homes, but now, with the home help (coming in once a week) it is all right. “My husband was so confused in the hospital, but now that he’s back home he is all right again.” The authors publish comparative international figures which show that New Zealand is currently sixth in the provison of

home help services, although they point out that the leaders have proportionately fewer hospital and residential home beds than does New Zealand. Thus their need for home help is greater. Sweden heads the list with 825 helpers per 100,000 population. Then come Norway (577), Netherlands (405), Britain (138), Finland (97) and New Zealand (66). The United States has 15, Japan 9, Australia 0.2 — and Italy, at the bottom of the list, 0.1 helpers per 100,000 population.

The provision of home help in New Zealand is patchy. Two centres with a good record are Ashburton (561 recipients per 100,000 population) and Palmerston North (374), compared with the national average of 142 per 100.000 population.

“We believe that the provision of such a high level of services in places like Ashburton and Palmerston North is not because the need is so much greater there but because the available resources are greater, and the means of identifying and referring

case* of need are better," says the report. “There is clearly a large unmet need in many areas. It is possible that much less than half the essential need is being met."

Perhaps the final word should be left to one of the recipients spoken to during the survey which preceded the report. “Am I,” she asked, “worth the effort and expense?” The report said: “It is sad, but understandable, that the more dependent a disabled person becomes on community resources, the less sure she is that she is entitled to support and that it will be provided regardless of her ability to contribute. “In spite of the reputation our country has of being a Welfare State, we clearly must still work hard at both the image and the reality. “One way is to provide help as a right wherever it is needed.”