Speech notes for visit to Seven Oaks Retirement Village, Paraparaumu

Dementia is a severe and devastating disorder for both sufferers and their families.

The rising number of people with dementia will be a major driver of demand for aged residential care over the next ten to fifteen years. We're living longer, with more of us living over age 85, and that all adds up to many more people living with dementia.

Before I talk further about dementia, let me comment on the other part of your work and this is as a rest home.

New Zealanders want us improving the quality of the services provided to our older residents of rest homes and hospitals through out the country.

There has been mounting public concern around issues of poor care in rest homes and residential facilities and this is particularly pertinent to older people with dementia who are more vulnerable.

Just before Christmas last year, the Auditor General released a damning report on the lack of monitoring of rest homes under the previous government. The report identified long standing shortcomings that the new Government began addressing when it took office.  

The 34,000 elderly New Zealanders living in rest homes deserve high quality care. The OAG report found that under the previous government the Ministry of Health struggled for years to ensure the quality and safety of rest home services. 

The OAG was highly critical of the lack of action between 2002 and 2008. The Auditor General was particularly critical of the agencies that audit rest homes, and this is a concern that the Government shares.

That same report recognised the action the new government has underway.

In last year's Budget we invested another $18 million into improving nursing supervision and quality in rest homes. This was on top of an additional $5m to provide more respite care for the elderly and those with dementia being cared for by family members.

We've introduced spot auditing of rest homes.

We are auditing the auditors, to ensure they are providing a

thorough and reliable service. 

And we are reviewing auditing systems and approaches.

For the first time ever, family members and older people can now see and compare audit summaries of rest homes online. This will help them know more about their options.

We are also building a profile of at-risk rest homes so that we can overlay that across the 700 rest homes in New Zealand to identify those we need to monitor more.

It is vitally important to maintain public confidence in the standard of care being provided in the country's rest homes.

The Ministry of Health is also working with District Health Boards (DHBs) and interested stakeholders, including providers, to develop a guidance document to advise DHBs on the best ways to meet the specialist clinical mental health needs of older people, and those people of any age who suffer from dementia.

The purpose of this project is to develop an integrated approach that crosses traditional boundaries, to make it easier for people with dementia, and their carers, to access specialist services for older people including those in residential care.

People with a diagnosis of dementia have special needs over and above general care.  The demands that dementia care makes on staffing resources and skills is widely acknowledged.

The level of care needed by those with dementia varies according to the stage of the disease. However, as dementia progresses through the moderate to the severe stages, there is a greater need for community support services and an increased likelihood of moving to a rest home or hospital level care. 

The rates of growth may be affected by various risk factors associated with dementia.

• A study of more than 10,000 people showed that obesity was associated with a 74 per cent increased risk of dementia 25-30 years later, while overweight people had a 35 per cent greater risk.
• Previous work has linked high blood pressure and high cholesterol with increased risk of Alzheimer's disease.

Protective factors may include physical activity:

• A study at Johns Hopkins in the US found that people who engaged in four or more physical activities, from gardening to biking, had about half the risk of dementia compared with those who engaged in one or none.
• Time spent in full-time education also appears to be negatively associated with dementia.
• Some research has suggested a possible link between a reduced risk of Alzheimer's disease and people with mentally demanding jobs

But as you know, there is no cure and the best science can do is slow down progression. An Australian study suggests that if the onset of dementia can be delayed 5 years, then by 2050 there would be 50% fewer of dementia than otherwise projected.

Caring for someone with dementia is hard work.  And that is why the new Government has boosted dedicated respite care for those caring for the elderly and those with dementia. 

We have invested an additional $5 million a year specifically targeted at increasing the number of respite beds available.

High quality residential care options are also important services as part of the continuum of care options for individuals with dementia. 

It takes special people to care for people with dementia.

Thank you for the work you do and thanks for having me here.