Issues Papers for the Minister for Senior Citizens

Robyn McDonald Senior Citizens

ISSUES PAPERS for the MINISTER FOR SENIOR CITIZENS

prepared by the
SENIOR CITIZENS UNIT
October 1996

OVERVIEW

Key points
  • Issues in the portfolio of the Minister for Senior Citizens are becoming
    more prominent.
  • The number of older people is projected to grow significantly early in the
    new century.
  • The increasing number and changing demographic profile of older people in
    New Zealand will present challenges in the area of policy formation.
  • It is important planning begins now across the range of government agencies
    to meet the challenges of an ageing population.

Introduction

Older people are a growing proportion of the population. Under medium
projection assumptions, the population aged 65 and over is expected to grow by 6
percent (25,250 persons) in the five years to 2001, by a further 18 percent
(84,650) in the decade to 2011, and another 32 percent (174,200) in the decade
to 2021. By the year 2031, the number of people aged 65 and over is expected to
reach 940,000. These increases in the number and proportion of older people have
significant implications for government policies, particularly those relating to
retirement income support, health, and community support service provision.

It is the role of the Minister for Senior Citizens to advocate for older
people at Cabinet and other government policy forums. The increasing proportion
of older people means that issues within the portfolio are becoming more
prominent. The scope of the portfolio is very broad, incorporating issues such
as transport, income support, housing and health. The advocacy function of the
Minister for Senior Citizens is complicated by the fact that the older
population is a diverse group with differing needs and expectations. It is
therefore essential that the advice provided to the Minister for Senior Citizens
takes into account the differing views of older people across the spectrum of
issues which are of interest and concern to older people.

The purpose of these papers is to provide a synopsis of the major issues
relevant to the portfolio of Minister for Senior Citizens. There are fourteen
papers, including this overview, which fall into the four broad categories: the
structures established by Government to represent the views of older people (papers 2, 3 and 4
); demographic features of the current

and future older populations (paper 5); and issues of
interest and concern to older people (papers 6 to 12). What follows is a brief summary of each paper.

Paper 2 - Portfolio of the Minister for Senior Citizens

This paper provides information on the establishment of the portfolio of the
Minister for Senior Citizens and outlines the roles and responsibilities of the
Minister. It explains the relationships between the Minister and the Senior
Citizens Unit and the Advisory Council for Senior Citizens.

The paper notes the increasing profile of issues in the portfolio of the
Minister for Senior Citizens and therefore the importance for the Minister to be
able to receive comprehensive advice on a wide range of issues quickly. It is
concluded that the small size of the Senior Citizens Unit limits its ability to
maintain its expertise across the range of issues affecting older people and
limits the volume of policy advice provided to the Minister.

Paper 3 - The Senior Citizens Unit

A review of the history, structure and key functions of the Senior Citizens
Unit and the Vision, Mission and Statement of Purpose developed by the Unit are
described in this paper. Details of the funding appropriated to Vote:Senior
Citizens is provided, noting that the operating budget of the Unit has remained
static since 1992/93 and that the total discretionary funding available to
operate the Unit places constraints on its ability to carry out its functions.
The paper also provides information on the current major areas of work of the
Unit.

The paper concludes that the Unit's placement within the Social Policy Agency
of the Department of Social Welfare is mutually beneficial and notes that the
Unit has gained recognition as a key advisor to Government on issues of concern
and interest to older people. It reiterates concern about the ability of the
Unit to maintain its effectiveness with the limited staff and funding resources
currently available, particularly given the increasing prominence of issues
relevant to the portfolio. The paper advocates for an increase in resources to
meet the growing demands being placed on the Unit.

Paper 4
- Advisory Council for Senior Citizens

In this paper, the establishment and role of the Advisory Council are
described and biographical information on current members is provided. The costs
of administering the Advisory Council are detailed and the Advisory Council's
work programme over the past four years is reviewed.

In addition, the paper examines the value of the Advisory Council, confirming
its importance in providing the Minister with advice from a community
perspective. The paper discusses the difficulties in balancing the competing
demands of the Advisory Council and the Senior Citizens Unit on a limited
budget, reinforcing the view that an increase in Vote:Senior Citizens is
essential.

Paper 5 - The Changing Older Population

This paper provides a demographic profile of the older population and sets
the context for the papers that follow, illustrating the diversity of the older
population. The paper analyses the impact that changes to the older population
will have on current policies and the challenges they will present in the
development of new policies.

The need to begin planning for an older population now is emphasised in the
paper. It is noted that while the work of the Task Force on Private Provision
for Retirement and the Prime Ministerial Task Force on Positive Ageing are
significant initiatives in this direction, there is a need for research into the
needs and expectations of older people to provide a sound base for future policy
development. The paper describes how the Department of Social Welfare has taken
a lead in preparing for the projected increase in the older population and
states the importance of policy to be developed in a co-ordinated way across a
range of government agencies.

Finally, the paper concludes by predicting the significant involvement of the
Senior Citizens Unit in the work that is likely to arise from the
recommendations of the Prime Ministerial Task Force on Positive Ageing.

Paper 6
- Retirement Income

New Zealand Superannuation is the only source of income for approximately
20% of superannuitants, with a further 52% receiving additional income of less
than $5,000. This key point is emphasised and an analysis of the level and
source of both personal and household income for older people in New Zealand is
included. Income support provisions available through Income Support offices of
the Department of Social Welfare are summarised, commenting on the low take-up
of supplementary assistance by superannuitants. The paper suggests that this
feature is likely to change with the continued development of Income Support
Super Centres providing client-focused services for older people.

Comments are made on the development of a Consumers Price Index for
superannuitants and on the superannuitant surcharge. Support is given by the
Senior Citizens Unit for a proposed study, as part of the work for the 1997
Periodic Report, on the standard of living of superannuitants and the adequacy
of their income. The information from such a study will be important in
developing future retirement income policies. The Unit also considers that
priority should be given to policy work on income provisions to enhance
government's objective of encouraging older people to remain in their own homes
as long as possible.

Paper 7
- Positive Ageing

Older people have the skills, experience and knowledge to contribute to
society and the benefits of positive and productive ageing are described. The
challenges of ageing populations are analysed, noting the need for government
policies across the range of sectors, including employment, health, housing and
income support, to allow and encourage older people to remain active
participants in the community. The significant role of Age Concern New Zealand
in promoting positive ageing in the community and with government agencies is
mentioned and, in addition to the work of the Prime Ministerial Task Force on
Positive Ageing, developments within both government and non-government agencies
which promote positive ageing are summarised.

The paper notes the initiative taken by the Department of Social Welfare in
developing a Positive Ageing Strategy and suggests that the Department has the
expertise, experience, commitment and existing interface with other government
agencies, community organisations, the private sector and older people to take a
lead in government responses to an ageing population. The position of the Senior
Citizens Unit within the Department of Social Welfare lends support to this
contention.

Paper 8 - Health

Older age is often associated with increased costs of health care. This
paper reports that the significant increases in health expenditure occur in the
population aged 80 and over. As the older old population is expected to
experience significant growth in the next few decades, the impact of this growth
on the health system is discussed. Current health services and related issues
for older people are also described.

The focus of the paper, however, is on the importance of promoting healthy
lifestyles through the life stages as the most effective strategy to minimise
increases in health expenditure resulting from an ageing population. The need
for a wide range of government agencies to be involved in health promotion
activities is advocated, as is the development of congruent policies to support
them.

Paper 9
- Housing

While most older people live mortgage-free in their own homes, housing costs
remain a significant issue for older home owners as well as for the minority of
older people who rent accommodation. This paper provides housing demographic
information and describes in detail the issues facing both older home owners and
those who rent. Most of these issues focus on the affordability of appropriate
housing for older people. Housing assistance currently available is outlined and
its ability to meet the needs of older people is assessed. In addition,
alternative housing options available to older people, including retirement
villages, are examined and comment on these options included in the paper.

The paper notes the impact that government housing reforms have had on older
people and the possible impact on future generations of older people is raised.
It argues that current housing policy is not congruent with current health
policy and discusses the need for policies to support older people to remain in
their own homes or to move to more appropriate accommodation.

Paper 10 - Community Support Services

The main issue raised in this paper is the increasing demand for community
support services for older people at a time when non-government organisations
providing these services are facing increasing difficulties obtaining funding
and attracting volunteers. The paper criticises the inadequacy of funding for
community support services and notes that this factor is undermining
Government's objective of supporting older people to remain in their own homes
for as long as possible.

It identifies the fact that there is no government agency with responsibility
for funding non-health related services and recommends the establishment of a
specific funding programme for this purpose by the New Zealand Community Funding
Agency. It concludes that additional money from Government is required.

Paper 11
- Transport

Adequate and appropriate transport is needed by older people to maintain
their independence and to take an active part in the community. Issues relevant
to older drivers, pedestrians and public transport passengers are reviewed in
this paper, as is the considerable policy work relevant to older people
currently being undertaken in this area. In particular, driver licensing
provisions are under review and the Ministry of Transport is developing a
National Land Transport Strategy which it plans to complete by July 1997.

Paper 11 notes that both the Advisory Council for Senior Citizens and the
Senior Citizens Unit have been active in providing input to the development of
relevant transport policies and practices. Further work on these issues is
expected to arise from the recommendations of the Prime Ministerial Task Force
on Positive Ageing when it reports to Government in June next year.

Paper 12 - Elder Abuse and Neglect

The final paper describes what is meant in New Zealand by the term elder
abuse and neglect and outlines the development of six elder abuse and neglect
pilot programmes by Age Concern New Zealand. An explanation is given on the
involvement of officials on the National Advisory Group overseeing the
development of the pilots. It gives details about the collection of data from
the pilots required to assist government decisions about the funding of and
policy responsibility for these services. It also provides an analysis of issues
surrounding service development and other related issues.

The paper concludes by drawing attention to the report currently being
prepared which will contain recommendations on a preferred model for elder abuse
and neglect services in New Zealand and on funding of those services will be
prepared by the National Advisory Group for the Minister for Senior Citizens and
the Minister of Health in December this year.

PORTFOLIO OF THE MINISTER FOR SENIOR CITIZENS


Key Points

  • Issues in the portfolio of the Minister for Senior Citizens are becoming more prominent.
  • The portfolio of Senior Citizens within Cabinet enhances its credibility with older people.
  • There is a potential for the advocacy role of the Minister for Senior Citizens to conflict with other portfolio responsibilities.
  • The effectiveness of the portfolio is dependent on the Minister receiving comprehensive advice on a wide range of issues quickly.
  • The size of the Senior Citizens Unit limits the volume of policy advice provided to the Minister for Senior Citizens.

History

Until the establishment of the portfolio of Minister for Senior Citizens, the
needs and interests of older people were not consistently represented by any one
Minister of Government. The increasing importance of senior citizens as a
specific group to be considered in public policy formation is reflected in the
fact that in 1990 both the National and Labour parties endorsed the principle of
appointing a Minister for Senior Citizens.

Holders of the portfolio of Minister for Senior Citizens have been:

  • Hon Margaret Shields : July 1990 - November 1990
  • Hon Graeme Lee : November 1990 - October 1991
  • Hon Wyatt Creech : October 1991 - November 1993
  • Hon Peter Gresham : November 1993 -

Roles and Responsibilities of the Minister for Senior Citizens

The role of the Minister for Senior Citizens is to advocate for older people
at Cabinet and other government policy forums. The Minister for Senior Citizens
works in the interests of older people, representing their views and concerns at
government level. This has been greatly assisted by the fact that all but one of
the portfolio holders have been Ministers inside Cabinet, and thus able to
advocate at the highest level.

In order to advocate for older people, the Minister and his/her officials
contribute to the policies affecting older people which may be developed in a
range of government agencies. The Minister for Senior Citizens is therefore
required to maintain close relationships with other Ministers. The advocacy role
of the Minister is informed by both officials of the Senior Citizens Unit, who
maintain close links with community groups and hold regular consultation
meetings with older people, and by the Advisory Council for Senior Citizens,
which provides the Minister with independent and confidential advice from a
community perspective. The advocacy responsibility of the Senior Citizens
portfolio means that the Minister for Senior Citizens may take a stance on an
issue that is in opposition to that of other Ministers. In such circumstances,
the issue would be debated and resolved at Cabinet level.

The advocacy function of the Minister for Senior Citizens is complicated by
the fact that older people are not a homogeneous group. An issue such as income
support, for example, gives rise to a range of viewpoints within the older
population. Further, while the portfolio responsibility requires the Minister
for Senior Citizens to represent the needs and expectations of older people,
their needs must be balanced against the competing needs and expectations of
other age groups in society.

The scope of the Senior Citizens portfolio is very broad, incorporating
issues such as health, income support, housing and transport. Services for the
Minister are provided by the Senior Citizens Unit which is part of the Social
Policy Agency of the Department of Social Welfare. The work programme of the
Senior Citizens Unit is negotiated with the Minister and formally agreed to on a
quarterly basis. The focus of the portfolio varies and may be influenced by both
changes in government policy and lobbying by older people's interest groups. The
Unit is proactive in identifying areas of current concern and relevance to older
people. It also works closely with the Department of Social Welfare and
non-government organisations in initiating new projects.

Issues that have been the subject of recent attention include: the surcharge
on New Zealand Superannuation; the funding of voluntary agencies providing
home-based support services; the effect of housing reforms on older people;
elder abuse and neglect; and a number of positive ageing initiatives. In
considering each of these issues, the focus of the Senior Citizens portfolio is
to enhance the well-being of older people.

Relationship with the Senior Citizens Unit

The Manager and staff of the Senior Citizens Unit maintain close contact with
the Office of the Minister for Senior Citizens and have regular briefings with
the Minister.

The Manager of the Unit has instigated a policy whereby individual policy
analysts are responsible for briefing the Minister on issues related to their
specific areas of expertise. This ensures that the Minister is provided with
high quality policy advice.

The Office of the Minister for Senior Citizens generally maintains a Private
Secretary with specific responsibility for the portfolio. The Senior Citizens
Unit values having a close working relationship with the Minister's Private
Secretary. Regular meetings with the Private Secretary has allowed for a two-way
flow of information and has ensured an open working relationship.

Relationship with the Advisory Council for Senior Citizens

The Advisory Council for Senior Citizens was established by the Hon Wyatt
Creech, who also held the portfolio of Associate Minister of Social Welfare, in
1992 to provide the Minister for Senior Citizens with expert, independent and
confidential advice on issues concerning the well-being of older people. The
advice of the Advisory Council is from a community perspective and in this way
complements the advice provided by the Senior Citizens Unit.

In its first year of operation, the Advisory Council concentrated on requests
for advice which it received from the Minister for Senior Citizens. More
recently, the Advisory Council has developed a draft work programme at the
beginning of each year which is sent to the Minister for consideration.
Throughout the year, additional work is undertaken at the Minister's request or
at the instigation of Advisory Council members. The amount of work undertaken by
the Advisory Council has increased significantly from its initial years of
operation.

Prior to each Advisory Council meeting the Minister meets with the
Chairperson, the Manager of the Senior Citizens Unit and the official who
provides the secretariat services to the Advisory Council to discuss the agenda.
The Minister generally attends the Advisory Council meetings to discuss issues
under consideration. Following the meeting, the Minister may meet again with the
Chairperson and officials to discuss the proceedings of the meeting.

The Advisory Council provides written reports to the Minister and the
Minister receives copies of the minutes of the meetings. Council members agree
that it is important to maintain regular communication with the Minister for
feedback on the issues they have raised. This gives the Minister the opportunity
to talk with other members and to affirm that their contributions are valued.

Future Directions

The portfolio of the Minister for Senior Citizens is becoming more important
as the population ages and the interests and needs of older people have a
greater impact on the social structure of New Zealand. The effectiveness of the
portfolio is dependent on the ability of the Minister to respond to issues
raised by and affecting older people. The placement of the portfolio of Senior
Citizens within the ranks of Cabinet has contributed to the effectiveness of the
position of Minister for Senior Citizens and has greatly enhanced its
credibility with older people.

Older people are a significant and growing proportion of the population and
they are becoming more politically active. Over the past three years the
Minister for Senior Citizens has been put under increasing pressure to use his
advocacy function to challenge government policy, particularly on health and
income support issues. It is therefore of increasing importance that the
Minister is able to receive comprehensive advice on a wide range of issues
quickly.

The Senior Citizens Unit is the primary source of advice to the Minister on
issues affecting older people. These range across many portfolio areas. The
small size of the Unit limits its ability to maintain expertise across the range
of issues affecting older people. Also, the volume of policy advice provided to
the Minister is affected. The continued effectiveness of the Senior Citizens
portfolio is therefore dependent on the resources available to the Senior
Citizens Unit to perform its policy advice function.

THE SENIOR CITIZENS UNIT

Key
Points


  • The placement of the Senior Citizens Unit within the Department of Social Welfare is a mutually beneficial arrangement.
  • The Senior Citizens Unit is currently working to full capacity, but is facing an increasingly heavy workload.
  • The issue of the resourcing of the Senior Citizens Unit requires urgent attention.

History
of the Senior Citizens Unit

The first Minister for Senior Citizens, Hon Margaret Shields, was appointed by a Labour Government in 1990. During late 1990, a series of meetings with older people was convened throughout the country to discuss possible ways of ensuring maximum security, independence and dignity for senior citizens. The meetings supported the idea of a Ministry for Senior Citizens and, in October of 1990, the Labour Government announced that it intended to establish a Ministry for Senior Citizens.

Following the November 1990 election, the incoming National Government decided that a Ministry for Senior Citizens would not be established, but rather, it would establish a Senior Citizens Unit located within the Department of Social Welfare to carry out a policy advice and ministerial servicing role for the Minister for Senior Citizens. The current focus of the Unit has meant that this arrangement has been beneficial to both the Senior Citizens Unit and the Department. In May 1992, the Department of Social Welfare restructured into six business units and the Senior Citizens Unit became a distinct unit within the Social Policy Agency.

Structure and Functions of the Unit

The Senior Citizens Unit has been part of the Social Policy Agency since it
was established in 1992. The Senior Citizens Unit currently operates with a
manager and four policy analysts. The Unit has developed the following Vision,
Mission and Statement of Purpose:

Vision: Well-being in older age.

Mission: The Senior Citizens Unit provides Government with the best
advice to enhance the well-being of older people.

Statement of Purpose:

The Senior Citizens Unit will enhance the well-being of older people by:

  • providing the Minister for Senior Citizens with the best advice to advocate
    for older people at government policy-making forums; and
  • promoting positive attitudes to older age in society.

Relationships and responsibilities

The principal client of the Senior Citizens Unit is the Minister for Senior
Citizens. The Senior Citizens Unit is responsible for providing the Minister
with the best advice to enhance the well-being of older people. In addition to
providing advice and ministerial services to the Minister for Senior Citizens,
the Unit provides advice to the Director-General of Social Welfare and the
Minister of Social Welfare. The Unit also works with a range of government
agencies and community organisations.

The key functions of the Senior Citizens Unit have been to:

  • provide the Minister for Senior Citizens with advice on policy issues
    affecting older people;
  • assist the Minister for Senior Citizens in advocating for older people and
    in representing their interests at government policy-making forums;
  • provide policy advice and secretariat services to the multi-party Accord on
    Retirement Income Policies;
  • co-ordinate and be a member of the inter-departmental officials group which
    services the Accord on Retirement Income Policies;
  • liaise with the Retirement Commissioner on retirement income policies;
  • provide policy advice and secretariat services to the Ministerial Advisory
    Council for Senior Citizens;
  • liaise with other government agencies and provide input into policy
    affecting older people;
  • consult widely with older people, organisations representing their
    interests, kaumatua and kuia, community leaders and researchers; and
  • provide ministerial services.

Budget

The Senior Citizens Unit is funded through it's own vote - Vote:Senior
Citizens. The Vote received a total appropriation of $4.370 million (including
GST) in the 1996/97 financial year. Of this, $0.707 million (16.2% of the Vote)
is for the purchase of services from the Department of Social Welfare, and
$3.663 million (83.8% of the Vote) is allocated to the purchase of services from
the Retirement Commissioner. The $3.663 million appropriated to the Office of
the Retirement Commissioner includes $2,812,500 (GST inclusive) for funding the
public education programme on retirement savings in 1996/97.

Of the $707,000 (GST inclusive) appropriated to the Department of Social
Welfare for the output class Senior Citizens Services, $215,000 is attributed
directly to work related to the production of the first Periodic Report on
Retirement Income Policies. The Senior Citizens Unit therefore operates on a
total budget allocation of $492,000 (GST inclusive), or $437,333 (GST
exclusive). The operating budget for the Unit has remained rather static since
1992/93.

The basic budget breakdown (GST exclusive) for 1996/97 is as follows:

Salaries 272,690
Training 7,500
Other Personnel Costs 15,710
Total Personnel 295,900
Airfares, taxis and accommodation 13,800
Senior Citizens Advisory Council 28,746
Other Administration Costs 9,100
Total Administration 51,646
TOTAL OPERATING BUDGET 347,546
OVERHEADS* 89,787
BUDGET TOTAL 437,333
* The overhead costs include occupancy, depreciation, capital charge and support services costs.

The budget shows the constraints on the Unit's ability to travel for
consultation purposes and to purchase, or carry out, research. The total
discretionary funding available for such purposes is only $22,900 (excluding
GST).

Project
Areas

The Senior Citizens Unit undertakes project work in a variety of areas
ranging from elder abuse to transportation. Underpinning each of the projects is
the Unit's vision: Well-being in Older Age . What follows is a brief overview
of current major areas of work of the Unit.

Consultation with older people

The Unit aims to undertake regular consultations with older people and groups
representing their interests. Such consultations provide both an opportunity for
the Unit to raise its profile and share information, and also provide a forum
for the discussion of issues of concern and interest to older people. The
information gathered at these meetings provides a basis from which policy advice
may later be provided to the Minister and other interested agencies.

A publication, Raising the Issues, was produced as a result of extensive
consultations undertaken by the Unit throughout 1993. This document has been
widely distributed amongst older people and groups representing their interests.
The findings from these consultations have been invaluable in guiding policy
advice both within the Unit and to outside agencies.

Liaison
with government agencies

The Unit has been successful in contributing to policies being developed in
other portfolio areas by utilising its well developed inter-departmental
network. By formally networking with other public sector agencies on a regular
basis, the Senior Citizens Unit has become recognised as a key advisor to
Government on issues of interest and concern to older people. Recognition of
this point is evidenced by the fact that other government agencies contact the
Unit seeking comment on their policy proposals.

Liaison
with community

Officials of the Senior Citizens Unit work alongside groups representing the
interests of older people, including Grey Power New Zealand and Age Concern New
Zealand. The Unit has recently established a network of community organisations,
both national and local, based in the Wellington area and which work for and
with older people. The network meets quarterly to share ideas and information.

Maintaining a close liaison with national and local groups is a mutually
beneficial process, enabling the Unit both to pass on relevant information on
policy issues, and to respond to concerns at an early stage. To assist in this
process, the Senior Citizens Unit provides informative material for publication
in both the Grey Power and Age Concern New Zealand official publications. The
Unit also maintains links with professional bodies providing services for older
people through publication of information in the New Zealand Association of
Gerontology quarterly newsletter.

On a more pragmatic level, the Unit has worked closely with community
organisations on a number of projects. One example is the Police Volunteer
project, which oversaw the development of guidelines for the recruitment of
volunteers to work in community police stations. This project drew on the skills
and expertise of Unit officials, Police personnel, Age Concern representatives,
and older people already working as volunteers in community police stations.

Ministerial Advisory Council for Senior Citizens

The Ministerial Advisory Council for Senior Citizens provides independent
advice to the Minister for Senior Citizens on issues related to the well-being
of older people. One half full-time analyst position in the Unit is allocated to
secretariat support and policy advice to the Advisory Council.

Elder abuse and neglect

Age Concern New Zealand has established six elder abuse and neglect pilot
projects throughout New Zealand. The aim of these projects is to prevent elder
abuse and neglect by implementing pre-crisis intervention strategies and to
respond rapidly to recorded incidents of elder abuse and neglect. The Senior
Citizens Unit is represented on the National Advisory Group overseeing the elder
abuse and neglect pilots.

Promoting positive attitudes to ageing

The Unit not only promotes well-being in older age by providing Government
with quality advice on issues of interest to older people, but also works to
promote positive attitudes to older age in society through a variety of
community-based projects. These include:

International Year of Older Persons

1999 has been designated the United Nations International Year of Older
Persons. The Senior Citizens Unit has already undertaken some preliminary
planning for the celebration of this year. It is anticipated that the Unit will
play a major role in the overall co-ordination of the New Zealand Government's
response to this international year.

International Day of Older Persons

1 October each year is the United Nations International Day of Older Persons.
The Unit works with older people's organisations to promote activities on the
Day which demonstrate the value of older people in the community. It is expected
that celebrations of International Day of Older Persons each year will gradually
build up towards the national celebration of International Year of Older Persons
in 1999.

Greats
and Grands Month

The Unit promotes each October as Greats and Grands Month to highlight the
role of grandparents and other older people who have a significant role in
family life. Schools throughout New Zealand are contacted and encouraged to
organise intergenerational events.

Future
Directions

Given the current focus of the Senior Citizens portfolio and the functions of
the Senior Citizens Unit, officials are of the opinion that the Unit is most
beneficially located within the Department of Social Welfare. The Unit benefits
from being part of the Social Policy Agency environment which is committed to
the provision of sound and strategic policy advice and to fostering a learning
culture. In addition, the Unit enjoys access to a wide variety of policy
information and, subsequently, the opportunity to contribute to policy
development in many areas. Importantly, its location within the Social Policy
Agency allows the Unit to take advantage of the economies of scale available to
larger organisations, resulting in cost-efficiencies, particularly in overhead
costs.

Equally, the Department of Social Welfare is committed to the well-being of
older people. The Director-General of the Department identified the development
of strategies to improve the well-being of older people as a Key Result Area in
her performance agreement with the previous Minister of Social Welfare. The
placement of the Senior Citizens Unit within the Social Welfare structure
provides the Department with an in-house source of expertise on older people's
issues and, in particular, adds strength to the Social Policy Agency's aim to be
the expert in the delivery of well-being policy advice to Government.

In recent years, the profile of the Senior Citizens Unit has been raised and
the Unit has gained recognition as a key advisor to Government on issues of
interest and concern to older people. To date, the Senior Citizens Unit has
consistently met or exceeded its performance standards and the Minister has
expressed his satisfaction with the service provided to him by the Unit.
However, an increasing workload, stemming largely from the recent and high
demands of the Accord on Retirement Income Policies and the Task Force on
Positive Ageing have stretched the Unit's capacity to meet the expectations
placed on it by the Minister, other parts of the Department of Social Welfare
and the general public.

An adequate level of staffing is central to the Unit's ability to operate
effectively. Over the past years, the Unit has maintained a stable and
enthusiastic team. However, the ability of the Unit to undertake new projects is
severely limited as current staff resources are entirely utilised in meeting
existing commitments. Extra hours are often worked to meet work demands.

The tension between the funding required to administer the Advisory Council
and the funding required to operate an effective policy advice unit is a matter
which needs to be addressed. Time spent in servicing the Advisory Council is not
only costly in a monetary sense, but it also has an opportunity cost in terms of
other project work that could be undertaken by analysts. As a result, the Senior
Citizens Unit is limited in the extent of work in which it can engage.

Further, the ability of the Senior Citizens Unit to accurately represent the
views of older people is contingent on staff actively pursuing an ongoing
programme of consultation with different sectors of the older community. Current
budgetary constraints and limited staff resources restrict the Unit's capacity
to undertake such consultations on a regular basis and risk compromising the
ability of the Unit to continue to provide quality policy advice.

It is therefore imperative that the level of resourcing available to the
Senior Citizens Unit is reviewed in the near future. Without increased staff
numbers and an administrative budget that allows for regular consultation, the
Unit will simply not have the capability to undertake any new project work in
the medium term. Furthermore, as issues relating to older people become more
significant due to the ageing population, with its present level of resourcing,
the Unit's ability to meet the increasing demands from the Accord work and from
the work expected to arise from the report of the Task Force on Positive Ageing
is severely restricted.

ADVISORY COUNCIL FOR SENIOR CITIZENS


Key
points

  • The Advisory Council provides the Minister for Senior Citizens with advice from a community perspective which complements the advice provided by the Senior Citizens Unit.
  • When the Advisory Council was established, no additional funding was allocated to Vote:Senior Citizens to fund or service the Advisory Council.
  • The Advisory Council's work over the past four years has covered a wide range of issues related to the well-being of older people.
  • There is a risk that the cost of running the Advisory Council could be greater than the allocation for Fiscal 1996/97, and for this reason the number of Advisory Council meetings may need to be reduced during 1996/97.
  • The terms of appointment of the present Advisory Council members have been extended until after the 1996 election and it is anticipated that new appointments will be made by 1 July 1997.

Introduction

The Advisory Council for Senior Citizens was established in July 1992 under
the direction of the Minister for Senior Citizens, who was also the Associate
Minister of Social Welfare at the time. The legislative authority under which
the Advisory Council was set up is contained in Section 30 of the Social Welfare
(Transitional Provisions) Act 1990. The purpose of the Advisory Council is to
provide the Minister with expert, independent and confidential advice on issues
concerning the well-being of older people. The Advisory Council provides advice
from a community perspective which complements the advice provided by the Senior
Citizens Unit.

Advisory Council members are appointed for a minimum term of two years. They
are chosen for their knowledge of older people's issues and their community
involvement. The terms of reference for the Advisory Council provide for the
appointment of up to seven members. Members are appointed as individuals rather
than as representatives of particular interest groups.

Current
Membership

The Advisory Council is in its second term and consists of six members. Three
members were re-appointed for a second term on 1 November 1994 to maintain
continuity on the Advisory Council. The terms of appointment for all current
members were due to expire on 31 October 1996, but the Minister agreed that they
be extended until after the 1996 election. It is anticipated that new
appointments will be made by 1 July 1997.

The current membership of the Advisory Council is as follows:

  1. The Chairperson is Dr Margaret Guthrie who was appointed to the Advisory Council on 1 January 1993. Dr Guthrie is a Wellington gerontologist and a former manager in the Department of Health with responsibilities for older people's services. She is the Chairperson of Age Concern Wellington and Vice-Chairperson of Age Concern New Zealand. She is also the National President of the New Zealand Association of Gerontology, a member of the Porirua Community Health Group and a Board member of the Nurse Maude Association in Christchurch.
  2. Mr Ronald Francis was appointed to the Advisory Council on 1 November 1994. He is a chartered accountant and is the manager of a religious and welfare residential care facility for older people, in the Hutt Valley. Mr Francis has a long association in a voluntary capacity with church social services.
  3. Mr Pihopa (Bishop) Kingi was appointed to the Advisory Council on 1 November 1994. He is of Te Arawa descent and lives in Rotorua. He is a former Chairman of the Te Arawa Kaumatua Council and has provided extensive service to the community and his iwi.
  4. Mrs Lysbeth Noble was first appointed to the Advisory Council on 10 August 1992. She was the Advisory Council's first Chairperson. Mrs Noble is a past Deputy Mayor of Wanganui and Wanganui District Councillor. She has been actively involved in community activities in Wanganui for many years. Mrs Noble is the President of Age Concern Wanganui, and is a Past President of Age Concern New Zealand.
  5. Dr Anne Opie was appointed to the Advisory Council on 10 August 1992. Dr Opie is a Senior Research Fellow at the Health Services Research Centre of Victoria University of Wellington. She is the Secretary of the New Zealand Association of Gerontology. Dr Opie's research on ageing has focused on caregiving with particular reference to caring for people with dementia. At her request, Dr Opie's term of appointment will not be extended beyond 31 October 1996.
  6. Mr Te Pehi Tahau was appointed to the Advisory Council on 1 November 1994. He is a former Cultural Advisory Officer with the Department of Justice in Christchurch. Mr Tahau is from Ngati Tuwharetoa, in the central North Island, although he has lived in the South Island for a number of years. He has extensive experience in working with South Island iwi.

Comment

Because the allocation for travel costs is limited, new members appointed to
the Advisory Council will need to be based in the Wellington area. However, if
the majority of Advisory Council members are to be from the Wellington area, it
is questionable whether the Advisory Council would be representative of the
varying views of older New Zealanders. Other issues that need to be considered
in appointing new members are gender balance and ethnic composition. The size of
the Advisory Council means that it can never accurately reflect the demographic
composition of the older population.

Servicing the Advisory Council

Advisory Council meetings are held for a full day every two months at the
offices of the Social Policy Agency. The Senior Citizens Unit provides policy
advice and secretariat services to the Advisory Council. One policy analyst is
specifically designated to work with the Advisory Council, and significant
support from other analysts is provided by the Unit to ensure that the Advisory
Council receives appropriate information and advice. The overall staff resource
allocated to service the Advisory Council is one half-time staff equivalent.

Cost of
Administering the Advisory Council

The cost of the Advisory Council is met from Vote:Senior Citizens. When the
Advisory Council was established in 1992, no additional funding was allocated
for the costs of administering the Advisory Council. The staff complement of the
Senior Citizens Unit was reduced to meet this cost. This reduction and the
demands of servicing the Council reduce the time available to provide other
policy advice services to the Minister.

Meeting
fees and expenses

Advisory Council members receive payment for attending meetings and for work undertaken between meetings at the following daily rates:

  • Chairperson: $230
  • Members: $180

Members can claim for Advisory Council work undertaken between meetings, up
to the following maximums:

  • Chairperson: 6 days
  • Members: 3 days

Travel expenses and direct costs, such as toll calls and postage, are
reimbursed.

1996/97
budget

The Senior Citizens Unit has allocated $28,746 for the Advisory Council for
1996/97. This is based on the cost of six meetings and an estimation of the work
members will undertake. Advisory Council expenditure for 1994/95 was $23,675 and
for 1995/96 was $21,773.

The
itemised budget for 1996/97 is:

Advisory Council budget for Fiscal 1996/97

Meeting attendance fees $6,780
Work between meetings $12,300
Airfares $3,600
Mileage and car parking $3,296
Information and research $300
Conference attendance fees $600
Other expenses $1,870
Budget total $28,746

The biggest and most variable expenditure item is work between meetings. If
members were to undertake the maximum allowable work between meetings, this item
would increase from the estimated $12,300 to $24,480 and the total cost of
running the Advisory Council would increase from the estimated $28,746 to
$40,926. This difference would be $12,180 above the budget total allocated for
1996/97. If the costs for the Advisory Council exceed the amount budgeted,
consideration may have to be given to reducing the number of meetings for Fiscal
1996/97 from six to five. The budget also needs to be taken into account when
new appointments are made to the Advisory Council. The small allocation for
travel costs means that most members need to be based close to Wellington.

Work
Programme

In its first year of operation, the Advisory Council concentrated on requests
for advice which it received from the Minister for Senior Citizens. More
recently, the Advisory Council has developed a draft work programme at the
beginning of each year which is sent to the Minister for consideration.
Throughout the year, additional work is undertaken at the Minister's request or
at the instigation of Advisory Council members. The amount of work undertaken by
the Advisory Council has increased significantly from its initial years of
operation.

The Advisory Council's work over the past four years has covered a wide range
of issues related to the well-being of older people and is summarised as
follows.

Health

Advice on health services and policies has been a major component as a result
of:
- the concerns of Advisory Council members about the effects of the recent
health reforms on older people; - the importance that older people place on
health; and
- the areas of knowledge and interest of the members.
The
Advisory Council has prepared reports on the following health issues:
-
income and asset testing for residential care (February 1993, February 1994,
September 1994 and October 1995);
- community care policies and home support
services (April 1993 and April 1996);
- assessment of older people and the
Support Needs Assessment Protocol (August 1994);
- the process of monitoring
rest homes (December 1994);
- voluntary euthanasia (July 1995);
- waiting
lists for people with cataracts (August 1995);
mental health of older
people (April 1996); and
- purchase of services by regional health
authorities (June 1996).

In addition, the Advisory Council prepared submissions on the following
public discussion documents:

- Quality Standards for Home Based Services, Ministry of Health, April
1995;
- Care for Older People in New Zealand, Core Services Committee,
August 1995, where the Advisory Council worked closely with the Core Services
Committee in the development of this report and reviewed the initial draft as
well as preparing a submission on the published document;
- Taking Care:
Safeguarding the Health of New Zealanders , Ministry of Health, December 1996;
and
- Mental Health Promotion and Mental Well-Being of Adults including
Older People, Public Health Group, Ministry of Health, June 1996.

Health
education and promotion

The Advisory Council has been concerned about the lack of health education
and promotion programmes targeting older people. These concerns have been
discussed with the former Public Health Commission, regional health authorities
and the Public Health Group in the Ministry of Health.

Housing

Reports have been prepared on:

- the effects of the housing reforms on vulnerable older people, in
particular those older people on fixed incomes living in rental housing (January
1994);

- pensioner housing provision by local authorities (December 1994 and June
1996); and

- home equity conversion (February 1995).

In addition, the Advisory Council prepared a submission in March 1994 to the
Securities Commission on the discussion paper Resident Funded Retirement
Villages.

Positive ageing

Since its establishment, the Advisory Council has been strongly supportive of
positive ageing initiatives. In 1994, a report to the Minister was prepared on
the contributions that older people make to the community and to their families.
Members provided input into plans for national celebrations of International Day
of Older Persons in 1995 and were involved in celebrations in their local
communities. In September 1996, the Advisory Council prepared a submission to
the Prime Ministerial Task Force on Positive Ageing and Task Force members will
be attending the November 1996 meeting of the Advisory Council.

Communication strategies

The Advisory Council has kept a watching brief on the development of the Age
Wise project, a proposal to develop a one-stop information service for older
people. Members also provided comment on the Income Support Super Centre
proposal.

Issues
affecting kaumatua and kuia

The contributions and input of the Maori members have assisted the Advisory
Council to include Maori perspectives in its advice to the Minister for Senior
Citizens.

In August 1995, the Advisory Council held a hui with Maori and Pacific
Islands women, including representatives from the Maori Women's Welfare League
and the Maori Women's Health League. A wide range of issues was discussed which
assisted the Advisory Council to include Maori and Pacific Islands perspectives
in its advice.

The Advisory Council met with the Chief Executive and staff of Te Puni Kokiri
in April 1996 to discuss issues of concern for kaumatua and kuia and to look at
opportunities for working together.

Funding
for community services

Officials from the Lottery Grants Division of the Department of Internal
Affairs and the Chairperson of the Lottery Aged Distribution Committee have met
with the Advisory Council to discuss concerns about funding for community groups
working with older people.

Transport

The Advisory Council has undertaken a significant amount of work on transport
issues and has prepared submissions on the following discussion documents:
The Older Road User , Land Transport Safety Authority, May 1994;
Driver
Testing Criteria and Driver Education , Land Transport Safety Authority,
September 1995; and
Licensing Requirements for Older Drivers ; Driver
Licence Revocations and Limitations on Medical Grounds ; and Driver Licence
Format , as part of the Land Transport Safety Authority's review of driver
licensing requirements in May 1996.

The Advisory Council has also commented on several policies and draft rules
prepared by the Land Transport Safety Authority which have been relevant to
older drivers, passengers and pedestrians.

Legal
and crime

In 1994, the Advisory Council prepared a submission on mandatory reporting
for elder abuse and neglect and appeared before the Social Services Select
Committee on the Children, Young Persons and their Families Amendment Bill 1994.
The Advisory Council's Chairperson is a member of the National Advisory Group on
elder abuse and neglect and has reported regularly to the Advisory Council on
the Age Concern elder abuse and neglect pilots.

The Advisory Council has also provided advice on:

- the Human Rights Act 1993;
- the United Nations Resolution 46/91;

- the Births, Deaths and Marriages Act 1995; and
- access to
grandchildren when parents are separated.

Future
Directions

The Advisory Council for Senior Citizens provides advice to the Minister for
Senior Citizens on a wide range of policy issues. As noted, this is a
particularly valuable stream of policy advice and is complementary to the advice
delivered by the Senior Citizens Unit. The Advisory Council members have close
community involvement and so they can keep the Minister in touch with the range
of views that older people have about current policies and issues. This makes
their advice especially relevant in assisting the Minister's advocacy role.

The Advisory Council reports in confidence to the Minister and at times
members have been frustrated by this confidentiality obligation. This factor,
coupled with the fact that the Council has not had a high profile, has resulted
in some public criticism that the Advisory Council has not been effective. The
confidentiality requirement is, however, an important means of ensuring that the
advice members give can be free and frank and cannot be used by members as a
political tool. The non-political status of the Advisory Council is important in
maintaining its credibility.

The Advisory Council is also a forum in which Senior Citizens Unit analysts
can test their assumptions and ideas on older people's issues. A strong working
relationship has been developed between the two parties allowing for productive
exchanges of information.

The Advisory Council is a reasonably cost-efficient body. The fees paid to
members are moderate and travel costs are kept to a minimum by ensuring that the
majority of members reside either in, or close to, the greater Wellington
region. The servicing of the Advisory Council does, however, significantly
increase its overall cost. As noted earlier, the allocated overall staff
resource required to service the Advisory Council is one half-time staff
equivalent. In reality, closer to one full-time equivalent is spent on servicing
the Advisory Council, with analysts assisting with information provision and
report preparation.

Time spent in servicing the Advisory Council is not only costly in a monetary
sense, but it also has an opportunity cost in terms of other project work that
could be undertaken by analysts. As a result, the Senior Citizens Unit is
limited in the extent of work in which it can engage. The cost of the Advisory
Council needs to be balanced with the value of the advice it provides to the
Minister. It is the Senior Citizens Unit's view that it is important for the
Minister to have advice provided from a community perspective and that the
Advisory Council performs this function well. However, if the Minister wants an
Advisory Council and a policy advice function which can keep up with the
increasing emphasis on older people's policy, then an increase in Vote will be
essential.

THE CHANGING OLDER POPULATION


Key
points

  • The older population is a diverse group with differing needs and expectations.
  • Significant growth is forecast in the 80 plus age group.
  • The Maori population will age at a faster rate, but at a later time, than the non-Maori population.
  • Women make up the majority of the older population and their predominance increases with age.
  • The increasing number and changing demographic profile of older people in New Zealand will present challenges in the area of policy formation.

Definition Of Older Age

There is no commonly accepted definition of what constitutes older age in
purely chronological terms. For the purposes of this paper, older people are
defined as those aged 65 years and over. Existing legislation is gradually
increasing the age of eligibility for New Zealand Superannuation to this age
and, subsequently, it may well become the new retirement age. Statistics New
Zealand also uses 65 years plus as their definition of older age, and note that
it is the age point used overseas to identify people as elderly.

The
Older Population

In March 1996, there were 432,900 people aged 65 and over, of whom 59 percent
were between 65 and 74 years of age, 32 percent were 75-84 years, and 9 percent
were aged 85 years and over. At the same time, there were 135,400 people in the
60-64 year age group, bringing the total population aged 60 and over to 568,300.

Population ageing and projected growth

Like many other developed countries, New Zealand's population has been ageing as a result of declining birth rates and improvements in life expectancy in recent decades. Older people are a growing proportion of the population; the 65 plus age group made up 12 percent of the population in March 1996, up from 11 percent in 1991. These proportions are expected to increase rapidly after the year 2011, as the large post-war baby boom generations enter the 65 plus age group, boosting it from 13 percent of the population in 2011 to 17 percent in 2021 and 21 percent in 2031.

Similarly, the number of older people is projected to grow significantly
early in the new century. Under 'medium' projection assumptions, the population
aged 65 and over is expected to grow by 6 percent (25,250 persons) in the five
years to 2001, by a further 18 percent (84,650) in the decade to 2011, and
another 32 percent (174,200) in the decade to 2021. By the year 2031, the number
of people aged 65 and over is expected to reach 940,000. These increases in the
number and proportion of older people have significant implications for
government policies, particularly those relating to retirement income support,
health, and community support service provision.

It is important to note that future increases in the size of the older
population will not be uniform across all older age groups. The most rapid
increases will occur amongst the old-old (those aged 80 years and over), who
will grow by 17 percent (16,750 persons) in the five years to 2001 and 37
percent (41,950) in the decade to 2011. By this time, the old-old will make up
28 percent of the population aged 65 and over. By the year 2031, people aged 80
and over are expected to number 259,300.

Such a growth in the number of very old people will have important
ramifications for health care providers in New Zealand. As age increases,
"...the proportion who require institutional care grows and serious disability
becomes more common. This factor underlies the need which many very old people
have for special care, and poses the question of who should provide for and pay
for this care - the individuals themselves, their families, their communities,
or the state?"

Ethnic
composition of the older population

The table below shows the changing ethnic composition of the older
population, contrasting 1991 and 1996 figures with projections for the years
2001, 2006 and 2011.

Changing ethnic composition of the older population (aged 65+)

Number
  1991 1996 2001 2006 2011
Maori 10,900 14,200 17,800 22,300 26,100
Pacific Island 3,700 4,800 6,000 7,600 9,600
Total 379,767 432,880 458,130 495,810 542,780
Percentage distribution
  1991 1996 2001 2006 2011
Maori 2.9% 3.3% 3.9% 4.5% 4.8%
Pacific Island 1.0% 1.1% 1.3% 1.5% 1.8%
Source: Demographic Trends 1994,
1995

Maori
older population

The Maori population has a younger age structure than the non-Maori
population with only 3 percent aged 65 or over, compared with 13 percent of
non-Maori. While this relative youthfulness will persist, the Maori population
will age at a faster rate, but at a later time, than the non-Maori population,
largely because the fall in the number of births in the 1970s was more rapid for
Maori. In March 1996, there were 14,200 Maori aged 65 and over. By 2011, the
number of Maori in this age group is expected to have increased by 84 percent to
reach 26,100 where Maori will comprise 5 percent of the population aged 65 years
and over. By 2031, the expected number of older Maori will be 59,000, more than
four times its current size, and they will account for 9 percent of the total
Maori population.

Pacific
Islands older population

The Pacific Islands population living in New Zealand will also age rapidly
but remain much younger than the population as a whole. In March 1996, there
were about 4,800 Pacific Islands people aged 65 and over, representing fewer
than 3 percent of the Pacific Islands population. By 2011, the number of older
Pacific Islands people will have doubled to 9,600, representing 2 percent of the
total population aged 65 years and over. By 2031, the expected number of older
Pacific Islands people will be 27,000, more than five times its current size,
and they will account for about 8 percent of the population in those ethnic
groups.

Asian
older population

The Asian population in New Zealand is also relatively young. While 11
percent of all New Zealanders were aged 65 years and over in 1991, less than 3
percent of the New Zealand Asian population were in this category. This is not
unexpected given that many of the Asian groups consist of recent immigrants to
New Zealand and that New Zealand's immigration policies mean that older people
make up only a small percentage of Asian migrants.

Comment

Ethnic differences will become increasingly important as the number of older
Maori increases. At the current time, a larger proportion of older Maori are in
rental accommodation than are Pakeha; dependence on state-funded superannuation
increases with age and is higher for Maori than Pakeha; and income differentials
between Maori and Pakeha are perpetuated to the end of life, although there is
some narrowing of ethnic differences with age.

The Pacific Islands population shares many of the same socio-economic
characteristics as the Maori population. Further, Pacific Islands people are
more likely to be in a higher income household because of multiple family
living. Income support, health, housing, and social services policies will all
require revision in light of the increasing importance of cultural diversity
within the older age group.

Dependency ratios

The total dependency ratio compares the size of the working age population
with the size of the combined populations of younger and older people. It makes
the assumption that the non-working age population is dependent on the working
age population for support. The ratio does not take into account the effects of
employment opportunities or education and training on workforce participation,
nor the extent to which a "dependent" person is actually dependent. While the
ratio measures both older age and youth dependency, there is no assumption made
on whether either of the two populations is more dependent on the working age
population than the other.

As the age of eligibility for state-funded retirement income is increasing
from 60 to 65 years of age, it is useful to consider two alternative scenarios
based on March 1996 population data. If the working age population is defined as
being between 16 and 59 years of age, this would indicate an aged dependency
ratio of 26 older persons per 100 people of working age and a youth dependency
ratio of 41 per 100. However, if the working age population is defined as aged
between 16 and 64 years, a dependency ratio of 19 per 100 for older people and
39 per 100 for young people is indicated. This demonstrates the significant
effect that the change in the accepted age of retirement, that is, the age of
eligibility for New Zealand Superannuation, has on the total dependency ratio.

There are expected to be 21 older persons for every 100 aged 16 to 64 by the
year 2011. Beyond then, the aged dependency ratio will increase rapidly to reach
36 per 100 in 2031. Meanwhile, the youth dependency ratio will have declined
from current levels to 33 per 100 by 2011 and is expected to plateau at just
over 30 children per 100 adults of working age in the period up to 2031.

The increase in the accepted age of retirement to 65 years will extend the
pool of working age adults and reduce the number of older adults regarded as
"dependent". Declining fertility rates suggest a lower youth dependency rate. At
the same time, however, youth are likely to remain in training or education for
longer than in the past and this will tend to produce partial offsetting
effects, reducing the pool of working age adults and increasing the number of
younger adults regarded as "dependent". As stated earlier, however, the
dependency ratio concept does not compare the relative costs to the state of the
two dependent populations, or take into account the extent of dependency on
state benefits among adults of working age. In March 1996, about one in every
six people aged 16-64 were receiving income-tested benefits.

Life expectancy

New Zealanders are, in general, living longer than ever before. The mortality
experience for 1992-94 indicates that a new-born male could expect to live, on
average, 73.4 years, and a female, 79.1 years. That is, women can expect to live
5.7 years longer than men While women generally have a greater life expectancy
than men, the gap is less marked in older age groups. For example, life
expectancy for New Zealand men and women at age 65 years is currently 15.0 years
and 18.8 years respectively, a difference of 3.8 years in favour of women. By
the time one reaches 85 years, however, life expectancy for men is 5.1 years,
and for women, 6.4 years, a difference of only 1.3 years in favour of women.
According to Statistics New Zealand, this is because ...the men who survive the
ages of highest cancer and coronary-related mortality tend to continue to live
for a similar length of time to women.

Maori life expectancy is lower than that for European/Pakeha New Zealanders
but is, nevertheless, improving. In 1950-52, a Maori baby girl had a life
expectancy of 56 years, compared to the 72 years that a non-Maori baby girl
could expect to live. A Maori baby girl born in 1990-92 could, however, expect
to live 73 years, compared with 79 years for their non-Maori counterparts. Maori
males have also experienced improved life expectancy, from 54 years in 1950-52
to 68 years in 1990-92. However, the difference in life expectancy between Maori
men and Maori women has widened, because of fewer deaths among Maori women than
Maori men.

Increased life expectancy will result in greater numbers of people reaching
the age of 80 and over. As noted earlier, the most rapid increase in the older
population will occur amongst the old old . The needs of this group will be
quite different to those in younger cohorts and such differentials must be
considered in social policy development.

Gender

Women make up the majority of the older population and their predominance
increases with age. In March 1996, while women accounted for 56 percent of all
those aged 65 and over, they made up 70 percent of those aged 85 and over. There
are twice as many women as men in the population aged 80 and over.

This gender imbalance means that women are far more likely than men to live
alone. The need for support services increases with age and older women are
twice as likely to be in residential care as older men. In 1991, 40 percent of
women aged 85 and over lived in non-private dwellings compared with only 23
percent of men of this age. At this time, only 8 percent of women aged 85 and
over were married, compared with 44 percent of men.

Smaller family sizes, greater geographical distribution of families, higher
labour force participation among women in late middle age and higher rates of
marriage breakdown will increase the numbers of older people living alone
without access to support from family members. Women will continue to make up
the majority of people in this category among the very old. The high proportion
of older women living alone has profound implications for social policy,
particularly in the areas of security and care. While older people generally
wish to remain as independent as possible in their own communities, the desire
for independence must be balanced against the need for adequate support.

Marital status

At the 1991 Census, 77 percent of men and 53 percent of women in the 65 to 74
year age group were married. The proportion of older people who are widowed is
significantly higher for women than for men. For example, 10 percent of men in
the 65-74 year age group were widowed, as opposed to 36 percent of women. By age
85 years and over, 48 percent of men were widowed, compared to 81 percent of
women. The difference can be attributed to the longer life expectancy of women,
together with the tendency for men to be married to women younger than
themselves.

A significant trend in the marital status of older people is the growth in
the number of people who are either divorced or separated. The proportion is
greatest amongst the younger olds , with 6 percent of those aged 65-74 years
being separated or divorced in 1991, as compared to 2 percent aged 85 years and
over. This compares with 3% and 1% in 1971. These proportions can be expected to
grow as the generations of New Zealanders affected by higher rates of separation
and divorce in recent decades enter the older age groups.

Employment

Since the age of eligibility for retirement income support began rising in
1992, the number of people in their early sixties who are either employed or
actively seeking work has increased. Between 1971 and 1991, the labour force
participation rates of people in their late fifties were trending downward for
men and upward for women. During the same period, the proportion of men and
women in the labour force beyond age 60 declined, particularly after the
introduction of National Superannuation in 1977.

trending downward for men and upward for women.60 declined, particularly
after the introduction of National Superannuation in 1977. Since the age of
eligibility for retirement income support began rising in 1992, the number of
people in their early sixties who are either employed or actively seeking work
has increased.

In March 1996, the labour force participation rates of 60-64 year olds were
53.1 percent for men and 25 percent for women, up from 33 percent and 17 percent
respectively, in March 1991. Over the age of 65 years, about 10 percent of men
are still in the labour force, compared with around 3 percent of women.

The pattern is different for older Maori and Pacific Islands people. In 1991,
when 10 percent of all men aged 65 and over were in the labour force, only 7
percent of Maori men and fewer than 5 percent of Pacific Islands men in this age
group were employed or seeking work. In contrast, the participation rate of
older Maori women, at 4 percent, was higher than average, while that of older
Pacific Islands women was lower, at 1 percent.

The majority of employed older people in the 60-64 year age group work
full-time (81 percent of employed men and 53 percent of employed women).
However, beyond age 65, most employed people work part-time (53 percent).

Continued participation in the paid workforce is dependent on a number of
factors including employment status and conditions, personal health, financial
commitments and aspirations, caregiving responsibilities and self-esteem. Lower
levels of continued participation in the paid workforce by both Maori and
Pacific Islands people may be linked to employment conditions. For example,
Maori men and women are more likely to be employed in manufacturing industries
than non-Maori. As employment in the manufacturing sector has declined over the
past 10 years, unemployment amongst Maori men in particular has increased. Maori
may thus be forced out of the paid workforce at a younger age.

It is also important to note that the median incomes for both Maori men and
women are lower than those of non-Maori. This may make continued participation
in the paid workforce beyond age of qualification for New Zealand Superannuation
less attractive from a financial standpoint. However, as the occupational
distribution of employed Maori is changing, particularly with more Maori
becoming self-employed, and therefore having greater control over their
retirement age, it is likely that an increasing proportion of Maori may stay in
the paid workforce for a longer period of time.

A further factor in the lower levels of participation in the paid workforce
by Maori and Pacific Islands people could be linked to family responsibilities.
Older Maori, and Pacific Islands women in particular, have an important role to
play in providing care for children or other dependants. It is also important to
note that older Pacific Islands people are more likely to live with other family
members and have greater access to care and support and, in addition, share
higher household incomes. These factors may act as both disincentives and
barriers to continued workforce participation.

Future Directions

The increasing number of older people in New Zealand will present new
challenges in the area of policy formation. The older population is an
increasingly diverse group with different needs and expectations. The provision
of healthcare services is one area which will be particularly exposed to the
impact of a larger and diverse older population. The health needs of the 80 plus
age group will be quite different to those in the 65-70 age group. Differences
will also occur on the basis of gender, ethnicity, living situation and
socio-economic profile.

Further, it cannot be assumed that the older generations of tomorrow will
have the same needs and expectations as older people today. The values, health
status and economic situation of older people may vary greatly not only within
generations, but also between them. For example, recent changes to housing
policy which have seen the removal of government incentives for low income
earners and subsidised home loans may result in a future generation of older
people who do not have equity in a residential property.

Planning for an older population needs to begin now. The Government has
realised the importance of preparing for the impact of an ageing population and
two recent government Task Forces have examined aspects of ageing in New
Zealand. The Task Force on Private Provision for Retirement presented its final
report to Parliament in December 1992. As a result of the findings and
recommendations of the Task Force, the Accord on Retirement Income Policies was
negotiated between the National, Labour and Alliance Parties and was later
signed up to by the United New Zealand Party. The Accord aims to achieve
consensus on retirement income policies so that people can plan with certainty
for and during their retirement.

In May 1996, the Government established the Prime Ministerial Task Force on
Positive Ageing. The Task Force has been charged with considering the
implications of New Zealand's ageing population and advising the Government on a
strategy for ensuring greater co-operation between agencies in monitoring the
needs of older people and promoting and supporting positive ageing. The Task
Force will present its final report with recommendations to Government by
December 1997.

Notwithstanding the work undertaken by the two Task Forces, research into the
needs and expectations of older people has been lacking, with no single agency
having responsibility for either research co-ordination or funding. Research
into areas such as health, housing, transportation, employment, security,
communications and recreation and leisure activities is needed to provide a
sound basis for future policy development.

The Department of Social Welfare has taken a lead in preparing for the
increase in the older population. The Director-General's Performance Agreement
with the Minister of Social Welfare requires the Department, in terms of Key
Result Area (KRA) 3, to develop and implement strategies across business units
to ensure that Social Welfare services are prepared for the growth in the size
of the older population, and that ageing is seen in a positive light by older
people themselves and the wider community. It is important that policy
developments also occur in other agencies and that these are coordinated in a
coherent way. The Task Force on Positive Ageing will advise Government on a
strategy for ensuring a comprehensive policy response to meet the challenge of
an ageing population in New Zealand. It is expected that the Senior Citizens
Unit will have significant involvement in the work that arises from the
recommendations from the Task Force.

RETIREMENT INCOME


Key points

New Zealand Superannuation is the only source of income for approximately
20% of superannuitants with a further 52% receiving additional income of less
than $5,000.

There is a low take-up of supplementary forms of assistance by
superannuitants.

Supplementary forms of assistance need to enhance Government's objective of
encouraging older people to remain in their own homes for as long as possible.

Recent legislative changes effective from 1 April 1997 will reduce the
number of superannuitants required to pay the surcharge from 29% to 14%.

It is important that policies remain stable, certain and sustainable to
ensure that people can plan properly for their retirement.

Introduction

The level of income that people can expect to receive during their retirement
years is an important issue for both older people and those planning for their
retirement. The principle that retirement income policies should be stable,
certain and sustainable is central to people being able to plan adequately for
and during their retirement.

It is important that supplementary forms of government assistance that are
available to older people enhance Government's objective of encouraging older
people to remain in their own homes for as long as possible. It is also
important that older people have the knowledge of the types of additional
assistance that may be available to them to supplement their New Zealand
Superannuation in order to support this government objective.

Income
Levels of Older People

Personal income

For most people, retirement is characterised by a significant drop in
personal income and increased financial dependence upon state provisions. Upon
reaching the age of eligibility for New Zealand Superannuation, men are likely
to see their total income fall as New Zealand Superannuation increasingly
becomes their main income source. However, for many women, becoming eligible for
New Zealand Superannuation causes their total income to rise and often
represents their first financial independence.

In 1991, the mean income for men aged 60 years and over was $16,359 per annum
(gross), 36.4% lower than that for men aged 55 to 59 years ($25,725 per annum
gross). Women aged 60 years and over had a mean income of $12,654. While this
was only 2.9% less than the income for women aged 55 to 59 years, both groups
received substantially less than their male counterparts.

Generally, older males have a higher income than older females. However, the
differential in income narrows with age. This may be largely attributable to the
difference in the age pattern of exit from the labour force and to the transfer
of assets to the surviving spouse, usually the woman. Amongst those in the 60 to
64 year age cohort, men on average were receiving nearly $6,500 more than women,
whereas men in the 75 year and over age cohort received on average $1,600 more.

There are increasing numbers of women with income well above the average,
many of whom have accumulated or inherited assets. However, there are large
numbers of women for whom the task of saving to prepare for retirement has not
been possible. Highly represented in this group are Maori and Pacific Islands
women as well as women whose circumstances have led to sole parenthood,
widowhood, separation or divorce.

Women tend to achieve the greatest level of income equality with men when
they are aged 65 years and over. This is because New Zealand Superannuation
payments are at a fixed level and do not differentiate according to gender or
past labour force experience.

Ethnicity issues

In general, older people in the Maori and Pacific Islands ethnic groups have
lower incomes than other older people. Incomes for these two groups are heavily
concentrated in the $5,001 - $10,000 range, which is the income bracket into
which the 1991 levels of New Zealand Superannuation fell. This reinforces the
view that many Maori and Pacific Islands people are solely reliant on New
Zealand Superannuation for their retirement income.

The following table illustrates the differences in total personal income of
people aged over 60 years according to ethnic group.

While less than 50% of the older people in the European ethnic group had an
income of $10,000 or less, this proportion increased to 69 percent for older
Maori and 79 percent for older Pacific Islands people. In 1991, the median
annual income for older Maori was $9,000, compared with $8,200 among older
Pacific Islands people and $10,700 among older people belonging to the European
ethnic group.

An issue that has been raised in Senior Citizens Unit consultations with
Maori is the effect on Maori of the increasing age of eligibility for New
Zealand Superannuation. Maori life expectancy in 1990-92 was 73 years for
females and 68 years for males. The issue is that the new qualification age for
New Zealand Superannuation of 65 years, combined with lower life expectancy
rates for Maori, means that some Maori will not receive New Zealand
Superannuation and most Maori will not receive New Zealand Superannuation for as
long as their non-Maori counterparts.

The Retirement Commissioner is planning to include strategies relating to
retirement income planning for Maori and Pacific Islands people in his education
programme on retirement savings.

Household incomes

The 1994-95 Household Expenditure Survey indicated that New Zealand
Superannuation was the major source of income in senior citizen households.
However, the extent to which the household was dependent on New Zealand
Superannuation varied amongst households of different compositions.

The survey also found that senior citizen households are generally small,
comprising one or two people. Approximately one-third of senior citizens were
living alone in 1994. The probability of living alone increases with age and is
particularly evident among women who have a higher life expectancy than men. The
Household Expenditure Survey does not include those who do not live in private
households.

The income levels of superannuitant households follow trends in other New
Zealand households in that income levels are closely related to involvement in
paid work and income obtained from investments. The following table provides
information on the sources of household income for older people.

Total Household Income
by Household
Composition and Source
Source of Income Single Person 60 years or more living Alone Two Person Household, both 60 years or more Two Person Household, one 60 years or more
Percentage of Total Percentage of Total Percentage of Total
New Zealand Superannuation 67.0% 58.9% 23.6%
Wages and Salaries 8.0% 6.6% 45.9%
Self Employment 1.4% 2.3% 11.0%
Social Welfare Benefit 0.6% 1.1% 4.7%
Private Superannuation 6.1% 10.2% 3.8%
Investment and Other 17.0% 20.9% 11.0%

The above information confirms that New Zealand Superannuation is the major
source of income in all households comprising single people or couples where
both partners are aged 60 or over. The dependence on New Zealand Superannuation
is greater where older people live alone. Other common sources of income for
superannuitants are interest, wages and salaries, and income from private
superannuation schemes. As could be expected where one person in the household
is aged under 60 years, a larger amount of household income is derived from
wages and salaries.

An issue that has been raised by community groups is that where households
are totally dependent on New Zealand Superannuation, this has particular
implications for the housing costs of superannuitants. Community groups have
reported that some superannuitants are significantly reducing expenditure on
food, heating and health care in order to meet housing costs which might include
rent payments, mortgage payments or costs incurred with the maintenance of a
home. Because many older people are managing to meet their ongoing costs within
their existing income, through reducing expenditure in this way, they then are
not eligible for supplementary assistance. Reductions in food, heating and
health care have obvious negative long-term effects on health and therefore on
the ability of the older person to remain in their own home.

Publicly Provided Retirement Income

New Zealand Superannuation is the largest single item of government
expenditure and accounts for over half of Social Welfare expenditure. The
following chart illustrates the Department's forecast expenditure for New
Zealand Superannuation between 1996 and 2031.

The chart above contains two CPI assumptions. Firstly, Treasury CPI estimates
as at April 1996 have been used up until the year 2000. After the year 2000, an
assumption of one percent CPI has been used. Secondly, expenditure is also shown
on the chart with this one percent CPI assumption removed. The chart illustrates
the effect that the changing demographic situation, due to the ageing of the
population, will have on expenditure on New Zealand Superannuation.

Accord on Retirement Income Policies

Costs of sustaining retirement income policies combined with the ageing
population will remain major issues to be taken into account in the future
development of retirement income policies. The Accord on Retirement Income
Policies represents the agreed policy position of the Alliance, Labour, National
and United Parties in relation to retirement income. The Accord sets out the
policies that will apply in respect of the public and private provision of
retirement income in New Zealand. The Accord was established in 1993 to achieve
political consensus on retirement income policies so that people could plan with
certainty for and during their retirement. It is therefore important that
policies remain stable, certain and sustainable.

Income support provisions

The following income support provisions for older people are available
through Income Support offices of the Department of Social Welfare.

New Zealand Superannuation

At 1 October 1996, the age of entitlement for New Zealand Superannuation was
62 years and nine months. At 29 June 1996, 481,498 people were receiving New
Zealand Superannuation at an annual cost of $5,083,119,000.

The following table indicates the rates at which New Zealand Superannuation
is paid, the percentage of superannuitants in each rate category and the weekly
and annual payments per person as at 1 July 1996.

New Zealand Superannuation Payment Rates at 1 July 1996

Rate category Percentage of recipients Weekly rate per person(gross) Annual rate per person (gross)
Half the married rate 1 48.9% $184.33 $9,585.16
Single living alone rate 27.3% $249.50 $12,974.00
Single sharing rate 14.8% $227.68 $11, 839.36
Non-qualified spouse half married rate 2 5.1% $175.78 $9140.56
Non-qualified spouse rate 3 3.8% $184.33 $9585.16
Hospital rate 4 0.1% $30.59 $1,590.68

1
Married people who are receiving half the married rate of New Zealand
Superannuation. If both partners qualify for New Zealand Superannuation, they
will each receive this rate.
2 Non-qualified rate post 1 October
1991 which is equivalent to the sum of the single person rate of the
Unemployment Benefit and half the married rate of New Zealand
Superannuation.
3 Non-qualified rate prior to October
1991.
4 Rate paid to superannuitants who have been in hospital;
for more than 13 weeks.

The rates of New Zealand Superannuation are adjusted each year in line with
movements in the Consumers Price Index. In addition, the Accord on Retirement
Income Policies requires that the after-tax rate of payment for a couple remain
between 65% and 72.5% of the average after-tax ordinary time weekly wage. At 1
July 1996, New Zealand Superannuation was 69.46% of the average after-tax
ordinary time weekly wage.

An issue which has been raised in many consultation meetings undertaken by
the Senior Citizens Unit is the level of New Zealand Superannuation. In
addition, groups representing superannuitants, in particular Age Concern New
Zealand and Grey Power New Zealand, have been active in lobbying Government for
an increase in the rate of New Zealand Superannuation. The policy manifesto of
Age Concern New Zealand states that the Government should commission research to
determine the levels of income needed to achieve a reasonable standard of living
for superannuitants who are dependent entirely on New Zealand Superannuation.

Accord Parties have agreed that part of the work programme for the 1997
Periodic Report should include a study on the standard of living of
superannuitants and the adequacy of their income. The Senior Citizens Unit
supports such a study being undertaken and considers that it would greatly
improve the information available on the adequacy of superannuitants' income.

Veterans Pension

Veterans Pension is paid instead of New Zealand Superannuation to people who
meet the service and military criteria. It is not income-tested but is taxable.
The rates of payment are the same as for New Zealand Superannuation but
entitlement is not subject to the surcharge. To be eligible, a person must have
reached the age of qualification for New Zealand Superannuation and qualify for
a war disablement pension of at least 70%.

There has been an increase in the number of recipients of the Veterans
Pension since a policy change in 1992 allowed veterans receiving New Zealand
Superannuation to transfer to the Veterans Pension. Previously, no movement was
allowed between New Zealand Superannuation and the Veterans Pension. There are
more women than men receiving this pension because widows of veterans are
entitled to continue to receive the Veterans Pension on the death of their
spouse. Organisations such as the Returned Services Association are active in
encouraging their members to transfer to the Veterans Pension if they meet the
70% disablement criteria.

Transitional Retirement Benefit

The Accord on Retirement Income Policies provides that the age of eligibility
for New Zealand Superannuation should continue a transition, to reach the age of
65 by the year 2001. To assist a defined group who were approaching the age of
60 at the time the increased age of eligibility was announced, the Accord
provides for a Transitional Retirement Benefit. This benefit was introduced on 1
April 1994. It is an income-tested benefit set at a rate lower than New Zealand
Superannuation, but paid at the same rate as the highest social security
benefit. It is available for a maximum period of three years prior to reaching
the age of eligibility for New Zealand Superannuation. The Transitional
Retirement Benefit will be completely phased out by 2004.

Supplementary Forms of Assistance

Supplementary forms of assistance are available to superannuitants and
beneficiaries who do not have enough income to meet their essential living
expenses. These forms of assistance are targeted to those most in need and can
be granted on a recoverable or non-recoverable basis depending on the personal
circumstances of the recipient and the purpose for the additional assistance.
The main supplementary forms of assistance are outlined below.

The Disability Allowance provides assistance to people who have regular and
ongoing expenses because of a disability or personal health need which is
expected to continue for at least six months. The need can be the result of a
permanent injury, illness or medical condition. Items currently attracting
disability allowance payments which are of particular relevance to older people
include elder day care and medical alarms. The criteria for Disability Allowance
is currently under review. The aim of the review is to clarify the purpose of
the disability allowance policy and to clarify roles and responsibilities
between the income support and the health systems.

A Special Benefit is paid to people, including low income earners, who do not
have enough income to meet their essential living expenses and whose individual
circumstances warrant a payment. It is a discretionary payment approved on a
case by case basis and the rate of payment varies according to an assessment of
the individual's need.

The Accommodation Supplement provides people with assistance in meeting their
housing costs. Eligibility is subject to income and asset testing. The
supplement provides a 65% subsidy on accommodation costs over the entry
thresholds up to a maximum rate depending on where the accommodation is located.
A significant concern for older people whose only income is New Zealand
Superannuation is that, because the Accommodation Supplement meets only 65% of
any rent or mortgage increase, the balance of any increase must be met by
reducing expenditure on other items such as food, heating or health care.

Special Needs Grants and Loans are available to all beneficiaries,
superannuitants and low income earners who are facing financial difficulties.
Special Needs Grants do not have to be repaid and can be granted for items such
as food. Superannuitants are also eligible to apply for a loan on their
superannuation to pay for items such as bond and rent or essential home repairs.
Special Needs Grants and advances are subject to income and asset testing to
determine whether the individual could reasonably be expected to meet the cost
themselves.

War Pensions

The War Pensions Act 1954 comes under the portfolio of the Minister in Charge
of War Pensions. The Department of Social Welfare is responsible for both the
administration and policy development for War Pensions. War Pensions provide war
disablement pensions and a variety of concessions for men and women whose
disability is either due to, or aggravated by, war service.

To be eligible, a person must have served with the forces in New Zealand or
overseas prior to 1974 (when the Accident Compensation Act came into effect) or
in a war or an emergency. Eligibility is not income or asset tested and a War
Pension can be received in addition to New Zealand Superannuation or Veterans
Pension. While most war pensions currently paid relate to service in the Second
World War, Vietnam War, and Korean War, the Minister in Charge of War Pensions
recently declared that service with certain New Zealand Peacekeeping forces will
also meet the criteria for a War Pension.

Comment A relatively small number of superannuitants receive supplementary
forms of assistance. The 1994/95 Household Expenditure Survey indicated that
approximately 20% of superannuitants are totally reliant on New Zealand
Superannuation. It is possible that some of these people may be eligible for,
but not currently in receipt of, supplementary assistance. A possible
explanation for this may be a lack of knowledge about assistance that is
available. Another factor is that many older people say that they do not like
borrowing money and try to meet costs from within their income rather than
seeking extra assistance. It is expected that the development of Super Centres
through the Income Support offices will improve access to information about
assistance provisions for superannuitants.

In addition, the Senior Citizens Unit considers it important that
supplementary forms of assistance that are available to superannuitants are
appropriate to the needs of older people. In particular, income support
provisions should support government policies which encourage older people to
remain in their own homes for as long as possible. The Senior Citizens Unit
considers that policy work in this area should be a priority.

Policy
Issues

Surcharge

Entitlement to New Zealand Superannuation is universal and 96% of people of
eligible age receive some New Zealand Superannuation or the Veterans Pension.
However the surcharge, which is administered by the Inland Revenue Department,
provides a targeting mechanism which has the effect of reducing the net amount
of New Zealand Superannuation in relation to other income received. Statistics
available from the Inland Revenue Department for the 1994/95 income year show
that approximately 4% of superannuitants paid all their New Zealand
Superannuation back through the surcharge.

In December 1995, Accord Parties announced an increase in the surcharge
thresholds which took effect from 1 July 1996. In addition to this change, the
Taxation (Superannuitant Surcharge Reduction) Act was passed by Parliament in
August 1996. The legislation significantly increases the surcharge thresholds.
The increase takes effect from 1 April 1997 and will allow a couple's gross
income to be about ten percent above average ordinary-time earnings. A couple
will be able to earn a total income of up to $34,900 per year before their New
Zealand Superannuation is reduced and a single superannuitant will be able to
earn a total income of up to $23,300 per year. The Act will reduce the estimated
percentage of superannuitants who are subject to the surcharge from about 29% to
14%, reducing or eliminating the surcharge paid by over 100,000 superannuitants.

Superannuation Surcharge Thresholds (per week)

The superannuitant surcharge is 25% on top of a superannuitant's ordinary tax
for income over the amounts shown in the table below.

Single
Couples
Previous Threshold From 1 July 1996 From 1 April 1997
$80 $90 $198
$120 $135 $297

    The superannuitant surcharge has remained a contentious government policy
    with superannuitants. Grey Power New Zealand, the national organisation
    representing superannuitants, has been particularly active in lobbying for the
    complete removal of the surcharge and has publicly commented that the new
    adjustment to the surcharge thresholds is still not satisfactory. Grey Power New
    Zealand is still in favour of the complete removal of the surcharge.

    The Accord requires that a targeting mechanism be applied to publicly
    provided retirement income but that this mechanism should not act as a
    disincentive to people saving for their retirement. Consultations undertaken by
    the Senior Citizens Unit over the previous three years have also shown that many
    older people believe that any private savings that have been made during working
    life should not be the subject of targeting for New Zealand Superannuation.

    Consumers Price Index for superannuitants

    The Accord states that the purchasing power of New Zealand Superannuation
    should be maintained by annually adjusting the after-tax rates of payments of
    New Zealand Superannuation by the same percentage as the change in the Consumers
    Price Index (CPI). The Veterans Pension is also increased annually in line with
    the CPI.

    However, there has been consistent pressure in the past from older people for
    the development of a price index with weightings reflecting the spending
    patterns of superannuitants. The Todd Task Force looked at this issue and
    recommended that increases in the level of New Zealand Superannuation be in line
    with movements in the CPI, until a robust alternative price index was introduced
    that more accurately reflected the mix of goods and services purchased by
    retired people.

    Statistics New Zealand began producing a Superannuitants Price Index (SPI) in
    1995. This index measures the changes in prices of a fixed group of goods and
    services purchased by superannuitants. Price movements in the SPI can be
    compared to those in the CPI showing whether prices of items bought by
    superannuitants change similarly, slower or faster than those purchased by all
    New Zealand householders.

    The results in the SPI show that superannuitant households spend a greater
    proportion of their expenditure on food, personal and health care, housing,
    housing operation and transport compared with the average New Zealand household.
    A smaller proportion of superannuitants' total expenditure was shown to be spent
    on apparel, credit services, tobacco and alcohol, and recreation and education
    services.

    A consultative period was held on the SPI, and Statistics New Zealand are
    currently refining the SPI in light of comments received from interested
    parties. It is important to note that the SPI could not be used to adjust the
    rates of superannuation without the agreement of Accord Parties and a change to
    existing legislation.

    Delivery Issues

    Super Centres

    Superannuitants comprise over half the client base of the Department of
    Social Welfare's Income Support offices. In recognition that older clients often
    have different needs and expectations of service delivery, Income Support has
    developed the concept of Super Centres providing a specialised client-focused
    service for older people. The Senior Citizens Unit has worked closely with
    Income Support in the development of the Super Centre concept.

    While Super Centres are primarily deliverers of income support services to
    older people, they also provide a one-stop shop offering information on a
    range of services for older people. Super Centre staff have developed strong
    community networks, enabling them to make appropriate referrals in response to
    client needs. The Senior Citizens Unit has been involved in the development of a
    training package specifically for Income Support officers working in Super
    Centres.

    The specific information needs of older people and the importance of the
    older sector are gradually being acknowledged by information providers. The
    Senior Citizens Unit views the development of Super Centres as a very positive
    step both for the Department and in meeting the information needs of its older
    clients.

    Future Directions

    Costs of sustaining retirement income policies combined with the ageing
    population will remain major issues to be taken into account in the future
    development of retirement income policies. The Accord on Retirement Income
    Policies provides for Periodic Reports to be delivered to the Government at six
    yearly intervals with recommendations on the future development of retirement
    income policies. The first Periodic Report will be prepared in 1997 and will
    provide comment on whether the emerging trends of public and private provision
    of retirement income are appropriate in terms of adequacy, efficiency, equity
    and sustainability. The Periodic Report will also suggest where adjustment of
    any of the retirement income policies is desirable.

    Parties to the Accord on Retirement Income Policies have requested that a
    study be undertaken, as part of the work for the Periodic Report, on the
    standard of living of superannuitants and the adequacy of their income. Accord
    Parties have invited the Retirement Commissioner to develop a work programme
    that would see this study undertaken. The Senior Citizens Unit supports such a
    study being undertaken and believes that it could provide valuable information
    on the income needs and living circumstances of superannuitants. Information
    provided by the 1997 Periodic Report on Retirement Income Policies will inform
    on trends in the retirement income levels of older New Zealanders.

    A relatively small number of superannuitants receive supplementary forms of
    assistance. It is important that supplementary forms of assistance that are
    available to superannuitants are appropriate to the needs of older people. The
    Income Support Super Centres are very important in ensuring that superannuitants
    have access to all the information they need in order to obtain their correct
    entitlements. Income support provisions should enhance government policies which
    encourage older people to remain in their own homes for as long as possible. The
    Senior Citizens Unit considers that policy work in this area should be a
    priority.

POSITIVE AGEING


Key
points

  • Older people have skills, experience and knowledge to contribute to society.
  • Continued productivity in older age has benefits for the individual concerned, the community and the State.
  • Changing attitudes about ageing and older people is the first step to promoting positive and productive ageing.
  • Intergenerational activities provide opportunities to dispel myths about ageing and older people.
  • Participation of older people in society is a key work area of the Department of Social Welfare.
  • The Prime Ministerial Task Force on Positive Ageing will present its final recommendations to Government by December 1997.
  • 1999 is International Year of Older Persons and the Senior Citizens Unit expects to play a major role in Government's response.

Positive Ageing Policies

The increasing older population throughout OECD nations provides a challenge
for governments to develop and implement policies to prepare for the expected
economic and social effects of the population change. Retirement from the paid
workforce means that more time is available for leisure activities, family
commitments, community involvement and volunteer work. For those who have not
been employed in the paid workforce, retirement of a spouse may affect how they
use their time. Educational, recreational and leisure programmes encourage older
people to remain fit and healthy for as long as possible, thus reducing the
demands on costly health services. Similarly, policies which allow older adults
to continue in the paid workforce not only maintain the self-esteem of the
individuals involved, but also help to reduce financial dependence on the State,
and contribute to economic growth.

Attitudes to Ageing

Ageing is a lifelong process. The concept of positive ageing embraces a
number of variables including health, financial security, independence,
self-fulfillment, community attitudes, personal safety/security and physical
environment. The underpinning premise is that the years of "older age" should be
both viewed and experienced positively. The focus is therefore not only
on the experience of older individuals, but also on younger generations'
attitudes, expectations, and actions regarding ageing and older people. The
ability to age positively requires an understanding of the ageing process and
making adequate preparation for older age.

At the present time, images of ageing are typically negative, with older
people portrayed as frail, depressed and lonely. Debate surrounding the ageing
population tends to focus on the burden of the ageing population, particularly
relating to the high costs of health care needed by older people. However, the
OECD reports that the stereotype that closely links ageing with infirmity is
unfounded and that the health characteristics of most people in their 60's and
in their 70's are broadly similar to the rest of the adult population. There are
enormous health variations within each older age group ranging from people with
hardly any impairment to people with severe disability. Changing attitudes about
ageing and older people is the first step to promoting positive and productive
ageing.

The development of intergenerational programmes is a powerful strategy for
changing attitudes about ageing. The geographic spread and mobility of families
today means that many children do not have grandparents living nearby, and their
experiences of older people are often restricted to the mainly negative images
of older people portrayed in the media. Intergenerational programmes provide
opportunities to dispel the negative myths about older age and to recognise the
contributions older people make to their community.

In New Zealand, the 1988 Royal Commission on Social Policy noted that as a
consequence of better living standards, people approaching retirement today are
healthier and live longer than their predecessors and have the ability to
actively participate in the labour force. The Royal Commission report concluded
that retirement often brings a loss of status and loneliness; and a withdrawal
from community life and social activities.

The concept of "productive ageing" recognises the life skills and experiences
of older people and encourages older people to continue to contribute these to
society. Retirement from the paid work force does not mean that people cease to
contribute to society - it provides opportunities for participation in different
ways and in a range of roles: as employees; volunteers; family members;
neighbours; caregivers; committee and trust members; kaumatua; and members of
communities. Continued productivity in older age has benefits for the individual
concerned, the community and the State.

Australian Response

Internationally, governments are beginning to recognise that fact that older
people make a significant contribution to society. A recent Australian
Government document, Continuing Participation in Community Life - The Australian
Government's Commitment to Older People, notes that it is Government's
responsibility to assist older people to live healthy, active lives. The
document states:

"This strategy involves a new approach to the development of policies for
older Australians, based on a recognition of the important roles played by older
people in the community - in family life, in provision of services and in
promoting harmony between generations. Policies which promote people remaining
active and involved members of society will also help people maintain
independence and dignity."

New
Zealand Strategies for Positive Ageing

The concept of positive ageing has been the primary focus of Age Concern New
Zealand, a national organisation promoting older people's interests. This
organisation, in particular, has been responsible for raising the issue within
government agencies. Age Concern Councils throughout New Zealand are active in
promoting local initiatives which demonstrate the contributions older people
make to the community.

There are a number of government agencies with a particular focus on
developing and implementing strategies to promote positive ageing. These include
the Prime Ministerial Task Force on Positive Ageing, the Department of Social
Welfare, the Senior Citizens Unit, and the Hillary Commission, and are described
below. In addition, successful initiatives developed by older people's
organisations in New Zealand, including the Retired Persons Association, Age
Concern Hamilton, University of the Third Age, the New Zealand College for
Seniors and SeniorNet, are also outlined.

Prime
Ministerial Task Force on Positive Ageing

The Prime Ministerial Task Force on Positive Ageing was established in May
1996 in response to requests from organisations representing older people's
interests which expressed the need for New Zealand to prepare for an ageing
population. The Task Force's terms of reference require it to work towards
Government's objective of developing public consensus on:

  • "the environment necessary to ensure people move through their life cycle
    towards a healthy, independent, safe, secure and dignified old age in which they
    are able to participate in and contribute to society, to the extent of their
    ability and wishes, and enjoy the respect and support of their families and
    communities; and
  • the measures that need to be taken by individuals, families, local
    communities, employers, voluntary organisations and Government to achieve this
    end."

The Task Force is chaired by Sir Ross Jansen and other members are Mr David
Harrison, Professor David Richmond, Ms Sue Suckling and Mr Alan Nixon (ex
officio). The Task Force is expected to:

  • review existing work in the field of positive ageing, including domestic and
    international literature;
  • identify all issues relevant to positive ageing, including the effects of
    current government policies;
  • consult widely with the public, older people's representatives, service
    providers, government and non-government agencies, professionals, researchers
    and any other bodies or individuals with relevant knowledge;
  • develop options which will ensure a favourable environment for positive
    ageing;
  • consult widely on the options developed; and
  • develop final recommendations for presentation to Government by 30 December
    1997.

The Task Force produced a consultation booklet "Facing the Future" which it
used as the basis for identifying relevant issues during the first phase of
nationwide public consultations held in July and August 1996. The planned second
stage will involve the preparation of an Options publication and another series
of public consultations during January to March 1997.

It is expected that the implementation of the Task Force's recommendations,
contained in its final report to Government, will involve significant policy
work for the Senior Citizens Unit, other parts of the Department of Social
Welfare and other government agencies.

Department of Social Welfare

Apart from the fact that the Senior Citizens Unit is part of the Department
of Social Welfare, the Department itself, through Vote:Social Welfare, has a
significant relationship with the older people of New Zealand. Through its role
in paying New Zealand Superannuation, almost all of the older population of New
Zealand are clients of the Department. In addition, the Department's role in
dispensing the Community Services Card and financial assessment for targeting
disability support services provides an interface with older people's access to
the health sector.

The Department is working to the government outcome "that social welfare
policies and practices support older people to live independently and facilitate
the participation and contribution of older people in community life". In
addition, Key Result Area (KRA) 3 in the Director-General's Performance
Agreement with the previous Minister of Social Welfare required the Department
"to develop and implement strategies across business units to ensure that Social
Welfare services are prepared for growth in the size of the older New Zealand
population, and that ageing is seen in a positive light by older people
themselves and the wider community."

Positive Ageing Strategy

The Department is developing a Positive Ageing Strategy in conjunction with,
and complementary to, the broader government-wide positive ageing strategy. The
Vision for the Department's Positive Ageing Strategy is:

"That older people are encouraged and supported to remain self reliant,
and that they continue to participate and contribute to the well-being of
themselves, their families, and the wider New Zealand community."

Key strategies for moving toward the vision are:

  • encouraging New Zealanders to plan for a positive and self reliant retirement;
  • encouraging and supporting older people to stay independent for as long as they are able;
  • encouraging and supporting older people to participate in and contribute to the wider community; and
  • promoting positive attitudes to ageing throughout New Zealand society.

While the actions below these strategies and measurable goals have yet to be
fully developed, the Department is already involved in activities that support
them. These include:

Super Centres

Income Support has developed the concept of "Super Centres" to provide a
specialised client-focused service for older people, who comprise over half of
its client base. The establishment of 38 Super Centres over the next four years
is planned and it is envisaged that Super Centres will expand beyond their
income support service role to provide information on a range of issues and
local services available to older people.

The Senior Citizens Unit has worked closely with Income Support in the
development of the Super Centre concept and the Unit has been involved in the
development of the training package for staff. Super Centre staff have developed
strong community networks, enabling them to make appropriate referrals in
response to client needs.

Keeping Independent Now (KIN) Programme

The Keeping Independent Now (KIN) programme was developed as a local
initiative by the Sydenham/Riccarton Income Support office. The Goal of the
programme is: "to assist our NZ Superannuation customers to achieve
self-sufficiency and to maintain independence in the community".

The programme is a partnership between Income Support, Age Concern, and the
RHA-funded provider of home support services. Seminar sessions for older people
provide information about the services and income support provisions available
to assist them to remain in their own homes. Income Support customers aged 75
years and over, or those less than 75 years in receipt of a Disability
Allowance, are sent personal invitations to attend the seminar, and transport is
provided if necessary. Local community and interest groups are also invited to
the seminars to and widen the information available to customers and to increase
promotion of the concept.

An evaluation of the programme found that KIN highlighted the need for
superannuitant customers to be fully informed about the services and support
provisions available in both the health and income support areas. Older people
reported that the seminars gave them a clear understanding of those services
and, as a result, a number of adjustments have been made to some people's
support provisions to further assist their ability to remain living
independently. Due to the success of the Sydenham/Riccarton pilot, KIN is now
being promoted and extended to other Income Support offices.

Senior
Citizens Unit Initiatives

The concepts of "positive ageing" and "productive ageing" permeate
throughout much of the work undertaken by the Senior Citizens Unit. The Unit has
developed a number of specific initiatives, with Age Concern New Zealand and
other agencies, to promote positive attitudes to ageing by:

  • celebrating the diversity of older people;
  • encouraging the development of intergenerational activities between older
    and younger people;
  • promoting well-being in older age; and
  • promoting full participation of older people in community life.

Examples of these initiatives include:

International Year of Older Persons 1999

1999 has been designated the United Nations International Year of Older
Persons and it is expected that New Zealand will join with other nations in
celebrating this significant time. In order to assist government decisions on
how the Year will be celebrated in New Zealand, the Senior Citizens Unit has
undertaken preliminary planning and is preparing a report for Cabinet
consideration. It is anticipated that the Unit will play a major role in the
overall co-ordination of the New Zealand Government's response to this
international year.

International Day of Older Persons

1 October each year is the United Nations International Day of Older Persons.
The Unit works with older people's organisations to promote activities on the
Day which demonstrate the value of older people in the community. It is expected
that celebrations of International Day of Older Persons each year will gradually
build up towards the national celebration of International Year of Older Persons
in 1999.

Greats and Grands Month

The Unit promotes each October as "Greats and Grands Month" to highlight the
role of grandparents and other older people who have a significant role in
family life. Schools throughout New Zealand are contacted and encouraged to
organise intergenerational activities. The Unit offers information to assist
schools to develop and organise local events.

Guidelines for Intergenerational Programmes

The Senior Citizens Unit is working with Age Concern New Zealand, the
Ministry of Youth Affairs and other interested parties on the development of
guidelines for intergenerational programmes. The guidelines will be based on
those developed for Police Volunteers and will provide advice and information on
recruitment, safety, training and management issues.

Police Volunteers Guidelines

The New Zealand Police, in conjunction with the Senior Citizens Unit and Age
Concern New Zealand have developed guidelines for police stations wanting to
utilise the skills and expertise of older people. These guidelines have now been
incorporated into Police national procedures.

Information Service for Older People

The Senior Citizens Unit is working with the New Zealand Community Funding
Agency and Income Support to examine options for a nationwide information and
referral service for older people. This project stems from the 1992 national
"Age Wise" conference, held to look at strategies for providing information to
older people and promoting life-long learning. The conference recommended the
establishment of a national co-ordination centre to provide information on
educational, recreational and cultural opportunities for older people. Two
feasibility studies commissioned by the Department of Social Welfare have
subsequently confirmed the value of such a service for older people. It is
proposed that the service be based around an information database and a
free-phone service.

Information to Publications

The availability of accurate and relevant information to older people is
recognised as an important factor contributing to their well-being. The Senior
Citizens Unit provides articles on policies and initiatives relevant to older
people and their carers to the quarterly publications of Age Concern New Zealand
and Grey Power New Zealand.

Hillary Commission

The Hillary Commission for Sport, Fitness and Leisure is a government sector
organisation with the aim of: "Improving quality of life by enabling all New
Zealanders to participate and achieve in sport, fitness and leisure." The
Commission co-ordinates an "Active-in-Age" programme which encourages people
over the age of 50 years to be more physically active. The Commission funds
seventeen Regional Sports Trusts which include Active-in-Age Co-ordinators whose
role is to promote local recreational opportunities for older people. Activities
organised include aquafitness, walking groups, fun festivals, and rest home
activities. The Hillary Commission also supports and promotes masters' and
veterans' sports.

Non-Government Organisations

Age Concern New Zealand Age Concern New Zealand is a non-governmental
organisation which aims to promote the rights and well-being of older people and
those who care for them. Its mission is "to work together to promote quality of
life for older people" and its key objectives are to:

  • empower older people to achieve equality and quality of life;
  • ensure the availability of services and opportunities to meet the needs and
    aspirations of older people;
  • promote understanding and positive attitudes towards older people and the
    ageing process; and
  • foster an age-integrated society in which adults acknowledge a shared
    responsibility for the welfare of people of all ages and work together to
    achieve that objective.

Age Concern New Zealand comprises 38 Age Concern Councils, which provide a
range of services to older people and their carers. Each week, about 4,000 Age
Concern volunteers provide services for over 12,000 older people. The Councils
also raise awareness about positive ageing and the needs of older people.

Age Concern Hamilton

Age Concern Hamilton has been particularly active in promoting positive
ageing and, in Hamilton each year, hosts a major "Age-on-the-Go" public event to
demonstrate the many activities undertaken by older people in the community. Age
Concern Hamilton has developed a variety of intergenerational programmes with
local schools including student visits to house-bound older people and older
people's participation in early childhood, primary and secondary school
activities. Last year, Age Concern Hamilton launched a positive ageing display,
video and educational resource kit called "A Wrinkle in Time". The kit has been
purchased by many schools throughout New Zealand, indicating their interest in
establishing intergenerational programmes.

Retired Persons Association

The Retired Persons Association of New Zealand developed Senior Achievers'
Awards to recognise the considerable voluntary work provided by older New
Zealanders. The Senior Citizens Unit provided advice and support to the Retired
Persons Association during the establishment of the awards. The annual awards
are sponsored by Trustees Executors and the Minister for Senior Citizens has
presented the awards since their establishment in 1995.

University of the Third Age

One initiative to promote lifelong learning is the University of the Third
Age (U3A), a concept which was first developed in France in 1972 and has since
spread around the world. There are twelve U3A groups in New Zealand, six of
which are in the Wellington area. Through U3A courses, older people share their
knowledge, skills and experiences with their peers. All of the teaching,
planning and administration is carried out by U3A members.

New Zealand College for Seniors

The New Zealand College for Seniors offers a programme of live-in courses for
people over 50 years of age at universities and polytechnics around the country.
In addition, the College organises and promotes tours to other countries. The
aim of the College is to provide continuing stimulation in a non-threatening,
fun environment with other people of like age and interest.

SeniorNet

SeniorNet is a voluntary non-profit educational and communication service
offering older people opportunities to: learn practical computer skills in a
friendly enjoyable way; add to the quality of their lives by helping them to
learn new practical skills in communication; make new friends; and use modern
technologies in communication to help younger members of their families and
community services.

Future Directions

The growth in the older population has significant policy implications for
all nations throughout the world. In developed nations in particular, there is
widespread concern about expected increases in health and retirement income
expenditure due to the ageing population. However, improved health status of
older people and increased life expectancies means that they are able to
continue to contribute to society in ways which may not have been possible for
previous older cohorts. It is important that government policies across the
range of issues, including employment, health, housing and income support, allow
and encourage older people to experience ageing as a positive and productive
phenomenon.

The twin concepts of positive ageing and productive ageing are closely
inter-related. The benefits of positive ageing for individuals are obvious; good
health, independence, intellectual stimulation, self-fulfillment and friendship
are just some of the valued outcomes of positive ageing. Society as a whole also
has a lot to gain from these outcomes: a healthy, happy, ageing population
places less demands on social services; contributes a wealth of expertise and
skills to the community and the workforce; and provides positive role models for
younger generations.

Changing media images of older people is an important strategy to break down
barriers which restrict older people's abilities to continue to contribute to
society. The development of intergenerational programmes is essential to dispel
the negative myths and stereotypes of ageing.

A stable and secure income in retirement is recognised as an essential
prerequisite for people to be able to age in a positive and productive way. A
lack of adequate income has negative effects on health and on the ability of
older people to remain active participants in society. In New Zealand, the
Accord on Retirement Income Policies aims to provide this security and encourage
future generations of older people to prepare for their retirement so that they
are able maintain a reasonable and secure standard of living.

Employment and labour reforms are another necessary component to encouraging
continued contributions of older people in society. From 1 February 1999,
compulsory retirement on the basis of age will be prohibited in terms of the
Human Rights Act. This change in legislation signals the reforms which are
necessary in order to achieve an environment where contributions of older people
in the workplace are valued. The choice to work later in life, using flexible
part-time arrangements is of central importance to meeting the active ageing
challenge. The evidence suggests that those who work longer enjoy better health
in their old age. The policy conclusion is clear: it is imperative to maintain
people in gainful activity longer. In order to achieve this objective, it will
be necessary to ensure that education and training policies are adapted to the
specific needs of older workers.

The OECD notes that ageing populations create four fundamental challenges for
public policy:

  1. Fiscal. Changes are required to fiscal policy to prevent the need for large
    increases in government spending.
  2. Market responsiveness. The need to create a policy framework within which
    labour and capital markets can be responsive to changes resulting from shifting
    demographics.
  3. Encouraging active ageing. Helping people to stay active, flexible and
    self-reliant as they age.
  4. Balancing collective and individual responsibilities.

These are major inter-related challenges. The Department of Social Welfare
has taken a lead in meeting these challenges through its Positive Ageing
Strategy. Because of its expertise and its position in the Department of Social
Welfare, the Senior Citizens Unit will continue to play a significant role in
the Department's Positive Ageing Strategy which is being developed for the next
ten years.

The above-mentioned and other policy issues are expected to be raised by the
Prime Ministerial Task Force on Positive Ageing when it reports to Government by
December 1997. The Task Force is expected to advise Government on a strategy for
ensuring a comprehensive policy response so that ageing in New Zealand is a
positive experience. It is important that policy developments occur in other
agencies and that these are co-ordinated in a coherent way. The Department of
Social Welfare has the expertise, experience, commitment and existing interface
with other government agencies, community organisations, the private sector and
older people to take the lead in government responses to an ageing population.
It is expected that the Senior Citizens Unit will have significant involvement
in the work that arises from the recommendations from the Task Force.

HEALTH


Key
points

  • People aged 65 and over are major users of health services.
  • The cost of providing health services to older people is increasing, partly as a result of the ageing population.
  • New Zealanders are living longer, however it is not clear whether increased longevity is matched by improved health status.
  • Promoting health and well-being throughout the life stages is an important strategy for improving the health of the older population.
  • Recent Government policy has been to support the concept of ageing in place and to promote community care options in preference to expensive residential care.

Introduction

In 1994, the population aged 65 and over comprised 12% of the total
population, while it accounted for 40% of all health costs. People aged 65 and
over are major users of health services and older people are a growing
proportion of the population. This will present significant challenges to the
health care infrastructure and has profound funding implications for Government.

While the OECD reports that most people in their 60's and early 70's share
many of the same health and social characteristics as younger adults, after the
age of 60, average personal health care expenditure grows steeply, with
preliminary estimates suggesting that per capita expenditures around age 70 are
twice the average, peaking to four times higher for those aged 80 and above. New
Zealand health data shows that from age 85 the cost per head is approximately
eight times that for adults aged 45 to 64 years.

The most significant feature of the ageing population, in relation to health
expenditure, is that the most rapid increases will occur amongst the "old-old"
(those aged 80 years and over), who will grow by 17 percent (16,750 persons) in
the five years to 2001 and 37 percent (41,950) in the decade to 2011. By this
time, the "old-old" will make up 28 percent of the population aged 65 and over.
By the year 2031, people aged 80 and over are expected to number 259,300.

A major contributor to the increased cost of health care for older people is
expenditure on residential care services, such as long-term rest home or
hospital care. The OECD states that the increases in expenditure are less
pronounced in other areas such as consultations with physicians,
pharmaceuticals, medical appliances and other ambulatory services. Some of the
most expensive chronic conditions such as dementia occur mainly in older age. An
analysis of the cost of health care for older people illustrates that major
health expenses are directly related to chronic illness and incapacity, much of
which does not occur until very old age.

Health
Status

To date, there has not been a definitive study of the health status of older
people in New Zealand, although older people are regarded as the age group most
likely to experience poor health and/or disability. A study undertaken by
Statistics New Zealand in 1992-93, found that 70% of people aged 65 years and
over reported either a diagnosed or self-identified long-term illness or
disability, compared with around one-third of the overall sample. Even so,
nearly three-quarters of older people reported their health as either
"excellent" or "good".

The survey demonstrates a disparity between individual's perceptions of their
health status and popular perceptions of relative health and disability. For
example, a person may have impaired mobility, requiring them to use a walking
stick, but may nevertheless consider themselves to be in excellent health and
able to maintain an independent life-style.

The Ministry of Health has commissioned two surveys on the health of New
Zealanders; A New Zealand Health Survey and A National Nutrition Survey. The two
surveys, to be run from October 1996 to November 1997, will provide the Ministry
of Health and Regional Health Authorities (RHAs) with information on which
health services can be planned and programmes developed.

Life expectancy has increased significantly in recent decades. For instance,
between 1980-82 and 1990-92 life expectancy at birth for men and women increased
by 2.5 and 2.3 years respectively. However, it is not clear whether increased
longevity has been matched by improved health status. Three competing theories
dominate international debate in this area:

  1. as people live longer, the ratio of "well' to "disabled" years will remain
    relatively unchanged;
  2. improvements in technology means that fewer years will be spent "disabled";
    and
  3. more years will be spent "disabled" as improvements are unable to keep pace
    with gains in life expectancy.

At the current time, there is little research to support any one of these
theories over the others. However, it would appear that the third theory fits
contemporary evidence best. That is, while people live longer "well", they also
live longer "disabled".

As noted above, chronic ill-health is generally concentrated among the very
old, particularly in the year or two preceding death. While physical changes do
take place throughout the ageing process, much of the physical decline commonly
associated with older age can be attributed to inactivity, rather than the
"ageing process". The OECD notes that the health characteristics of most people
in their 60's and on into their 70's are broadly similar to the rest of the
adult population.

The incidence of mental disorders does appear to increase with age,
especially for conditions such as Alzheimer's Disease and related dementias. It
is estimated that 10% of people aged over 65 have some form of dementia and that
this figure rises to 20% in the 80 plus population. By 2001, it is estimated
that there will be 45,000 people in New Zealand with dementia. It is anticipated
that the incidence of dementia will further increase in line with the forecast
growth of the older population, particularly in the 80 and over age group.

Older people receive hospital care at higher rates than younger adults, and
have longer average stays in hospital. From 1986 to 1991, hospital discharge
rates for people aged 75 and over rose by around 30% compared to a 16% increase
in number of people in this population cohort. The increase in hospital
discharge rates cannot, therefore, be attributed entirely to an increase in the
cohort size.

In summary, while some older people may experience increased ill-health as
they age, there is considerable individual variation in the health status of
older people. For this reason, it is important that old age is not treated as a
medical condition.

Maori
health status

The Public Health Group of the Ministry of Health is at present preparing an
issues paper, "Health of Older People and Kaumatua Well-Being", which will be
ready for public consultation early in 1997. A study of the well-being of
kaumatua is being undertaken by Massey University for Te Puni Kokori and the
Ministry of Health which should provide better information on what factors
contribute to well-being for older Maori. An analysis of submissions and hui
that contributed to the Public Health Commission's document, He Matariki (1995)
identified that the contributors believed that the major determinants of Maori
public health status were social and economic.

Maori life expectancy is lower than that for European/Pakeha New Zealanders
but is, nevertheless, improving. In 1950-52, a Maori baby girl had a life
expectancy of 56 years, compared to the 72 years that a non-Maori baby girl
could expect to live. A Maori baby girl born in 1990-92 could expect to live 73
years, compared with 79 years for her non-Maori counterparts. Maori males have
also experienced improved life expectancy, from 54 years in 1950-52 to 68 years
in 1990-92. However, the difference in life expectancy between Maori men and
Maori women has widened.

The causes of death which accounted for most of the differences in life
expectancy between Maori and non-Maori in the 1985-87 period were circulatory
disease, respiratory disease and cancer, particularly lung cancer. Subsequently,
rates for hospital care for Maori aged over 65 are higher than for non-Maori of
the same age, with hospital rates for respiratory and circulatory diseases being
particularly high.

Health
Promotion

Addressing the issues of health and well-being at each of the life stages is
an important strategy for improving the health of the older population. Health
promotion needs to start at an early age, recognising that an individual's early
life-style impacts on their future health and well-being. Such a strategic
approach, while not producing immediate results, will have a significant impact
in the longer term.

Demographic factors, socio-economic status, the physical environment, food
and nutrition and other life-style factors such as physical activity all have an
influence on health status. These determinants may act alone, but more generally
interact. For example, demographic factors such as gender and ethnicity may also
influence an individual's socio-economic status and together these factors
combine to determine health status. The responsibility for the promotion of good
health must therefore be shared across a range of sectors.

Significant work on health promotion with older people was undertaken by the
Department of Heath from 1985-91. This work was continued by the Public Health
Commission, however, the Commission was disestablished in 1995. While the
Ministry of Health considers that many of the Commission's programmes will be
continued under the current structure, the focus on older people's issues in the
short-term appears to have lost some momentum.

Many government agencies have a potential policy role in health promotion.
The housing issue, in particular, is one that can be directly linked to health.
For frail older people, unsatisfactory accommodation can mean increased
likelihood of moving into residential care rather than remaining in the
community. While government health policies encourage older people to remain in
their own homes, there are few specific housing policies which support this
objective. Such incongruencies in government policies need to be addressed.

The Hillary Commission for Sport, Fitness and Leisure is one example of a
government agency that has embraced the health promotion concept. Its aim is to
improve quality of life by enabling all New Zealanders to participate and
achieve in sport, fitness and leisure. The Commission's "Active-in-Age"
programme, which promotes local recreational activities for older people, has
gained international recognition.

While the OECD notes that it is possible the baby boom generation may reach
old age in far better health than did their predecessors, as a result of their
better education and information about healthy life-styles, this is nevertheless
dependent on sustained investment in educational programmes and preventative
measures.

Health Services

Since 1992, health services for older people have been delivered through two
systems; personal health services and disability support services. If an older
person has an illness requiring acute care, their needs are addressed through
personal health services, but if their condition has stabilised and is expected
to continue for at least six months, services are provided through disability
support services.

Both personal health services and disability support services are funded
through the RHAs, although the funding streams for these two services are
distinct. The separation of funding for the two areas has had service delivery
implications. Health professionals involved in the review of the assessment
protocol reported that services for older people had become fragmented since the
separate funding regimes had been introduced.

Rather than ensuring that clients are provided with an appropriate mix of
services, the current system has the potential to encourage cost-shifting
between the two funding streams, resulting in delays in service delivery.
Comment from older people suggests that, in some areas, cost-shifting has become
a reality. Discussions with geriatricians and feedback from organisations
representing older people indicate that greater co-ordination between these
services is necessary to ensure the effective utilisation of health funding for
this age group.

Disability support services

Access to disability support services is largely controlled by way of an
assessment protocol. In order to receive disability support services, older
people must be assessed by Assessment, Treatment and Rehabilitation Units, of
which there are 22 in the country, to determine the level of care and the
services they need. Disability support services purchased through RHAs can also
be subject to income and/or asset testing.

A national protocol to assess the support needs of older people was
introduced in July 1993 to ensure that services would be provided only to those
who were assessed as needing them. While the assessment protocol is an important
control mechanism, there is considerable regional variation in the waiting times
for assessment and for service provision. RHA guidelines stipulate that a needs
assessment should take place within two weeks following contact with the
assessment service. A survey of RHAs undertaken by the Advisory Council for
Senior Citizens in mid-1996 showed that, in some areas, older people were
waiting for more than 12 weeks to be assessed.

The continued viability of needs assessment-based disability support services
is dependent on adequate resources being available to ensure that older people
receive the services they are assessed as requiring. Comments frequently made by
older people and health professionals indicate that service delivery is not
consistent throughout the country.

Residential care

At the current time, 60% of the disability support services budget is
ring-fenced for services for older people, and 90% of this expenditure is
attributed to the Residential Care Subsidy. The high level of expenditure on
residential care is due not to a large volume of older people in residential
care, but to the high cost associated with the provision of residential
services. It is estimated that only 7.4% of people aged 65 and over, or 31,000
individuals, are in residential care.

These figures support the OECD analysis which identifies expenditure on
residential care as the major contributor to the increased cost of health care
for older people. Residential care services have an important place in the
overall health framework providing intensive, specialised services to those
older people experiencing chronic ill-health in their latter years. Given New
Zealand's ageing population and, in particular, the forecast growth in the over
80's age group, the demand for residential care services is likely to increase.

The current focus of policies in the residential care area has been to
tightly target the services to those people who are no longer able to continue
living in their own home or with a caregiver. A Residential Care Subsidy is
provided to assist older people who are assessed as requiring residential care
and who meet the criteria of an income and asset test. Regional health
authorities contract with rest homes and private hospitals to care for older
people who are assessed as being eligible for the Residential Care Subsidy. One
of the contract conditions is that the provider agrees to only accept residents
who have undergone a needs assessment. The reason for this policy is to prevent
private-paying people being inappropriately admitted to residential care
facilities who, at a later point, may then require a Residential Care Subsidy.

Home-based services

Current government policy is to promote community care which will assist
older people to remain living in their own homes for as long as possible. This
policy is in line with a general desire among older people to remain living in
the community. Home-based services currently funded by RHAs include meals on
wheels, cleaning and personal care services for bathing, dressing, and feeding.
The provision of home-based support services for older people with a significant
disability is not only desirable from a social perspective, it is also
attractive in economic terms. North Health RHA estimates that it is
cost-effective to keep someone at home with up to the level of 34 hours of
home-based care per week.

Targeted access to residential care has meant that the demand for community
care is increasing dramatically and RHAs are looking at how to best meet this
demand within a capped budget. With the growth of New Zealand's older population
and the increased geographical spread and mobility of families, the requirement
for home-based services is expected to further increase. An adequate level of
funding for these services is therefore essential.

Personal health services

Personal health services received by older people are essentially the same as
those provided to the general population. The main issue of concern to older
people is the waiting times, particularly for elective surgery such as cataract
and hip replacement operations.

While the Unit is not aware of any data on the opportunity cost of delayed
surgery, it is reasonable to assume that such costs would be considerable, and
could include items such as income support, home care services, hospital care,
residential care and other health and social services. There are also social
costs as older people in this situation would have less opportunity to continue
to contribute to their community and family.

The National Health Committee, formerly the National Advisory Committee on
Core Health and Disability Support Services, is working in conjunction with RHAs
to produce standardised criteria for assessing patient priority. In making these
decisions, there is a need to take into account the opportunity cost of delaying
surgery. It is therefore important that health planners have access to robust
data on opportunity costs on which to base their assumptions on how services
should be prioritised.

Future Directions

The forecast increase in older New Zealanders, in particular those aged 80
and over, will have a major impact on the country's health services. Early
co-ordinated planning is needed to determine how best to cope with this
demographic change.

Health promotion strategies, implemented throughout the life stages, will
have an important role in improving the health status of future generations of
older people. Health promotion policies need to recognise the multiple
determinants of health status and a co-ordinated approach should be adopted
across a broad range of government agencies.

A co-ordinated inter-agency approach is also essential to the development of
broader positive ageing strategies. For instance, if health policies are
promoting ageing in place, then housing polices need to be congruent with this
objective. The need for better co-ordination between government and
non-government agencies has been raised at consultations undertaken by the Prime
Ministerial Task Force on Positive Ageing. Any recommendations that the Task
Force may make in response to this concern will be particularly pertinent to
health issues.

More immediately, current tensions in health service delivery, apparently
caused by the separate funding streams for disability support services and
personal health services, should also be addressed. Greater co-ordination of
service delivery in these areas is essential for the well-being of older people.

While high levels of expenditure on residential care are expected to remain a
feature of disability support services for older people, it is essential that
funding for home-based services is sufficient to meet the needs of an increased
number of older people who will live longer, and to mitigate against the use of
residential care in circumstances where community support could sustain living
in the community.

Advancing technology, medical knowledge and pharmacology continue to increase
the range of procedures and medications that can improve the quality and length
of life in older age. The expectation of many older people, as with other
sectors of the population, is that they will have access to publicly-funded
health services as they need them. It is anticipated that despite the work in
defining core health services, public debate will continue on priority areas for
health expenditure. Ultimately, public opinion will influence decisions on the
level of resources allocated to health.

HOUSING


Key
points

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  • 93% of older people live in their own households and expect to remain there as long as possible.
  • Government policies are needed to support older people to remain in their own homes or to move to more appropriate accommodation.
  • Different groups of older people have specific housing needs.
  • The cost of home maintenance and local authority rates can cause significant hardship for older home owners.
  • Older tenants are finding it difficult to afford market rents.

Introduction

Most older people prefer to remain in their own homes rather than moving
into residential care. Recent government health policies promoting home-based
support services have responded to older people's expectation that they will
continue to live in their own homes for as long as possible. It is important
that older people have appropriate housing to support this policy direction.

Older people's housing needs include a safe and comfortable environment, low
maintenance and well-sited dwellings with easy access to shopping, transport,
recreational and community facilities. Among the most vulnerable groups in the
housing market are frail older people, older women living alone, older Maori,
older Pacific Islands people and those for whom New Zealand Superannuation is
their only source of income.

Housing
Demographic Information

Geographical location

People aged 65 and over made up 11.4% of the total population in the 1991
Census. This proportion was not evenly distributed between geographical
districts. While some people retire in the community where they have been
living, others move to areas that offer specific lifestyle options. Areas with a
significant percentage of older people are the Kapiti Coast, Thames-Coromandel
and Tauranga. In these regions, there is likely to be a greater demand for
housing and other services that meet the needs of older people than in other
regions.

Dwelling type

In 1991, most people aged 65 years and over lived in private dwellings, with
only seven percent living in rest homes, hospitals or similar accommodation.
Those living in residential care were mostly aged 80 and over. Only 2% of people
aged 65 to 69 lived in residential care compared with 13% of people aged 80 to
84 years and half of those aged 90 or older. Most older people in private
dwellings live in separate houses, but older people are more likely to live in
flats or houses that are attached to others.

Living arrangements

In 1991, 50 percent of people aged 65 and over who were residing in private
dwellings lived with a spouse or partner, and one third lived alone. A further
12 percent lived with their children or siblings. Of men aged 65 and over, 18%
lived alone, whereas 44% of women lived by themselves. The likelihood of living
alone increased with age; approximately half of all those 80 years and older
were living alone. Older Maori and older Pacific Islands people were more likely
to be living with their children or siblings than other ethnic groups.

Issues
Facing Older People Who Rent

In 1991, 12% of older people lived in rental accommodation. Affordability is
the most significant factor influencing older people when deciding the type of
rental housing in which to live. The other factors are availability and supply
of housing. The small number of two bedroom units means many older renters live
in bedsits or one bedroom units which may not meet their needs. In a bedsit, a
tenant's living room is combined with their bedroom, which can make it
embarrassing to entertain visitors, particularly for older women. A bedsit or
one bedroom unit can restrict social contact with families and the ability of an
older person to remain independent. The lack of facilities for caregivers to
stay during periods of illness can lead to unnecessary overnight, or longer-term
entry, into hospital or residential care facilities. On the other hand, the lack
of large rental properties can make it difficult for older members to live with
their extended family.

The cost of moving is a significant inhibitor to older people changing their
accommodation. These costs include advance rental payments, rental bond, energy
supplier connection charges, telephone connection costs, and actual removal
costs. The cost factor is a particular barrier to older people whose only income
is New Zealand Superannuation.

There are gender and cultural differences in housing tenure:

  • fifteen percent of women aged 75 and over live in rented accommodation
    compared with 11% of men of the same age; and
  • older Maori and older Pacific Islands people are more likely to live in
    rented accommodation than their Pakeha counterparts. Factors contributing to
    these differences include the generally lower average income level of Maori and
    Pacific Islands peoples and cultural expectations of providing financial support
    to family and their communities. This means less income is available for home
    purchase. As a result, many older Maori and older Pacific Islands people have
    significant housing costs in either rent or mortgage payments.

Recent changes to government housing policy which have seen the removal of
government incentives for low income earners to purchase homes, including the
removal of subsidised home loans, may result in a future generation of older
people who do not have equity in a residential property. This indicates a
possible higher demand in the future for rental properties suitable for older
people.

Housing New Zealand tenancies

Housing New Zealand is the major provider of public housing for New
Zealanders of all ages. Its role is both to manage public housing on a
commercial basis and to contribute to the Crown's social policy objectives of
facilitating access to rental housing for those on low incomes. The recent trend
has been for Housing New Zealand to sell more properties than it purchases.
Forty-three percent of older tenants rent from Housing New Zealand. As part of
the housing reforms, rents for Housing New Zealand properties have gradually
been increased to market rates. Community organisations report that these higher
rents have caused significant affordability problems for older people. With the
move to market rents, Housing New Zealand introduced a policy of "matching"
tenancies, reinforced through higher rentals for larger properties, to encourage
single tenants and couples who lived in three or four bedroom homes to move to
smaller homes or units.

Tenure protection policy

Recognition of the difficulties older people face in moving house or leaving
established community networks led to the introduction of a tenure protection
policy as part of the housing reform process. Under this policy, Housing New
Zealand or Te Puni Kokiri tenants who were resident at 1 October 1992 and were
aged 65 and over, or those with significant disabilities, are not required to
move and a Tenure Protection Allowance (TPA) is provided if their rent is higher
than the average for the region.

Until recently, the TPA was only available while tenants remained in the
property they occupied at 1 October 1992. This was causing considerable
financial difficulty for those tenants who, because of a change in
circumstances, had moved. Since 1 October 1996, tenants who receive a TPA and
wish to move have been able to apply for a Special Transfer Allowance. The
allowance is calculated as the difference between the tenant's new rent and the
average rent for the region, but cannot be greater than the applicant's TPA
prior to moving. The TPA is an interim provision only and is not available for
tenants who turned 65 years after 1 October 1992.

55 Plus provisions

The 55 Plus provisions have been introduced by Housing New Zealand to target
tenants who are approaching retirement age. The provisions are designed to give
tenants rent stability for three years while they make decisions about their
future accommodation. Many of those eligible are also receiving a Transitional
Retirement Benefit. To be eligible for the 55 Plus provisions, the principal
tenant, or their partner, must be aged 55 or over and have lived in their
present tenancy since 30 July 1991. Under these provisions, the tenant's rent
cannot be raised above the average regional rent, or their existing rent if this
is greater, for three years as from 1 July 1995.

Local authority pensioner housing

At 22 June 1996, there were 13,959 local authority pensioner units which
housed 28% of older people who lived in rental accommodation. Eighty-two percent
of tenants in local authority pensioner housing units had annual incomes of less
than $15,000. Although each local authority owns some pensioner housing units,
the distribution of pensioner housing varies significantly between local
authorities.

Comments received from older people indicate that they prefer pensioner
housing units to be sited in community settings, rather than in distinct
pensioner housing areas which can be isolated. Although many local authority
pensioner units are either bedsits or have only one bedroom, a number of local
authorities are modifying these units as part of refurbishment programmes to
better meet the needs of older tenants.

Most local authority pensioner housing units were built with the assistance
of low interest government loans. As a result of the housing reforms, the
interest rates on these loans were raised to market rates. Since then, there has
been considerable public concern that local authorities may consider selling
their pensioner housing units.

A survey undertaken by the Department of Internal Affairs in 1995 indicated
that the majority of local authorities had no plans to sell pensioner housing.
The survey found that only 60 pensioner housing units had been sold in the
previous five years and further investigations by the Advisory Council for
Senior Citizens found that the money from these sales was used either to
purchase more appropriate units or for refurbishing existing pensioner housing.

While it appears that most local authorities are committed to retaining
existing pensioner housing, there is no evidence that they are planning to
increase pensioner housing stock. With an ageing population, there will be
greater demand in the future for housing designed to meet older people's needs.

Privately owned rental accommodation

Twenty percent of older tenants rent privately owned accommodation. The
number of older people living in privately owned rental accommodation is likely
to rise because:

  • there will be more older people;
  • it appears that the level of public housing stock will not be increased; and
  • an assumption cannot be made that the current level of home ownership in New Zealand will be maintained.

Accommodation Supplement

The Accommodation Supplement was introduced on 1 July 1993 as the main form
of government housing assistance. It provides for a 65% subsidy for rental
outgoings which exceed 25% of household income or, in the case of home-owners, a
65% subsidy for regular housing expenses which exceed 30% of household income.
The Accommodation Supplement is subject to a cash assets test undertaken by
Income Support which determines entitlement and the level of assistance, as
follows:

  • for a single person, the cash assets exemption is $2,700 and those with cash
    assets over $8,100 are not eligible. Assets between $2,700 and $8,100 reduce the
    level of Accommodation Supplement by one dollar for each $100 of cash assets;
    and
  • for couples, the cash assets exemption is $5,400 and those with cash assets
    over $16,200 are not eligible. Assets between $5,400 and $16,200 reduce the
    level of Accommodation Supplement at the same rate as for a single person.

These asset levels are of concern to older people for the following reasons:

  • most older people try to keep some money aside for emergencies, or to give
    them the dignity of paying for their own funeral costs. About $5,000 is the
    usual sum older people put aside for funeral costs. This is considerably more
    than the lower asset level set for a single person receiving the Accommodation
    Supplement;
  • an older single person receiving the Accommodation Supplement, who has
    $5,000 in cash assets would have their Accommodation Supplement abated by $5.75
    per week because of their savings. The effect of this reduction would be that
    they would have to use their cash assets to meet their accommodation costs. The
    gradual reduction in cash assets could leave insufficient savings to cover their
    funeral costs or other expenses; and
  • these asset levels are considerably lower than those set for financial
    assistance for long-term residential care, which are $6,500 for a single person,
    $13,000 for couples where both partners are in care and $40,000 for a couple
    where one partner remains living in the community.

A survey in 1996 found that superannuitants who were eligible for the
Accommodation Supplement had a much lower take-up rate, 55%, compared with
beneficiaries who had a take up rate of 78%. The take-up rate for eligible older
tenants was 74% but it was only 15% for eligible older homeowners. This
indicates that there are a large number of older people, especially home owners,
who are entitled to the Accommodation Supplement, but who are not receiving it.

Issues Facing Older Home Owners

In 1991, 76% of those aged 65 and over lived in a mortgage-free private
dwelling and a further 9% owned their home with a mortgage. The major housing
issue facing older home owners is meeting costs such as home maintenance, local
authority rates and home alterations.

Older people who have lived in their own home for many years are often faced
with major home maintenance. For frail older people or older women living alone,
who are unable to do their own repairs, even small house maintenance tasks can
be expensive. In some areas, non-governmental organisations, such as Age Concern
Councils and the Retired Persons Association, operate volunteer schemes to
assist older home owners with minor home repairs and maintenance. However, such
assistance is not available nationwide. The costs of, or difficulties associated
with, home maintenance can contribute to:

  • older people living in substandard or unsatisfactory accommodation; and
  • the increased likelihood of a frail older person moving into residential
    care rather than remaining in the community.

For some older home owners, the values of their properties have increased
dramatically over time, but with retirement their incomes have declined. This
means that an older person's annual rates bill may be a significant cost for
them.

Assistance For Home Owners

Advances for home repairs

Superannuitants can apply for an advance on their New Zealand Superannuation
to meet the cost of home maintenance and repairs. The maximum advance is $1,000
however there is discretion to vary this if circumstances warrant. No interest
is charged on these advances and the total advance is generally required to be
repaid within two years, although this period is negotiable. Older people who
are totally reliant on New Zealand Superannuation are likely to find it
difficult to repay advances.

Grants for home alterations

Regional health authorities (RHAs) provide grants to older people with
disabilities who need to make essential home alterations, for example for
hand-rails, ramps, and for kitchen, plumbing, or electrical alterations. The RHA
will provide a grant for alterations that cost between $200 and $7,900 with
terms and conditions set by the RHA. Grants for alterations that cost more than
$7,900 are subject to an income and asset test.

Rates rebate scheme

Low income residential ratepayers can apply to their local authority for a
rebate on their annual rates. These applications are assessed against
eligibility criteria agreed to by Government, including an income test. Once the
rebates have been granted, the local authority applies to the Department of
Internal Affairs for reimbursement through the Rates Rebate Scheme. Thirty-three
percent of those receiving a rates rebate are single superannuitants living
alone.

The number of ratepayers receiving rebates has declined substantially, from
102,000 in 1976 to 3,600 in 1994/95, as the scheme's income limit has not kept
pace with increases in wages, benefits and New Zealand Superannuation. During
the Department of Internal Affair's annual review of the Rates Rebate Scheme in
1994, it was suggested that the Scheme be abolished. The Senior Citizens Unit
was among the government agencies that advocated retaining the scheme until
further policy work was undertaken to ensure that government housing assistance
was appropriate for older home owners on low incomes. The scheme has been
retained, but there have been no changes to the eligibility criteria.

Papakainga loans

The Housing Corporation provides loan finance at commercial rates for people
to build on land which has multiple ownership. This loans programme has been
utilised by some iwi to build kaumatua flats and is a financing option for older
Maori who wish to return to their papakainga when they retire. However, the
process of getting approval from the local authority and other owners can be
time consuming and complicated. As well, many papakainga sites have no road
access and services or are in isolated areas which can make building a house
more expensive.

Accommodation Supplement

Home owners with regular housing-related outgoings of more than 30% of their
income can apply for the Accommodation Supplement. As most older home owners do
not have a mortgage, few will meet this threshold. This means that the
Accommodation Supplement is unlikely to provide assistance to many
superannuitants with high home maintenance or rates costs.

Home Equity Conversion

Many older home owners, especially those who are mortgage-free and whose
only source of income is New Zealand Superannuation, are asset rich but income
poor. Home equity conversion provides an opportunity for older people to convert
some of the value of their home into income. The Housing Corporation trialled a
pilot scheme (Helping Hand Loans) during 1990-91 which allowed older people to
convert the equity in their home to help with housing expenses. An evaluation of
the scheme found it was satisfying an unmet need in the market at that time
however the scheme was not continued.

A private company, Invincible Life Assurance, offers a range of Reverse
Annuity Mortgage (RAM) products which allow the homeowner to borrow money in the
form of a monthly annuity, based on the age of the homeowner and the value of
their house. Investigation of this option by the Advisory Council for Senior
Citizens found that the schemes' high compound interest rates resulted in a
rapid loss of equity in the home for the client. Some lawyers and real estate
companies also offer home equity conversion arrangements.

Older people are generally supportive of the concept of home equity
conversion, but hesitant to enter schemes which are promoted by private
enterprise. This may be because of overseas experience where the failure of some
home equity conversion companies forced participants to sell their homes. For
this reason, older people want Government to underwrite home equity conversion
schemes or to establish a scheme, through the Housing Corporation, to enable
older people to use this option.

Home equity conversion options could provide older home owners with
additional income to pay for home repairs and local authority rates. This could
assist them to remain in their own homes longer and prevent crisis situations
which may result in a move into residential care. It also could reduce
applications by superannuitants for supplementary assistance.

The Department of Social Welfare administers government policy which provides
for the equity of a person's home to be used towards the cost of residential
care services, through registration of a caveat on the home. An extension of
this policy to support older people to live as long as possible in their own
homes is an option which the Department will consider as part of its strategy to
encourage older people to maintain their independence.

There are, however, possible fiscal implications for Government from such a
policy. Should older home owners who have taken advantage of a home equity
conversion option later require residential care, there could be a reduction in
the equity of their home which may be required to meet the cost of residential
care. Conversely, keeping up the value of the home through home maintenance can
protect the value of the asset. In conclusion, given that the percentage of
older people requiring residential care is small and that it is possible only a
small proportion of residents will use home equity conversion, the fiscal risk
to Government is likely to be minimal.

Other
Types of Housing

Retirement villages

An increasing number of retirement villages are being built by private sector
companies. These facilities are promoted as providing security, maintenance,
medical backup, and recreational facilities. There is usually a minimum entry
age of 55 years and those living in retirement villages are mainly active older
people, who require little medical or other outside assistance. Many retirement
villages have residential care facilities so that residents can remain in the
village if they become frail. Residents pay a market rate for their unit, which
is repurchased by the village trust when the owner leaves or dies.

A taskforce was set up by the retirement village industry in 1992 to make
recommendations for an ongoing regulatory regime for retirement villages and to
increase the protection of the residents. The taskforce has reported to the
Securities Commission which is considering its recommendations.

Kaumatua housing

Government assistance for the construction of kaumatua flats was introduced
in the 1960's in recognition of the generally poor standard of living
accommodation available to older Maori in rural areas. Kaumatua flats were
mostly built near marae, and occupied by older people of Maori descent, usually
of the local iwi.

In line with the housing reforms, responsibility for these units and their
mortgages has been transferred to local marae committees. For many of these
properties, the mortgage is equal to the total construction cost of the units
and does not reflect the market value of the property. This has placed
substantial financial pressures on marae committees. There are a number of
criticisms about the design and location of the units. Most of the units have
one bedroom which means that there is no room for mokopuna (grandchildren) or
caregivers to stay.

Abbeyfield houses

The Abbeyfield concept was developed in the United Kingdom and provides a
housing option for older people who are living alone, but do not want to be on
their own. Abbeyfield houses accommodate between eight and ten residents each of
which has their own bedroom and en-suite. Other facilities are shared and meals
are provided by a cook/housekeeper. The house is run by a committee of
volunteers from the local community. Two Abbeyfield homes are operating in New
Zealand: the first one was built in Nelson in 1992; and a second home was opened
in Masterton in 1996. Committees have been established in other centres and
planning is underway for more houses. The level of rent is set so that it can be
met from the resident's New Zealand Superannuation and Accommodation Supplement
payments.

Future
Directions

The housing needs of older people are varied and depend on factors such as
whether an older person owns their home or lives in rented accommodation and the
person's gender, ethnicity, level of income and health status.

Recent changes to housing policy which have seen the removal of government
incentives for low income earners and subsidised home loans may result in a
future generation of older people who do not have equity in a residential
property.

Affordability of housing is a factor for older people on low incomes. Older
people have higher costs in other areas, such as health expenses, when compared
with younger age groups. In addition, people live on their retirement income for
several decades with little opportunity to earn more income. Community
organisations report that older people with high housing costs often reduce
their expenditure on other essential items such as heating and food in order to
meet fixed costs, such as rental payments. This is detrimental to their health
and well-being and often precipitates the need for expensive hospital or
residential care services.

Older people have an expectation that they will continue to live in their
home for as long as it is possible and home support services have been developed
to support this expectation. There is an assumption that an older person's home,
in which they have lived during their life, will still be safe, affordable and
appropriate as they get older.

Present government health policy promotes community care through the
provision of home support services. Unless accommodation is appropriate, the
provision of home support services will not be enough to ensure a frail older
person can remain in their own home. There is a need for other government
policies to be developed to support older people to remain in their own home or
to move into more appropriate accommodation.


COMMUNITY SUPPORT SERVICES


Key
points

  • The growing older population, in particular those aged 80 and over, requires community support services to enable older people to remain in their own homes.
  • No government agency has responsibility for funding non-health related community support services for older people.
  • The Lottery Aged Distribution Committee is the major source of funding for non-government organisations providing community support services for older people.
  • The level of Lottery Aged funding has decreased at the same time as the older population has increased.
  • Community support services require a permanent source of funding.
  • Funding for non-health related community support services for older people should be the responsibility of the New Zealand Community Funding Agency.

Introduction

ome support services, such as meals on wheels, cleaning, and personal care
services for bathing, dressing and feeding, are defined as core disability
support services and are therefore funded through regional health authorities.
These services enable older people to remain living in their own homes for as
long as possible.

Community support services, include lawn mowing, home maintenance, assistance
with shopping, social support, transport, outings and the provision of advice.
These services are generally provided by volunteers working for community
organisations. The services provide practical support to assist older people to
remain active and independent. For this reason, they are just as important as
health-related services.

Demand for community support services is steadily increasing. The growing
pressure for these services is a result of:

  • the growth in New Zealand's older population, and in particular people aged 80 and over;
  • older people's expectations that they should be able to live in their own homes for as long as possible;
  • recent government health policies which have encouraged and supported older people to live in their own homes, rather than moving into expensive residential care; and
  • the geographical spread and mobility of families, which often prevents families from providing informal care to their older members.

Because community support services are not defined as core health or disability support services, there is an expectation by the health sector that these services for older people are the responsibility of the non-government sector. However, many community organisations are reporting that they are finding it increasingly difficult to fund these services and to attract sufficient volunteers to provide them.

Current Sources of Funding

The main funding source for community support services for older people is
the Lottery Aged Distribution Committee of the Lottery Grants Board. Other
sources of funding available to community organisations are the Community
Organisations Grants Scheme (COGS), philanthropic trusts, corporate sponsorship
and local fund-raising. Regional health authorities (RHAs) at present only fund
core health and disability support services. The New Zealand Community Funding
Agency (NZCFA) of the Department of Social Welfare does not have a funding
allocation for services for older people, although some of the community
services it funds are used by older people.

Lottery Aged funding

The Lottery Aged Distribution Committee makes grants to non-profit
organisations for projects which improve the physical, mental and social
well-being of older people. Lottery Aged provides salary subsidies as well as
funding for travel, administration, equipment and volunteer expenses. Priority
for funding is given to projects which provide support for older people to
enable them to remain in the community. The Senior Citizens Unit provides
information to the Committee on services which meet the needs of older people in
the community.

Over the last decade, while the funding available for distribution through
the Lottery Grants Committees has increased substantially, the funding allocated
to Lottery Aged has decreased since Fiscal 1991/92.

  • In 1991/92, 22.55% ($5.75 million) of the total funding for Lottery Grants
    Committees was allocated to Lottery Aged.
  • In 1994/95, 3.05% ($3.8 million) of the total funding available to Lottery
    Grants Committees was allocated to Lottery Aged.
  • In 1996/97, 2.67% ($3.7 million) of the total funding available to Lottery
    Grants Committees was allocated to Lottery Aged.

There are two issues of concern. Firstly, while there is a major growth in
the older population, the level of funding available through the Lottery Aged
Distribution Committee has decreased. Secondly, because there is no government
agency responsible for funding community support services to maintain older
people in their own homes, the Lottery Aged Distribution Committee is being
called on to fill this role.

Due to the uncertainty of its annual budget, the Lottery Aged Distribution
Committee only provides funding on an ad hoc grants basis. This has created
difficulties for community organisations, particularly at a time when demand for
community support services is growing. Lottery Aged cannot adequately fund
community support services at the present time and, in attempting to meet the
demands, it is disadvantaging older people's organisations seeking funds for
other purposes. The nature of its funding base and the breadth of its funding
mandate means it is inappropriate for the Lottery Aged Distribution Committee to
be the major source of funding for community support services.

Community Organisation Grants Scheme (COGS)

COGS is funded through Vote:Internal Affairs and its aim is to "help
community organisations provide essential social services to disadvantaged
people within their local community". Older adults are listed among the people
that COGS would particularly like to help. COGS does not give ongoing project or
service funding, but rather provides a small amount of funding to community
groups on a one-off basis. Applications to COGS far exceed the funds which local
COGS committees have available to allocate. According to comments received
during Senior Citizens Unit consultations with older people, COGS is the
preferred source of funding for groups providing services for older Maori
because they say their applications are more likely to be successful.

Philanthropic trusts

In the past, philanthropic trusts provided significant funding to community
organisations. However, voluntary organisations state that it is much more
difficult to obtain funding from this source due to increased competition for
funds. As a result, community organisations are receiving less funding from this
source. There are also major geographical variations in the availability of
trust funding. Because of pressure on available funds, trusts tend to favour
one-off or short-term projects.

Sponsorship from corporate bodies

Over recent years, an increasing number of community organisations have
approached corporate bodies for sponsorship of specific projects. Funding from
this source tends to be for high profile activities or for resource material,
rather than for the provision of community services.

Other Issues Raised by Community Organisations

Uncertainty of funding

In addition to the increasing difficulties faced by community organisations
in obtaining funding to provide services, uncertainty over ongoing funding makes
it difficult for organisations to plan services. The Lottery Aged Distribution
Committee does not guarantee ongoing funding for projects. However, it is
currently looking at options which would provide greater security of funding for
established community organisations.

Attracting volunteers

Community organisations rely on the goodwill and labour of their volunteers
and are facing increasing difficulties in attracting and retaining volunteers.
This trend is partly the result of the following changes in family roles:

  • women with young families, who traditionally provided a pool of volunteer
    labour, are now tending to return to the paid workforce;
  • women are remaining longer in the paid workforce; and
  • older family members, another traditional source of volunteer labour, are
    increasingly providing support such as caring for grandchildren, to enable their
    adult children to undertake paid employment.

Recognition and reimbursement of volunteers

At consultations held by the Senior Citizens Unit, volunteers often commented
that they felt their services were being taken for granted and that increasingly
more was expected from them. While most volunteers do not wish to receive
payment for their work, there is general agreement that volunteers should not be
out of pocket as a result of that work. The Senior Citizens Unit has found that
many people are not aware that organisations can apply to Lottery Aged for funds
to reimburse volunteers' expenses, such as transport, parking and phone calls.
Lottery Aged has now included reference to this provision in its publicity
material.

Lack of funding for purchase of vehicles

Prior to 1993, Lottery Aged provided funding for community groups to purchase
vehicles, although this was given a lower priority than funding other projects.
In 1993, the policy was changed and funding is no longer available for vehicle
grants. Concern about this policy change has been raised with the Senior
Citizens Unit by a number of Maori and Pacific Islands groups. Lack of transport
is a barrier to older Maori and Pacific Islands people taking part in cultural
activities or accessing support services such as day care which provide
essential social contact for them. This issue has been discussed at Ministerial
level but no changes have been made to the policy. As the issue is of ongoing
concern for these groups in particular, the Unit will continue to pursue a
change in this policy.

Future Directions

The demand for community support services for older people is increasing. Factors contributing to this demand are:

  • New Zealand's ageing population, especially the projected increase in those aged 80 and over;
  • the expectation that older people will live in their own homes most of their lifetime; and
  • the reduced ability of family, particularly women, to provide support for older members due to changing employment patterns and increased geographical spread and mobility of families.

Community support services are mostly provided by non-government
organisations which are facing increasing difficulties obtaining funding and
attracting volunteers.

Funding for community support services for older people is inadequate,
currently provided on an ad hoc basis through the Lottery Aged Distribution
Committee. Lottery Aged has a significant role in funding older people's
organisations, but the funding of essential community support services is not
its responsibility.

Although government policies encourage older people to remain in their own
homes, there is no government agency responsible for funding non-health related
services to support this policy. Regional health authorities are responsible for
funding core health and disability services, but these do not include community
support services. However, community support services are just as important as
health-related services in maintaining older people in their own homes.

The New Zealand Community Funding Agency (NZCFA) was established to manage
Vote:Social Welfare's funding responsibilities to non-government organisations
which provide services to meet Government's policy objectives. At the time of
its establishment, NZCFA was not funded for services for older people as
responsibility for these had been transferred to the Ministry of Health as part
of the health reforms.

A specific funding programme for community support services, distinct from
health-related services, should be established by the New Zealand Community
Funding Agency to meet the increased demand for these services, to reinforce
government policy direction, and to provide for greater sustainability of
service provision by non-government organisations. Additional money would be
required from Government to establish a new funding programme for this purpose.

TRANSPORT


Key
points

  • Mobility is an important factor in enabling older people to remain healthy
    and active.
  • Adequate and appropriate transport systems are needed for older people to
    access services and facilities, take an active part in community activities and
    keep contact with friends and family.
  • An older driver, passenger or pedestrian is more likely to be injured or
    killed in an accident than a younger person.
  • The number of older drivers in New Zealand is expected to increase
    significantly over the next few decades.
  • The requirement for people over the age of 70 to renew their driver's
    licence is currently under review.
  • The needs of older pedestrians are often ignored in town and road planning
    and in the design of shopping centres and community facilities.

Introduction

Mobility is an important factor in enabling older people to remain healthy
and active. Adequate and appropriate transport is needed for older people to
access services and facilities, take an active part in community activities and
keep contact with friends and family. The loss of a driver's licence can have a
major impact on an older person's independence and can lead to feelings of loss
of self-worth.

The publication of "The Older Road User" by the Land Transport Safety
Authority (LTSA) in 1994 and recent policy work on transport disadvantage by the
Ministry of Transport have given the transport needs of older people a higher
profile. The Advisory Council for Senior Citizens has taken a specific interest
in this area and has prepared submissions to the LTSA on relevant public
discussion documents. Public Transport Use of public transport increases with
age and is greater among older women than older men. Lack of public transport or
a reduction in services can increase the isolation of older people. This has
been confirmed during consultations which the Senior Citizens Unit has held in
rural areas, where older people have mentioned that lack of rural public
transport means difficulties in getting to medical appointments, banks and
Income Support offices. In city areas, suggestions from older people have
included that bus routes be more user friendly and that smaller, more frequent
bus services be considered.

In response to public demand, many local bus companies are considering better
ways of meeting the needs of passengers who have difficulties with mobility. The
technology of buses has improved in recent years and options now include ultra
low floor buses which eliminate the need for passengers to climb several high
steps when entering or exiting; and "kneeling" buses in which the floor can be
lowered to the level of the kerb. For older people, these types of buses will
help make public transport more accessible.

Accessible public transport is essential to assist older people to remain
active and to enable them to travel to services and facilities. For this reason,
it is important that those planning public transport systems consult with older
people, as well as other client groups, about their requirements and preferences
as part of the planning process. In addition, maintaining regular contact with
users will enable planners to keep track of changing needs.

Older
Drivers

At 1 April 1996 , approximately 140,000 people over the age of 70, or 54% of
this age group, held a driver's licence. The proportion of the older population
holding a driver's licence is gradually increasing. This, in conjunction with
the ageing population, means that over the next decades there will be a
substantial increase in the number of older drivers.

Reported road accident rates for older people on a population basis are
similar to those in the middle age ranges. On the other hand, older people drive
shorter distances than other age groups and the accident rate per kilometre
driven is higher than the rest of the population. This higher accident rate
could be due to the fact that an accident involving an older driver is more
likely to result in injury and therefore the accident is more likely to be
reported. In general, older drivers follow safe driving practices more often
than younger drivers. They are more likely to wear seat belts and less likely to
drink and drive.

Over the last 15 years there has been a gradual relaxation of the testing
requirements for drivers over 70 years of age, with no significant change in the
accident injury rates. At present, 30,000 people over the age of 70 reapply for
a driver's licence each year with a pass rate of 98%.

Driver licensing provisions

Sections 37 and 38 of the Transport (Driver's Licensing) Regulations 1987
contain the following provisions requiring people aged 71 and over to regularly
renew their driver's licence.

  • During the month of their 71st birthday, drivers are required to present a
    medical certificate, including an eyesight test, in order to renew their
    driver's licences. The licence issued is valid for five years.
  • On reaching age 76, drivers are required to renew their licences again. This
    involves both a medical certificate and a short practical driving test.
  • After age 76, drivers must renew their licences each year. An annual medical
    certificate is required and they must sit a practical test every second year.

The cost of licence renewal is $17.50 if a practical test is required and $9
when only a medical certificate is needed.

The Land Transport Safety Authority is currently reviewing the driver
licensing provisions, including those related to older drivers. It has issued
discussion papers on the topic and sought public comment on whether these
provisions should be changed. The main issues for discussion are that:

  • the current relicensing provisions do not identify drivers under 71 years of
    age who have a disability or illness that renders their driving unsafe;
  • safe and competent drivers aged over 70 years are penalised by being
    required to undergo additional, and what can be costly, driving and medical
    tests;
  • compulsory testing does have the benefit of prompting a decision from people
    aged over 70 as to whether they continue to drive. It is likely that some older
    drivers voluntarily cease driving as they approach the time for re-testing
    either by their own decisions or as a result of persuasion from families,
    doctors and licensing authorities; and
  • the provisions of the Human Rights Act 1993 which prohibit discrimination on
    the basis of age will apply to government agencies from the end of 1999. This
    means that if age is to be used as the criteria for relicensing, a sound case
    will need to be made for an exemption from these provisions in the Act.

The other regulation of specific interest to older drivers concerns driver
competency and is contained in section 45A of the Transport Act 1962. Under this
section, medical practitioners and optometrists must advise the Land Transport
Safety Authority if they believe that a person whom they consider is unfit to
drive will continue to drive against their advice. This advice can lead to
revocation of a client's driving licence. It appears that this regime is not
applied universally or consistently by medical practitioners and optometrists,
and so the effectiveness of this strategy is limited.

The Land Transport Safety Authority anticipates that by the end of 1996, its
review of relicensing provisions for older drivers will be completed and a
proposed option will be available for public discussion.

"Safe with Age" driver education programme

The Land Transport Safety Authority has developed an education programme for
older road users, entitled "Safe with Age". The programme discusses how ageing
changes can affect driving skills, updates driving knowledge and introduces
defensive driving concepts. Older people are trained as facilitators and use
activities, discussions and a video to present the programme to their peers.
Although the programme has proved very popular and appears to be effective, the
actual number of older people who have attended the course is low.

Transport Needs of Kaumatua and Kuia

A further issue that has been raised at a number of consultations held by the Senior Citizens Unit is the transport needs of kaumatua and kuia. The responsibilities and obligations of kaumatua and kuia require them to travel to hui and tangi. In the past, a number of kaumatua groups and marae committees have received funding from the Lottery Grants Board Committees, including Lottery Aged, to buy vans. A decision in 1993 to no longer fund the purchase of vehicles has removed this avenue of funding assistance. The Senior Citizens Unit has raised this concern with Lottery Aged and the Minister of Internal Affairs on a number of occasions. There has, however, been no change to this policy.

Transport Assistance

Financial assistance for transport and concessions for older people or people
with disabilities are provided by a range of agencies. Some transport providers
such as airlines and bus companies provide concession tickets or reduced fares
for superannuitants. An older person with a disability may be eligible to
receive a Disability Allowance from Income Support to assist with some transport
costs.

Total Mobility Scheme

The Total Mobility Scheme is available to people who, because of a
disability, have difficulty using buses. The scheme provides clients with
vouchers that they can use to claim a half-price discount on taxi fares. It also
provides funding for wheelchair hoist vehicles. Total Mobility was initially set
up by the Disabled Persons Assembly but is now administered by regional
councils. Applicants are referred for assessment to an agency which supports
people with disabilities and if approved, applicants are provided with the
discount taxi vouchers they require.

Operation Mobility

To assist drivers or passengers with limited mobility, New Zealand CCS
operates Operation Mobility, a parking concession scheme for people with
physical disabilities. Obtaining a Mobility Card requires verification by a
medical practitioner that the applicant has a relevant physical disability or
medical condition; and payment of a $28.50 administration fee. People with a
temporary disability resulting from an accident or illness are entitled to a
temporary card.

Local concession tickets

In Palmerston North and Wanganui, the Manawatu-Wanganui Regional Council
provides concession tickets for people it defines as transport disadvantaged. In
these two centres the provision of urban bus services has been contracted to
local taxi companies. Large city buses have been replaced by minibuses which are
also used by the companies to provide taxi services. Other regional councils are
investigating similar schemes. Comments from Wanganui indicate that many older
people have found it difficult to get in and out of the minibuses because of the
high step up into the vehicles.

Volunteer transport schemes

In many centres, community organisations such as Age Concern councils and the
Country Women's Institute run volunteer transport schemes. Volunteers involved
in these schemes drive older people who require transport to doctors' and other
appointments or to local activities or groups for older people. Many of the
volunteers are older people.

Older
Pedestrians

Walking is an important means of personal transport for older people. Older
people are over-represented in pedestrian accident figures. In 1991, 20% of all
pedestrians hospitalised following an accident with a motor vehicle and 34% of
all pedestrians who died were aged 60 years or more. The high ratio of deaths to
injuries reflects the increased fragility of older people who are much more
likely to be seriously injured or killed if they are hit by a vehicle, than a
younger person in the same circumstances.

Apart from injury caused by vehicles, hazards for older pedestrians include:

  • uneven or broken footpaths;
  • children riding bicycles or skateboards on footpaths;
  • poor street lighting; and
  • traffic signals at crossings often provide insufficient time for older
    people to cross an intersection safely.

In designing shopping centre parking areas, the needs of pedestrians are
frequently forgotten. Reaching shops often requires walking around parking
vehicles, crossing busy main roads and navigating obstacles such as speed humps
and low walls.

Good design and maintenance can eliminate many of the dangers for
pedestrians. Provision of more public seats at bus stops, in parks and on the
roadside would provide more places where older pedestrians could rest. Some of
the requirements of older pedestrians may conflict with the interests of other
road users. For instance, longer pedestrian signal crossing times create longer
delays at red lights for motorists.

National Land Transport Strategy

At present the Ministry of Transport is developing a National Land Transport
Strategy. The purpose of this strategy is to develop long term land transport
goals and policy objectives, and measurable targets for achieving these
objectives. It will cover safety, transport disadvantage, economic
sustainability and environmental factors. Consultation on the strategy began in
July 1996 and the Ministry of Transport plans to release a draft for public
discussion by 30 September 1997, with the final strategy being launched in May
1988.

Future
Directions

There is considerable policy work relevant to older people being undertaken
in the transport area. The Land Transport Safety Authority has sought public
comment on licensing provisions for older drivers and it is expected that it
will decide to further relax these. The provisions of the Human Rights Act 1993
may have an impact on age restrictions for licences. In addition, the Ministry
of Transport is working on a National Land Transport Strategy which it plans to
complete by July 1997.

The Senior Citizens Unit liaises regularly with the Land Transport Safety
Authority and Ministry of Transport and will have opportunities to comment on
the development of relevant transport policies and rules. It is anticipated that
the Advisory Council for Senior Citizens will continue its interest in this
policy area and provide submissions.

Concerns regarding creating a safe environment for pedestrians are being
acknowledged by many planners and providers. More positive attitudes about
ageing are likely to create greater awareness of this issue. The Prime
Ministerial Task Force on Positive Ageing has identified transport as one of the
areas on which it will be providing recommendations to Government. This will
reinforce the need for local authorities to plan responsive strategies, policies
and services for older people in their communities.

ELDER ABUSE AND NEGLECT


Key
points

  • There is no international standard definition of elder abuse and neglect.
  • Increased awareness of elder abuse and neglect is needed.
  • Data on elder abuse and neglect in New Zealand is inadequate.
  • The incidence of elder abuse and neglect is expected to increase due to the
    projected increase of older people in the population.
  • No government agency has policy and funding responsibility for elder abuse
    and neglect services in New Zealand.

Introduction

Elder abuse and neglect may occur in a number of different settings,
including private residences, rest homes and hospitals. There is no
international standard definition of the term 'elder abuse and neglect'. The
definitions provided by Age Concern New Zealand in their elder abuse and neglect
resource kit are good examples of what is generally meant by these terms, and
these definitions will serve as the terms of reference for this paper.

According to Age Concern New Zealand, both elder abuse and neglect are
distinguished from general criminal activity in that the perpetrator of the
abuse or neglect is known to the person being abused and the relationship is one
of implied trust.

Categories of elder abuse may be identified as:

  • Physical abuse - infliction of physical pain, injury or force;
  • Psychological abuse - behaviour that causes mental or emotional
    anguish or fear;
  • Sexual abuse - sexually abusive and exploitative behaviours involving
    threats, force, or the inability of a person to give consent; and
  • Material/Financial abuse - the illegal or improper exploitation
    and/or use of funds or other resources.

Types of neglect are further defined as:

  • Active neglect - conscious and intentional deprivation by a carer of
    basic necessities resulting in harmful effects.
  • Passive neglect - refusal or failure by carer, because of inadequate
    knowledge, infirmity or disputing the value of the prescribed service, to
    provide basic necessities resulting in harmful effects.

Causes of elder abuse and neglect

There is no simple explanation as to why elder abuse and neglect occurs.
There are, however, several factors that are known to contribute to incidents of
elder abuse and neglect:

  • dependency of the older person on others for all or part of their care;
  • carer stress;
  • dysfunctional family dynamics, including a history of family violence and/or
    alcohol abuse;
  • social isolation of both the older person and the abuser; and
  • psychological and social problems of the abuser.

The variation of these contributing factors reflect the complexity of elder
abuse and neglect and the need to develop responses appropriate to the different
causal factors and the particular needs of older victims.

Extent of the problem

Elder abuse and neglect has only recently received recognition. It is
therefore difficult to obtain accurate information about its prevalence in New
Zealand or internationally. A preliminary examination of international research
suggests that between 3% and 5% of older people are subject to abuse or neglect.
However, the complexity of elder abuse lends itself to inconsistencies between
research definitions, which make reliable comparisons of research findings
difficult. Davies suggests that about 3% to 4% of older people in New Zealand
are victims of elder abuse and neglect.

Elder
Abuse and Neglect Services in New Zealand

Elder abuse and neglect pilot programmes

There are six elder abuse and neglect pilot programmes operating throughout
New Zealand: in Whangarei, North Shore, Auckland, Wanganui, Wellington, and
Invercargill. The pilots, initiated by Age Concern New Zealand, have been
established for about three years. An elder abuse service was already operating
in Christchurch before the establishment of the six pilot programmes. This
scheme is a joint venture between Age Concern Canterbury, Healthlink South and
Presbyterian Support Services.

Each of the elder abuse pilots adheres to the general principles contained in
Age Concern's elder abuse and neglect resource and training kit. In general, the
pilots consist of multi-disciplinary teams to assist in the prevention of elder
abuse and neglect by implementing pre-crisis intervention strategies and
responding rapidly to incidents of abuse and neglect. Representatives from the
Police, local CHEs and RHAs are involved in the pilots, together with a range of
other professional service providers.

Central to the implementation of the pilot programmes is the position of
"Regional Co-ordinator". Regional co-ordinators will, in general, act as a first
point of contact for all enquiries concerning elder abuse and neglect, and make
referrals as appropriate. Lottery Aged grants have funded the salaries of the
regional co-ordinators and provided limited administrative costs for each of the
pilot projects, which are operated by the local Age Concern Council. North
Health Regional Health Authority has also provided some additional funding to
the North Shore and Auckland pilots. Local responsibility for the pilot
programmes has resulted in differences in the roles of the co-ordinators and in
the management of the programmes.

In an attempt to gain improved consistency in the provision and quality of
services provided by the pilot programmes, additional Lottery Aged funding was
secured in 1994 for the half-time (0.5) position of a national co-ordinator. The
main role of the national co-ordinator, located in the national office of Age
Concern, is to provide advice to the pilot programmes and the Christchurch
programme and to collect and report on data from the programmes.

National Advisory Group on elder abuse and neglect

This advisory group was established by Age Concern to monitor and maintain a
general overview of the pilot programmes. Membership of the advisory group
includes representatives from Age Concern New Zealand, the Senior Citizens Unit,
the Ministry of Health, Police National Headquarters, New Zealand Association of
Gerontology, and Alzheimers Society. Advisors affiliated with Maori Women's
Welfare League, Pacifica and the Social Policy Information Service of the Social
Policy Agency also provide advice to the National Advisory Group.

National Advisory Group's report to Ministers

In September 1995, the National Advisory Group prepared a report, Elder
Abuse and Neglect in New Zealand,
to the Minister for Senior Citizens, the
Minister of Health and other interested parties. The report provided information
on the progress of the pilot programmes and other issues relating to elder abuse
in New Zealand. The report was expected to include information collected from
the pilot programmes to assist Government in deciding: which government agency
should have primary policy responsibility for the area of elder abuse and
neglect; the level of resources to be allocated to the area; and whether the
pilot projects initiated by Age Concern New Zealand should be extended to other
centres throughout New Zealand.

The major recommendations from the National Advisory Group's report were:

  • the introduction of elder abuse and neglect services throughout New Zealand
    to respond to and prevent an expected increasing number of reported incidents of
    elder abuse and neglect; and
  • the establishment of an officials group to consider the most appropriate
    government agency to take responsibility for furthering work on the introduction
    of the elder abuse and neglect services and to make recommendations on how these
    services might be funded.

Minister's response

Officials represented on the National Advisory Group agreed that the pilots
demonstrated an ongoing need for intervention and prevention strategies to
combat elder abuse and neglect in New Zealand. They recognised, however, that
Government requires sound evidence on which to base any decision regarding
funding and policy responsibility for elder abuse and neglect services. It
became apparent during the preparation of the report that the data collected
from the pilots was incomplete.

The Minister for Senior Citizens agreed that a decision regarding agency
responsibility for the policy and funding of elder abuse and neglect services
would best be made by Government following collection of adequate information
from the pilots. This decision requires the pilot programmes and the
Christchurch programme to continue with funding from Lottery Aged, and delays
the consideration of government funding for other elder abuse and neglect
services until adequate information has been collected from these services. In
order to achieve this, the data collection and analysis is being undertaken by
the Social Policy Information Service of the Social Policy Agency. This data
collection is expected to be completed by December 1996 and a report to the
Minister for Senior Citizens will follow. The purpose of the report will be to
advise Government on the incidence of elder abuse and neglect in New Zealand and
also to make recommendations on how current and future elder abuse and neglect
services could be funded.

Service Development Issues

National model for elder abuse and neglect services

Elder abuse and neglect intervention services are currently being developed
on an ad hoc basis to meet local demands in other areas of New Zealand. The lack
of policy responsibility for elder abuse and neglect services increases the risk
that developing services will not provide a consistent or appropriate standard
of service. Operational differences between elder abuse and neglect pilots which
affect the delivery of services have already been identified. The lack of a
single funding source for services increases the risk of inconsistency between
services.

Age Concern New Zealand has attempted to encourage consistency in the
provision of services by providing advice and relevant resource materials, such
as the elder abuse and neglect kit, to developing intervention programmes. To
date, a comprehensive service has been established in North Shore, funded by Age
Concern North Shore, funds from the local community and from North Health
Regional Health Authority. In addition, fledgling services are developing in
Hamilton, Napier, Taupo, Palmerston North, Ashburton, Waitake and Dunedin. The
level of service available in these centres is limited due to funding
difficulties. Age Concern New Zealand is providing advice and information to
these developing services.

In its report to Government in early 1997, the National Advisory Group is
expected to recommend a preferred model for elder abuse and neglect services in
New Zealand. The recommended model will result from a comparison of the six Age
Concern pilot programmes and the Christchurch model.

Refuge

An area of particular concern to those who currently work in the area of
elder abuse and neglect is the lack of suitable refuge for victims of elder
abuse and neglect. Places of safe refuge must be sensitive to the needs of older
people, not merely on the basis of their age, but also in terms of their gender,
ethnicity, cultural values and health status.

Women's Refuges cater primarily for women and children who have been subject
to abuse, usually by a male partner. The needs of older women who are victims of
elder abuse and neglect, possibly from another family member, but also from
other caregivers or service providers, are in the main different from those of
younger women and their children. As such, these refuges are not usually an
appropriate avenue of assistance for older women. There is no equivalent refuge
for older male victims of abuse.

Rest homes and hospitals have been considered and are used in the pilot
programmes as alternative refuges. However the use of rest homes and hospitals
present problems both in terms of appropriateness and cost in many cases. Rest
homes and hospitals are unable to provide the element of safety necessary for
true refuge, and admissions of victims of elder abuse and neglect to these
institutions may in fact put other residents at risk. Furthermore, many
continuing care hospitals or rest homes do not have staff with the expertise
necessary to provide the counselling and support that may be needed by older
people in these situations.

The use of private homes as emergency short term refuge for elder abuse
victims is being trialled by some of the Age Concern pilot programmes. Again,
concerns about the level of quality of care and the safety of both victims and
carers means that the use of private homes as refuges may not be appropriate.

Culturally appropriate services

It is recognised that any policies or programmes developed to address the
issues of elder abuse and neglect must be culturally appropriate if they are to
render positive results. Maori and Pacific Islands people's participation is
being sought in each of the pilot areas, and those involved in the pilots agree
that a greater effort needs to be made to develop links with local groups, and
to recruit their assistance as appropriate. Early feedback from the project
teams indicates that elder abuse and neglect is as prevalent amongst Maori and
Pacific Islands communities as it is in other communities, and that the custom
of "looking after one's own" can make the disclosure of such abuse particularly
difficult for these groups.

Policy Issues

Education

Elder abuse has not gained the same high profile as child abuse in the
community, yet if overseas trends are followed, it will become more of an issue
as public awareness is heightened. Currently there are not adequate resources to
deal with the issue, and there is still a need for preventative measures in the
form of public education.

Age Concern New Zealand has recognised the importance of education and has
taken this educational role upon itself. The organisation has been assisted by
funding for the development of resource material from the former Public Health
Commission. Education about elder abuse and neglect is regarded by the National
Advisory Group as integral to the role of the pilot co-ordinators. In their work
to raise awareness about elder abuse and neglect, pilot co-ordinators spend a
significant time speaking to community and public groups, and to health
professional students. The question of who is to take responsibility in the
long-term for such education needs to be addressed. This issue is expected to be
discussed in the National Advisory Group's report to Ministers in early 1997.

Effect of the Domestic Violence Act 1995

The first opportunity for legal protection of older people in a domestic
relationship other than marriage is provided in the Domestic Violence Act,
effective from 1 July 1996. Due to the personal relationship with their
offenders, victims of elder abuse have tended not to want legal action to be
taken against offenders. It is not clear whether the new legal provisions, which
mean that most offenders could be dealt with in the Family Court rather than the
District Court, will result in an increase in legal action being taken against
perpetrators of elder abuse and neglect. The effect of publicity about the Act
on the number of incidents reported is also unknown.

Community care

The link between carer stress and the incidence of abuse and neglect has been
well established. As government policies move progressively away from
institutionalisation and towards community care, where increasing
responsibilities are placed on family members in particular, it is imperative
that appropriate support services are introduced. Unless adequate support
services for family carers, including respite care, are available, the risk of
elder abuse and neglect will increase.

The need for assessment in order to access caregiver support services is
included in the 1996/97 Policy Guidelines for Regional Health Authorities
released by the Minister of Health. Accordingly, the previous entitlement of up
to 28 days respite care has been replaced with the provision of respite care on
the basis of individual need. This means that, in some cases, less than 28 days
may be provided while in others more than 28 days may be available to assist
family caregivers.

Access to 28 days respite care was previously available for caregivers on the
recommendation of a general practitioner. The change in policy now requires the
person being cared for to undergo a geriatric assessment by a multi-disciplinary
assessment and rehabilitation team. There is public concern that this change in
policy means that access to respite care for caregivers is reduced. There is
also public concern that access to respite care will be delayed for many clients
due to fact that waiting lists for assessment services already exist in all
regional health authority areas. The Senior Citizens Unit has been advised that
all regional health authorities have developed processes to ensure that clients
with urgent needs have priority for assessment services. The Unit intends to
monitor whether family caregivers are receiving appropriate support.

Service providers supplying home-based support services to older people in
their own homes will also require careful monitoring. Services provided in the
home are more difficult to oversee than those based in an institutional setting.
Educational programmes for home-based service providers, together with a
protocol for supervising and monitoring of services provided in the home, will
go some way towards reducing the likelihood of abuse and neglect in the home
setting.

Mandatory reporting

As with child abuse, the issue of the mandatory reporting of elder abuse has
been raised as an option for increasing awareness and increasing protection of
those most vulnerable to abuse and neglect.

Mandatory reporting of elder abuse and neglect is seen as a potentially
expensive option that may do little to improve the situation of older people,
and in some cases could result in a worsened situation, for example, the
inappropriate institutionalisation of older people. In addition, mandatory
reporting may inhibit the reporting of elder abuse by victims, thus compromising
their autonomy, dignity, and self-esteem.

Such arguments against mandatory reporting have been similarly noted in other
countries. The New South Wales Task Force on the Abuse of Older People, for
example, concluded that arguments against mandatory reporting are currently
stronger than those in support of it.

The Senior Citizens Unit supports the view that rather than introducing
mandatory reporting, it is preferable to use all possible means to inform and
empower older people, their families and formal caregivers to take measures to
prevent abuse in the first instance.

Future Directions

The issue of elder abuse and neglect has only recently gained recognition in
New Zealand. As public awareness of elder abuse and neglect grows, the demand
for services to deal with the problem will intensify. Unless the Government,
through one of its agencies, takes responsibility for service provision in this
area, the problem is likely to remain largely hidden, to the detriment of older
people, their families and their caregivers.

The collection of data on the actual incidence and types of elder abuse and
neglect prevalent in New Zealand will provide a sound base from which government
strategies and intervention and education programmes may be developed. Data is
currently being collected from seven elder abuse and neglect programmes but
further data and research on elder abuse in New Zealand will be required.

The National Advisory Group for elder abuse and neglect will be reporting to
the Minister for Senior Citizens and the Minister of Health in December 1996 on
elder abuse and neglect in New Zealand. The report will provide recommendations
on a preferred model for elder abuse services and the funding of those services.

Officials represented on the National Advisory Group, from the Senior
Citizens Unit, the Ministry of Health and NZ Police, will then provide comment
on the report and provide recommendations on funding guidelines, co-ordination
of elder abuse and neglect services in New Zealand and strategic issues related
to those services. The Senior Citizens Unit will be seeking your agreement to
refer these recommendations for consideration by Cabinet early in 1997.